In all hernia repairs after the hernia is identified and placed back in the abdomen the hole has to be closed. Nowadays this is almost always done with a mesh. The mesh is usually a synthetic (plastic type) material, though recently biological meshes have been introduced.

Mesh repairs are often called "tension-free” because the mesh provides a bridge to cover the gap in the tissue instead of having to close the gap by pulling the tissue together, under tension, with sutures.

Tension free repairs make sense. They are much less painful in the early post-operative period, last longer and will give the best long term results. The mesh is biologically ‘inert ‘usually polypropylene and is well accepted by the body. The mesh is a kind of scaffolding through which the repairing tissue can grow.

But mesh repairs, particularly with non-absorbable or permanent mesh have acquired a bit of a bad name, mainly I think because they have been used inappropriately, indiscriminately and incorrectly.

If I had been getting the kind of (poor) results that some surgical groups have been reporting in the surgical literature I would have been out of a job long ago.

Nowadays we recognise that some of the meshes that were being used in the past were too 'heavy'. Too much material, causing irritation in the deep tissues.

Here are two excellent articles by some colleagues of mine. They will bring you up to date with current thoughts on mesh.

The lightweight & large porous mesh concept for hernia repair read article

Prosthetic mesh materials used in hernia surgery read article