One of the problems reported with hernia mesh has to do with the issue of biocompatibility between the materials used and human tissues. Surgical mesh (which is used in other types of surgeries as well) can be made from biological materials, such as pigskin or tissues taken from elsewhere in the patient’s body. However, many mesh devices are made from synthetic materials.
These synthetic materials are either polypropylene (PP) or polyester (PET). For example, while PP may be effective in making surgical repairs, the plastic can stiffen over time, increasing the chances of severe inflammation and erosion. It also has a tendency to adhere to the visceral lining, can crack or disintegrate, or cause fibrosis. PET, on the other hand, degrades after a period of time, essentially undoing the repair.
The question posed by researchers at the University of Kentucky College of Medicine is whether one of these materials cause infection more than the other? A meta-analysis and review of over 100 studies involving more than 10,000 patients found no significant difference between the two. However, the researchers did find that patients who underwent laparoscopic surgery had lower rates of infection and recurrence than those who had open surgery.
Laparoscopy involves the insertion of a fiber-optic instrument through a small incision in the abdomen, where the surgical procedure is carried out. It is less invasive, less painful and involves a shorter recovery period. Now, according to this recent meta-analysis (an extensive review of previous research studies), laparoscopic surgery can reduce the risk of infection from hernia repair as well.
There have been many other complications reported that have been due to hernia mesh repair. These include serious, even life-threatening side effects, such as bowel obstruction, migration, organ perforation, and fistula formation (abnormal connections between blood vessels and organs). In many cases, these problems may not be apparent for years and the fix can be risky and complicated. Revision surgery to remove the mesh and/or additional surgical repairs may be required, but for a significant number of patients, the damage may be permanent.
Despite these dangers, market analysts are predicting that the market for hernia meshes to grow by over 26 percent over the next seven years.
In May of 2019, U.S. District Judge Richard Story of the North District of Georgia’s Atlanta Division announced the selection of ten bellwether lawsuits against Ethicon Physiomesh, the first of which is scheduled to go to trial in April, 2020. How this litigation will play out will depend on the credibility of expert witnesses and what scientific reports entered into evidence have to say.