From the Research
The first mesh hernia repair was performed in 1958 by Dr. Francis Usher, who used a polypropylene mesh (later known as Marlex mesh) to repair hernias. This innovation marked a significant turning point in hernia surgery by introducing a tension-free repair technique. Before this development, hernia repairs relied on suturing the patient's own tissues together, which created tension and led to high recurrence rates. Usher's mesh technique revolutionized hernia surgery by providing structural support to the weakened abdominal wall without tension. The mesh acts as a scaffold that allows the body's tissue to grow into it, creating a stronger repair. This approach dramatically reduced recurrence rates compared to traditional tissue repairs and decreased post-operative pain.
Key Points
- The use of mesh in hernia repair has a long history, with the first reported use of synthetic mesh by Dr. Francis Usher in 1958 1.
- The introduction of mesh hernia repair marked a significant improvement in hernia surgery, reducing recurrence rates and post-operative pain.
- The mesh technique provides structural support to the weakened abdominal wall without tension, allowing for a stronger repair.
- Variations of mesh repairs remain the standard of care for most hernia surgeries today, with ongoing research and development aimed at improving materials and techniques.
Evolution of Mesh Hernia Repair
The concept of mesh hernia repair has evolved over the years, with various techniques and materials being developed. The use of prosthetic materials, such as polypropylene mesh, has become a standard in hernia surgery. Laparoscopic techniques have also been developed, allowing for minimally invasive hernia repair. The Lichtenstein tension-free mesh onlay repair is a commonly used technique, with a recurrence rate of less than 1% 2.
Current Practice
Today, open and laparoscopic mesh-based techniques dominate the inguinal hernia repair marketplace. The choice of technique depends on various factors, including the type and size of the hernia, as well as the patient's overall health and preferences. Ongoing research and development aim to improve the materials and techniques used in mesh hernia repair, with a focus on reducing recurrence rates and post-operative pain. The use of national hernia registries has enabled less recurrences and better prospective research, paving the way for further advancements in hernia surgery 1.