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Hernia Repair: No Simple Solution

Hernia repair is a staple of the general surgeon’s practice, with more than two million procedures performed annually worldwide. However, the procedure has proven problematic due to the mesh products used to repair the hernia defect and their potential to cause complications over time. At the Fifth International Hernia Congress, held recently in New York City, physicians debated the pros and cons of the many hernia repair mesh products that are now available. Although the general consensus at the meeting was there is no “ideal mesh,” mesh manufacturers continue to innovate in this field, offering a host of new products for this $500+ million market, including a variety of biologic meshes for complex repairs, synthetic meshes with biologic-like properties, fully resorbable meshes, and meshes with bacteriostatic properties.

It’s not uncommon for new approaches to a seemingly simple surgical procedure to result in a host of unintended consequences. This has certainly proven true for hernia repair, a staple of the general surgeon’s practice and one of the most commonly performed operations, with more than two million procedures done annually worldwide. At the recent Fifth International Hernia Congress (IHC) in New York, the complexity of hernia repair was readily apparent, with physicians debating the relative pros and cons of the 80+ different open/laparoscopic surgical approaches and the 160+ hernia repair mesh products now available.

In spite of strides made in laparoscopic surgery, such as single-port access and natural orifice translumenal endoscopic surgery (NOTES) using...

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