The use of a mesh implant for inguinal hernia

Removal of an inguinal hernia is performed by open or laparoscopic hernioplasty. Each variant of the operation can be carried out with the installation of a mesh implant. The latter grows together with the tissues of the abdominal cavity, holding the organs in their anatomical place, preventing their exit through the weakened muscles of the anterior abdominal wall. Mesh installation can be performed with a defect of any size and type.

Endoprostheses for hernia can speed up the recovery process, preventing the occurrence of relapse and postoperative hernia.

An inguinal hernia is more often diagnosed in men and can cause infertility, therefore, after identifying the disease, the doctor prescribes an operation and preparation begins. Hernia repair with the installation of a mesh leads to the recovery of the patient and his recovery within six months.

An inguinal hernia mesh is an endoprosthesis that replaces the peritoneal fascia, taking over their function. Such an implant is often made of polypropylene threads that can be stretched, which does not interfere with the natural contraction of the muscles.

Types of implants for hernia

In order to strengthen the anterior abdominal wall, several types of meshes are used. They differ in size, weaving technique and material.

There are three main types of networks:

1. Absorbable.
2. Non-absorbable.
3. Partially absorbable.

Absorbable meshes are used in rare cases, they have a limited list of indications.

The choice in their favor is made after assessing the complexity of the upcoming surgical intervention and the size of the hernia ring. With weakness of the connective tissue, they are almost never used, because in this case, the muscles need to be maintained throughout life. For large and giant hernias, non-absorbable or partially absorbable implants are indicated.

With a frequently recurring pathology, it also makes no sense to install a temporary endoprosthesis, because soon the hernia will again appear against the background of high physical exertion and increased intra-abdominal pressure.

In inguinal hernia, the use of non-absorbable meshes is indicated, which fuse with tissues after surgery and fix weakened ligaments to prevent protrusion of internal organs.

What grids are used in Russia

In Russia, the most well-known manufacturer of mesh implants is the Lintex company, which produces various models of endoprostheses.

Representatives of prostheses from the company "Lintex":

• " Ftorex " - have a special coating that prevents infection;
• " Esfil " - made of monofilament polypropylene;
• " Flexilen " - flexible endoprostheses;
• " Uniflex " - used to fix a defect in postoperative hernias;
• " Eslan " - made from soft lavsan threads.

The manufacturer "Lintex" manufactures mesh implants to order according to individual parameters by type of weaving and size.

Partially absorbable meshes are produced by such a well-known Russian company as Ultrapro. These products tend to gradually dissolve as the connective tissue grows. Such implants are more often used to close large and medium-sized defects.

With a hernia in the groin, three-dimensional implants are also used, which are characterized by increased strength. Such a mesh consists of an anterior, posterior and connecting lobe.

For the manufacture of implants, polymer and commercial meshes are used. The first are similar in structure to the mosquito, they are characterized by low cost, and are used in countries with a weak financial situation of patients. Commercial mesh is made from polyester and polypropylene. A well-known representative producing high-quality commercial nets is the Bio-A company.

Benefits and Choices

Advantages of using a mesh implant for inguinal hernia:

• fast rehabilitation after hernia repair;
• does not cause discomfort, absolutely imperceptible to the patient;
• prevents the re-development of pathology;
• not rejected, does not cause an allergic reaction;
• there is no feeling of tension in the tissues.

The variant of the mesh implant is selected taking into account the technique of the operation being performed. To close the inguinal triangle, the surgeon fixes the implant 6 cm wide and 9 cm long. The size of the mesh is of great importance, because when installing a small implant, there is a risk of a recurrence of the disease, and when fixing an endoprosthesis that is too large, folds will appear.

Most young patients are shown to install a small endoprosthesis to cover the inguinal triangle. Elderly patients, when the risk of recurrence increases many times, are shown a wide mesh for installation in the preperitoneal space.

The disadvantage of the implant is the presence of contraindications, but otherwise it is an excellent way to close the defect of the inguinal canal.

Installation Features

Hernia repair begins with creating access to the hernial sac, then the inguinal hernia is removed and the mesh is fixed in the region of the inguinal triangle.

During the fixation of the mesh implant, the following points are important:

• the implant must be well held between the aponeurotic tissues to prevent its migration;
• in a mixed operation, when the intervention is carried out to eliminate several pathological processes, the use of non-absorbable meshes is contraindicated;
• the implant is installed so that it does not come into contact with subcutaneous fat.

Possible Complications

Violation of the hernia repair technique or the wrong choice of implant can lead to the development of complications. Hernioplasty for inguinal hernia shows good results, but much depends on the patient's condition, the characteristics of the course of the pathological process and the size of the defect. In some cases, during hernia repair, other pathologies of the abdominal cavity are detected that were not previously diagnosed, and this will also affect the choice of prosthesis.

The first few days after herniotomy, the patient is worried about soreness and discomfort. These are normal phenomena, unless this condition persists for a long time. After the operation, the doctor prescribes painkillers and various procedures to the patient to improve well-being and accelerate the healing of the scar.

The mesh itself does not cause any discomfort. The implant is installed for a long period or for life, and even if another abdominal operation is necessary, it will not interfere and will not be removed.

Very rarely after surgery there is a risk of such complications:

• mesh rejection;
• suppuration of the wound;
• product erosion;
• sensation of a foreign body;
• chronic pain;
• in men - violation of ejaculation;
• mesh sticking;
• implant migration.

Such complications are excluded if the patient follows the postoperative regimen. The latter includes dieting, exclusion of physical activity, prevention of constipation and bloating, wearing an inguinal bandage.

Prices for mesh implants

The cost of mesh implants varies significantly between manufacturers, and the difference in price for one model can be several thousand rubles.

How much does a mesh endoprosthesis cost to close an inguinal canal defect:

• absorbable - from 5000 to 16000 rubles;
• non-absorbable - from 2000 to 5000 rubles;
• three-dimensional - from 9000 rubles;
• partially absorbable - from 4000 to 8000 rubles.

The use of a mesh during surgery gives a good recovery prognosis. Today, such an implant is considered the most optimal option for preventing recurrence and the development of ventral hernia.