Anthony Echo, MD
Plastic Surgeon & Reconstructive Surgeon located in Houston, TX
If you have a painful hernia, you only have one treatment option, and that’s surgery to repair the damaged muscles. While most surgeons use a synthetic mesh to strengthen the muscles, Anthony Echo, MD, specializes in no-mesh hernia repair, also called a Shouldice repair. A no-mesh repair eliminates complications caused by mesh, while also giving you faster recovery, stronger results, and a nearly zero chance of hernia recurrence. To learn more about no-mesh hernia repair, call one of the offices in Houston Methodist Hospital or the Willowbrook neighborhood of Houston, Texas, or book an appointment online.
No Mesh Hernia Repair Q&A
Why does a hernia need surgical repair?
Hernias develop when tissues inside your abdomen push out through weak or torn abdominal or groin muscles. Once a hernia develops, it doesn’t heal on its own. Instead, it continues to enlarge and causes increased levels of pain. The only way to treat a hernia is with surgery to put the abdominal contents back in their proper places and repair the muscle.
What is the difference between mesh and no-mesh hernia repair?
When repairing the weakened or torn muscles that allowed the hernia to develop, surgeons often insert a piece of synthetic mesh as a permanent implant to strengthen the muscle wall.
By comparison, Dr. Echo performs a no-mesh procedure by carefully and precisely stitching together each layer of muscle, tendon, and ligament. This technique works best on thin, fit patients.
In cases where the muscle is thin and weak, the mesh may be necessary to ensure the best outcomes. However, you shouldn’t be forced to use mesh because it’s quicker or because the surgeon hasn’t received training in a no-mesh technique.
What are the risks of using mesh during a hernia repair?
Synthetic mesh implants can increase your risk for several health problems, including:
Foreign body reaction
Since the mesh is a foreign object inside your body, it triggers an immune response. As a result, you develop inflammation and the mesh may become loose and move around as your immune system tries to eliminate the foreign substance.
The scar tissue that grows around the mesh typically tightens and shrinks, compressing the mesh and creating a hard mass.
Nerve and tissue entrapment
Mesh consists of a lattice-like structure that contains many small holes. If the mesh is not carefully placed, then the sensory nerves in the groin can stick to the mesh and cause severe pain. Over time, the mesh can also stick to surrounding tissues and organs, causing additional complications.
If the mesh adheres to your intestines, you can develop a bowel obstruction. Surgery to remove mesh that’s embedded in any tissue or organ is extremely difficult.
What symptoms and complications develop due to mesh?
Mesh repairs are not always bad, but it really depends on the placement of the mesh, type of mesh, and protecting the nerves. However, complications with mesh are not infrequent, and the most common problems reported by patients are:
About 12-15% of patients develop severe chronic pain, but some estimate the rate to be as high as 60%. The pain occurs as nerves are entrapped and/or the mesh sticks to surrounding tissues.
The inflammation caused by the mesh can lead to chronic and severe infections.
As the mesh hardens, it loses flexibility and strength, which can lead to another hernia.
How is a no-mesh hernia repair performed?
There are several different types of no-mesh hernia repairs, but Dr. Echo performs the Shouldice Repair. This technique was first described by Dr. Edward Shouldice during World War II.
The procedure requires a three-inch incision in the groin crease as Dr. Echo gently places the protruding organs and tissues back into their proper locations. Then he proceeds to repair every muscle layer individually, carefully overlapping the muscles and stitching them together.
This technique strengthens the natural muscle without placing extra tension on any of the tissues. Dr. Echo also repairs any other damage he discovers during your surgery, such as torn tendons or other areas of weakness in the muscle.
About 13% of patients who go in for one hernia repair have another weak area, or a hidden hernia waiting to happen. Surgeons like Dr. Echo who offer the Shouldice technique know how to find and repair these areas, helping to prevent another hernia.
If you need a hernia repair, call Anthony Echo, MD, or schedule an appointment online.
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