Non-mesh Repair Of Hernias


Welcome to our comprehensive guide on hernia repair, where we delve into non-mesh techniques. Hernia management has evolved significantly over the years, and our approach focuses on personalized care. We help you understand the principles behind hernia repair to exploring various surgical options, we provide detailed insights to help you make informed decisions about your health.
What is it? The main principle of any hernia operation is to close the hole in the muscles in the best possible way. Broadly, this can be achieved by either covering the hole with a mesh which is a synthetic material that looks like a fishnet and closes the opening in the muscles or by using stitches to bring together the edges of the hole.
Why it happens:For years, surgeons primarily used non-mesh repairs before meshes became prevalent. Meshes have simplified hernia operations, although some hernia types are challenging or impossible to repair without them. Recently, partly due to highly publicized reports, there’s renewed interest in non-mesh hernia surgery.
Meshes are foreign bodies. Although designed to be biologically neutral, they sometimes trigger bodily reactions. Such reactions are rare, but when they occur, managing them medically or surgically is challenging.
hernia repair


Non mesh repairs, particularly in the groin area were evolving for decades prior to the introduction of meshes. They were perfected when Shouldice, a Canadian Surgeon, published his technique which is named after him. It is a technically demanding, native tissue, four-layer inguinal hernia operation which offers excellent, tension free repair of inguinal hernias with results which are comparable (for some dedicated proponents even superior) to that of mesh repairs. However, the technique may be underestimated even today as it requires solid surgical skills and excellent knowledge of the anatomy – the inexperienced and unskilled surgeon can produce a much inferior result with significant post-operative tension and pain. In recent years, an emergence of interest in non-mesh, native tissue repairs for inguinal hernias, led to the development of alternative mesh-free techniques, such as the Desarda repair, which offer similar outcomes with excellent repair quality.


There are also options for non-mesh repair in other types of hernias which depend on the site and the size of the hernia. As a rule, big anterior abdominal wall hernias will most likely require a mesh whereas smaller hernias may be repaired without a mesh – this will also depend on the age of the patient, their expectations, their activities and ultimately the surgeon’s expertise.


Advantages of non – mesh repairs
  • They avoid prosthetic material use.
  • They may lead to fewer Post-surgery complications.
  • Their recurrence rate is similar to mesh repairs, although comparison studies are challenging.
If you are interested in a non mesh repair of your hernia
  • Mention it to your doctor from the first appointment.
  • Seek opinions from experienced non-mesh hernia repair surgeons.
  • Ensure you understand the advantages and disadvantages of each approach.