Non-mesh Hernia repair – What you need to know
A hernia is a common medical condition that affects 10% to 12% of the adult population annually. A hernia is caused when tissue protrudes through the weak spot in the abdominal wall resulting in a bulge. Certain hernias are reversible and can be treated by watchful waiting along with natural hernia repair remedies. Occasionally, when a hernia grows in size and the intestinal parts get trapped, immediate surgery is required. This kind of open hernia repair surgery is performed with and without mesh. Non-mesh hernia treatment can be performed using various techniques by the surgeon and is preferred now due to fewer complications.
Major difference between Mesh and Non-mesh hernia repair
|Criterion||Hernia mesh repair||Non-mesh repair|
|Operation Time||60 minutes||45 minutes|
|Same rate for both||Same rate for both|
Discomfort in movement
|3% to 6%||1% or less|
|Stay at hospital||3-4 days||5 to 6 days|
|Reoccurrence rate||Below 3%||Between 1% to 8%|
|Post-correction surgery rate||10% to 12%||1.5% - 17% (depends on technique followed)|
|Time to start back lighter activities||1 to 2 weeks||5 to 6 weeks|
|Time to start back daily activities||4 to 6 weeks||15 to 16 weeks|
How is non-mesh hernia repair performed?
A non-mesh hernia is performed by suturing one’s own abdominal tissues rather than the usage of a mesh to reinforce the wall. This significantly reduces the risks associated with mesh usage such as triggered reaction by the body’s nervous and immune system to reject the implant (mesh). Non-mesh hernia repair is usually performed by highly trained and experienced medical surgeons. The treatment method will be chosen based on the patient’s symptoms assessed by diagnostic tests such as MRI or CT scans. The hernia opening during the surgery is closed by the patient’s own skin graft taken from another place in his/her body. Hence, it is called as pure tissue repair. This repair is sometimes called the tension method because of the pull exerted on the side muscles of the hernia. Patients undergoing the repair is advised to refrain from eating solids/liquids at least seven hours before the surgery. Patients are suggested to follow healthy eating habits pre and post-surgery. Patients are administrated with anaesthesia during the onset of the hernia surgery.
Different procedures in non-mesh hernia repair
There are different methods used for the non-mesh hernia repair. These methods broadly fall under two categories: Tension-free repair and Tension repair.
- Bassini repairThis repair was first introduced by Italian Surgeon Dr. Edoardo Bassini in 1887. He had extensively performed the procedure on more than 260 patients before proposing the same. Bassini is often known as the father of inguinal hernia surgery.This tension hernia repair is performed by stitching the conjoined tendon and the transversalis fascia to the inguinal ligament with a non-absorbable monofilament suture. This procedure is carried out by imbrication. The reoccurrence rate for this procedure varies from 10 to 15 percent and depends mainly on the doctor’s skill levels.
- McVay/Cooper’s ligament repairThis technique was introduced in the year 1942 by Dr.Chester Mcvay. This procedure is an improvised version of Bassini repair and is suitable in the treatment of large hernias.In this technique, the doctor sutures the conjoined tendon (internal oblique and transversus abdominis) to the cooper ligament with non-absorbable interrupted sutures. This procedure is recommended for patients with initial herniorrhaphy and femoral hernia. The reoccurrence rate of hernia is high.
- Shouldice repairShouldice hernia repair technique is the golden standard for the treatment of prosthesis free repair performed by doctors over many decades. This pure-tissue method was devised by the Canadian Dr. Edward Earle Shouldice during the 2nd world war to help the militants to stage a faster recovery.This is a complex four-layer repair procedure. The transversalis fascia from the internal abdomen is incised laterally to the tubercle to create the upper and lower flaps which are then overlapped with 2 layers of sutures. Then, the inguinal ligament is further sutured to the conjoined tendon in two more overlapping layers of sutures to reinforce the walls. This is widely used because of the various benefits it offers like shorter recovery time, less reoccurrence rate, and improved results.
This technique can be performed only by skilled experienced doctors. Doctors at Ansa health care are experts in performing the surgery with a high success rate.
- Desarda repairThis method was presented by Indian doctor Dr. Mohan Desarda in 2001. This is a tension-free procedure. It is predominantly used in the treatment of groin hernias.In this method, a small strip will be separated from the upper part of the aponeurosis which will be sutured with the ligament below. Then, the new layer is sutured behind the spermatic cord to form a new layer that reinforces the deep narrowing of the abdominal wall. This technique is often compared with Lichtenstein’s technique (Open hernia repair)
- Guarneiri repairThis repairing technique was first proposed and performed by Dr. Antonio Guarnieri in 1988. It falls under the tension-free technique. This pure tissue method has a low reoccurrence rate of less than 1%.In this procedure, the outer aponeurotic flap is sutured to the rectus sheath, which narrows down the inguinal canal and that of an inguinal triangle. The lateral flap is covered adequately with the medial flap that reduces the tension of the oblique aponeurosis from moving.
Advantages of Non-mesh hernia repair
Following are the advantages of non-mesh hernia repair:
- Low cost
- Reduced post-surgery complications
- Low reoccurrence rate
- Quick surgery procedure
Consult our medical experts today
Hernia doctors at Ansa healthcare are certified and highly trained medical professions who are committed to helping the patients with tailor-made comprehensive repair surgery based on the symptoms and complexity. Our medical practitioners have a proven record of success rate in performing mesh and non-mesh hernia repair over a decade.