Hernia Mesh Surgery
Surgeons perform hernia mesh surgery by using surgical mesh made from plastic or biologic materials to hold in protruding tissue or organs. The chance of the hernia coming back is less likely if doctors use hernia mesh. Complications include pain, infection and hernia recurrence.
Surgery is the only way to permanently correct a hernia. Hernia repair surgery is one of the most common surgeries in the United States, and the majority of these repairs use mesh.
For example, doctors perform more than a million hernia surgeries every year in the United States. About 800,000 of these surgeries are inguinal hernias — hernias in the groin. Surgeons perform about 90 percent of all inguinal hernia repairs with mesh.
Recurrence was the most common complication before the hernia mesh’s invention. Research is mixed on how long a mesh hernia repair will last. A 2022 study followed 100 patients for ten years after a ventral abdominal hernia repair.
No recurrence was recorded after three years, while about 10% had a recurrence after roughly eight years. Two patients had a central breakdown of the mesh at about seven years. Mesh had stretched across the defect by an average of 21%. Mechanical testing showed that the mesh lost its elasticity at low forces.
Hernia surgery can be done with or without mesh. But the U.S. Food and Drug Administration has found that surgical mesh may improve a patient’s outcome. It can decrease both the time in surgery and the time it takes to recover.
But other factors can play a role, too. These include the type of mesh used, the patient’s condition and the surgical approach. Some types of mesh have been recalled for higher failure rates that have led to serious complications and the need for more surgery.
The average cost of hernia surgery in the United States is about $7,750, according to New Choice Health. This rate may be more or less depending on the type of surgery, where you get surgery and your insurance plan.
How Hernia Repair with Surgical Mesh Works
Surgical mesh acts as a flexible scaffold in hernia repair. It can reinforce muscle walls and prevent organs from coming through. This can prevent the condition from worsening. General surgeons or urologists typically perform hernia surgeries.
Surgeons place the mesh over the open hernia. They use sutures, tacks or surgical glue to hold the mesh in place. Over time, the patient’s tissue should grow into the small pores in the mesh and strengthen the muscle wall. This creates scar tissue that strengthens the hernia site.
Most mesh repairs are permanent, meaning the implant remains in the body for the rest of the patient’s life.
The time it takes to repair a hernia varies from 30 minutes to two hours. The type of surgery and technique the surgeon uses makes a difference. Some techniques require local anesthesia and others require general anesthesia.
Types of Surgery
There are two types of surgery to implant hernia mesh: laparoscopic repair and open repair.
This is minimally invasive surgery. It is always done under general anesthesia. The surgeon makes several small incisions. He then inserts surgical tools through the openings to implant and secure the mesh.
This procedure allows for a shorter healing time and less blood loss. But it is more challenging to perform and costs more.
Surgeons also use laparoscopic repair to fix hernia recurrences, as it avoids old scar tissue. Recovery time is one to two weeks. Strenuous exercise is generally allowed after about four weeks.
Surgeons use this procedure with or without surgical mesh. Most open hernia repairs use general anesthesia. But surgeons may instead use spinal or local anesthesia accompanied by sedation. The surgeon makes an incision near the hernia to repair the weak muscle area.
This type of surgery cuts through more muscle and may have more blood loss. Recovery time is about three weeks. Strenuous exercise is generally allowed after six weeks.
There are three main techniques to repair hernias with mesh. Surgeons may choose one over another because of the patient’s particular condition. Or they may choose a technique they are more familiar with.
Most surgeons use the TAPP or TEP techniques. The IPOM technique can sometimes cause adhesions and perforations.
TAPP (TRANSABDOMINAL PREPERITONEAL)
Surgeons enter the peritoneum, the thin membrane covering the abdominal organs. They place the mesh through a small incision.
TEP (TOTALLY EXTRAPERITONEAL)
Surgeons avoid the peritoneal cavity. Surgeons consider TEP more difficult to perform than TAPP. But it may result in fewer complications.
IPOM (INTRAPERITONEAL ONLAY MESH TECHNIQUE)
Surgeons enter the peritoneal cavity. They place mesh on the inside of the peritoneum. The mesh comes in direct contact with intestines and other organs. This technique is faster and easier to perform than TAPP or TEP. It grew in popularity in the 90s.
What to Expect Before and After Hernia Surgery
Hernia patients should arrange for someone to take them to and from the hospital on the day of the surgery. They will also need someone to stay with them for at least a few days after the surgery.
Doctors may tell patients to stop using aspirin or blood thinners a week before surgery. These medicines can slow clotting and cause excess bleeding during surgery. Using the medicines may slow the healing process.
Hernia mesh surgery is usually an outpatient procedure, meaning that patients do not have to stay overnight in the hospital. Patients may experience pain as they heal after surgery and should expect recovery to take several days or longer.
Recovering from hernia mesh surgery can take several days to several weeks. It depends on the procedure and the patient’s condition. Patients should tell their doctor as soon as possible about any problems they notice.
How Much Do Hernia Surgeries Cost?
The cost of a hernia repair in the United States ranges from $3,900 to $12,500 and up, on average. The national average cost is $7,750, according to New Choice Health. The biggest factors in cost are where you get the surgery, what your health insurance covers and whether you have an open or laparoscopic surgery.
Where You Get Your Surgery
Cost greatly varies depending on what part of the country you have your surgery in and whether you have it in a hospital or outpatient surgery center. For example, people in Atlanta, Georgia, may pay between $4,700 and $11,100 but people in Phoenix, Arizona, may pay between $5,500 and $12,900.
In general, surgeries performed in hospitals and other inpatient facilities have a bigger price tag. Hospitals may not disclose all their fees up front. Outpatient surgery centers have lower fees, and this leads to fewer costs out of pocket for the patient.
“Most of the time, the hospital charges alone can be five times more expensive than the total cost you can be charged in a surgery clinic,” according to Dr. Clay Albrecht, a robotic surgeon.
What Your Insurance Covers
Different insurance plans will have different benefits. The rate your insurance company negotiates with the care provider, whether you are in-network or out-of-network and what type of deductibles you have on your policy will influence your out of pocket costs.
For example, Medicare Part B covers 80 percent of the cost of outpatient hernia surgery. You would pay 20 percent plus your deductible. The 2020 deductible is $198.
If you require a hospital stay, Medicare Part A would cover the hospital care and you would pay your Part A deductible. The Medicare Part A inpatient hospital deductible is $1,408 for 2020.
Open Versus Laparoscopic
Open surgeries generally cost less than laparoscopic surgeries because they may be performed without general anesthesia and use less medical supplies. Extra supplies may add hundreds or thousands more to the cost.
Serious Complications Can Result in Hernia Mesh Revision Surgery
Hernia repair with surgical mesh can lead to complications. Surgery is the only way to correct some of the most serious hernia mesh complications.
A surgeon may have to remove healthy tissue to repair damage. Surgeons may also have to remove part of the intestines if tissue adheres to the mesh.
- Severe pain
- Serious infections around the mesh
- Severe reactions to mesh
- Mesh adhering to internal organs
- Bowel obstruction
- Hernia recurrence
How Do You Know If Your Mesh Failed?
Sometimes hernia mesh might not perform as well as it should. Some types of mesh are prone to early failure. When mesh fails, it causes symptoms.
Symptoms of mesh failure include high fever, flu-like symptoms, nausea, vomiting, pain, bruising, swelling and difficulty passing gas or stool and difficulty urinating. If you have these symptoms, see your doctor and tell them you have had hernia mesh surgery.
Some people have filed hernia mesh lawsuits after they claimed failed mesh caused complications.
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