Our Summary

This study looked into the pros and cons of using mesh versus non-mesh methods to surgically repair groin hernias in an emergency setting. Groin hernias are a common condition where part of an organ, usually the intestine, pushes through a weak spot in the muscles near the groin. If not treated promptly, it can lead to serious complications like reduced blood supply to the bowel.

Mesh repair is a common method used to fix hernias, but its use in emergency situations is controversial because of the risk of infection at the surgical site. The researchers wanted to compare the benefits and risks of using mesh against non-mesh methods in emergency groin hernia repairs.

They looked at 15 studies involving 1,241 patients who underwent emergency groin hernia surgery. Some patients were treated with mesh repair (626), and others with non-mesh repair (615). The studies were conducted in China, the Middle East, and South Asia, mostly involving men with an inguinal type of hernia, which is the most common type of groin hernia.

The evidence suggested that using mesh might slightly increase the risk of infection within 30 days of surgery compared to non-mesh repair, but the researchers weren’t completely sure. They also weren’t sure about the effect on 30-day mortality rates. The evidence suggested there might be more deaths within 30 days of surgery with mesh repair, but again, the researchers weren’t completely sure.

The study also found no evidence that mesh repair reduces the chance of the hernia coming back within a year, and there were no cases of the mesh being removed within 30 days of surgery.

In conclusion, the researchers found the evidence regarding the use of mesh versus non-mesh in emergency groin hernia surgery to be very uncertain. They suggest that more high-quality studies are needed to reach a more definitive conclusion.

FAQs

  1. What is the most common method used to surgically repair groin hernias?
  2. What are the potential risks of using mesh in emergency groin hernia repairs?
  3. Does the use of mesh in hernia repair reduce the chance of the hernia recurring within a year?

Doctor’s Tip

In general, a doctor may advise a patient undergoing hernia repair to follow post-operative care instructions carefully, including avoiding heavy lifting and strenuous activity, maintaining a healthy weight, and practicing good hygiene to prevent infection. They may also recommend regular follow-up appointments to monitor the healing process and address any concerns. It is important for patients to communicate openly with their healthcare provider about any symptoms or complications they may experience after surgery.

Suitable For

Patients who typically undergo hernia repair are those experiencing symptoms such as pain, swelling, or a bulge in the groin area. They may also have difficulty with bowel movements or experience nausea and vomiting. In some cases, hernias can become incarcerated or strangulated, cutting off blood flow to the affected organ, which requires emergency surgery.

Patients who are generally healthy and have a lower risk of complications from surgery are usually recommended for hernia repair. However, the decision to undergo surgery should be made on a case-by-case basis, taking into consideration the patient’s overall health, age, and any underlying medical conditions.

It is important for patients to discuss their options with their healthcare provider and weigh the risks and benefits of using mesh versus non-mesh repair methods for their specific situation. Ultimately, the goal of hernia repair surgery is to alleviate symptoms, prevent complications, and improve the patient’s quality of life.

Timeline

Before hernia repair:

  1. Patient experiences symptoms of a groin hernia, such as pain, swelling, and a bulge near the groin.
  2. Patient consults with a healthcare provider who diagnoses the hernia and recommends surgical repair.
  3. Patient undergoes pre-operative tests and evaluations to ensure they are fit for surgery.

After hernia repair:

  1. Patient undergoes emergency surgery to repair the hernia, either with mesh or non-mesh methods.
  2. Patient may experience post-operative pain, swelling, and discomfort.
  3. Patient is monitored for complications such as infection at the surgical site.
  4. Patient is discharged from the hospital and instructed on post-operative care, including wound care and activity restrictions.
  5. Patient follows up with their healthcare provider for follow-up appointments to monitor recovery and ensure the hernia does not recur.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hernia repair include:

  1. What are the benefits of using mesh versus non-mesh methods for hernia repair in my specific case?
  2. What are the risks associated with using mesh versus non-mesh methods for hernia repair?
  3. How likely am I to experience complications, such as infection or hernia recurrence, with each type of repair?
  4. What is the recovery process like for mesh versus non-mesh hernia repair?
  5. Are there any long-term effects or considerations I should be aware of with each type of repair?
  6. What factors should I consider when deciding between mesh and non-mesh hernia repair?
  7. Are there any alternative treatment options for my hernia?
  8. How experienced are you in performing hernia repairs with mesh versus non-mesh methods?
  9. What is the success rate of each type of repair in terms of preventing hernia recurrence?
  10. Are there any specific pre- or post-operative instructions I should follow based on the type of hernia repair chosen?

Reference

Authors: Sæter AH, Fonnes S, Li S, Rosenberg J, Andresen K. Journal: Cochrane Database Syst Rev. 2023 Nov 27;11(11):CD015160. doi: 10.1002/14651858.CD015160.pub2. PMID: 38009575