Is surgical mesh safe?

Discussion about whether mesh is the cause of chronic pain after inguinal hernia surgery is ongoing, and several lawsuits have been filed on this topic in the USA. The fact is that the use of surgical mesh in hernia surgery reduces the risk of a new hernia in the same location. Two meta-analyses have also shown that when using mesh versus suture only, patients experienced less pain after hernia surgery. Both fixation technique and mesh weight may play a role, although there are studies that show no difference.

A new prospective observational study published in ANZ Journal of Surgery (November 2019) examined 1680 inguinal hernia surgeries performed on 1366 patients, predominantly men. The aim was to look at pain before and after inguinal hernia surgery. One group underwent open surgery (Lichtenstein) and one keyhole surgery (TEP). Questionnaires were given to patients before the procedure regarding pain, and again one week and 12 months after the procedure.

The researchers found that compared to pain before the procedure, patients had significant improvement in their pain regardless of which type of surgery was used. Few patients experienced chronic pain after the procedure. They concluded that the results support other evidence that surgical mesh in inguinal hernia surgery does not lead to an unacceptably high frequency of chronic pain after surgery.