A hernia is essentially a condition that develops when the muscle wall around an organ becomes compromised. The weakness in the muscle wall allows for the formation of a gap through which the intestines protrude. To repair it, the gap is stitched, and if the muscle is not strong enough to hold the stitches, a mesh is put in place. Does that imply no hernia repair is performed unless a mesh is inserted?

No. Hernia repair without mesh is possible in certain cases where the muscle tissue is sufficiently strong to support the repair. Some of these conditions are as follows.

Cases Where You Don’t Need a Hernia Mesh

In Congenital Hernias

This occurs without any underlying muscle defect and is most common in young children and newborns. Usually, they seal up after the baby is born. A congenital hernia occurs when the abdominal wall defects do not heal properly at birth. Due to the absence of muscle weakness, a mesh is unnecessary to repair this type of hernia; the intestine is simply repositioned, and the hole is closed with stitches.

In Traumatic Hernias

It is possible for the intestine to protrude through a hole in the abdominal wall following an injury, especially if the injury involves a sharp object penetrating the abdomen. There is zero muscle-wall weakness under these circumstances. In most cases, the intestine is repositioned, and the hernia is repaired with stitches.

You can also read: Hiatal Hernia: Causes, Symptoms, And Treatments

In Small Umbilical Hernias

The area around the belly button typically contains no muscles. After birth, the incision where the umbilical cord enters the body is typically sealed with scar tissue or fibrous tissue to prevent infection. In some people, the scar tissue or thin plugging tissue can weaken to the point where a small defect opens up, allowing the intestines to protrude through it. Belly button hernias can often be repaired without a mesh if the patient has a strong abdominal wall and a small hernia.

Thus, there do happen to be times when a mesh is not required to repair a hernia, and a simple repair of the muscle with simple stitches suffices.

Dr Atul Shah

Dr Atul Shah

Dr. Atul Shah is a senior Laparoscopic & GI Surgeon practicing at Ahmedabad for more than 25 years. At present he is the MEDICAL DIRECTOR, at Kaizen institute of Gastroenterology and practicing laparoscopic Bariatric and Hernia surgeon.

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