As I stated last week in Part One, “95% of groin hernias require reinforcement to ensure the hernia will not reoccur.” Recurrence is to be avoided because when it happens, the hernia becomes much more complex and the second surgery more difficult.

Most hernia surgeons offer polypropylene (think plastic) mesh for repair of the defect. Polypropylene has been used for decades in this country with success but also with some side effects and issues because it is a synthetic.

Polypropylene is made to be reactive so that it incorporates into the tissues. This reactivity, however, can cause a chronic sensation and sometimes even chronic discomfort due to the continued low-grade inflammatory reaction. In the medical literature, this is called a “foreign-body sensation.”

Another drawback of polypropylene mesh can be fixation or erosion into adjacent internal organs, such as the gastrointestinal tract. This can become a very significant, if not life-threatening, problem for a patient. It is my opinion that if polypropylene mesh is utilized for repair, the mesh should always be carefully placed in layers of the abdominal wall, thus greatly minimizing these types of complications. Even with this precaution, however, there remains the problem of the foreign-body sensation mentioned in the above paragraph.

Because polypropylene is not 100% ideal, surgeons have been looking for a biologic mesh (think organic tissue) to repair hernias for over 150 years. Very basically, a biologic must incorporate and/or become the patient’s own tissue to be successful.