Hernias are caused by a combination of pressure and weak abdominal tissue or muscle. When the pressure is applied, organs break through the weakened flesh, causing pain and, at times, the trademark hernia bump. This injury is fairly common, with up to 100,000 cases nationally each year. A well-known treatment for hernias is a mesh implant, situated during surgery, which will keep the organ in place and from again bursting the fragile tissue.
There are four types of hernia meshes:
- Absorbable mesh
- A mesh that will lose its strength over time and dissolve into the body. Strong tissue should regrow in the affected area and hold the organ in place.
- Non-absorbable mesh
- These are not meant to degrade within the body (although this is not always the case). They are a permanent solution to fixing the hernia, rather than letting tissue reinforce the organ.
- Composite mesh
- A mesh coated with fatty acids or collagen so as to not make direct contact with the organ in question. These are the most expensive and have the highest complication rate.
- Animal-derived mesh
- This is a mesh made from either pig or cow skin that has been sterilized. They are absorbable.
As simple as this concept itself is, fundamental design flaws in these meshes have been linked to higher, more severe infections and bowel erosion.
Ethicon, a subsidiary of Johnson & Johnson, has recently come under public scrutiny for their synthetic hernia weave, Physiomesh, although it is not the only mesh manufacturer with questionable mesh products. Most synthetic meshes (included but not limited to Physiomesh) are made from the cheap plastic polypropylene. It contracts and degrades once it is in the body for an extended period of time. For these reasons, the plastic’s producers have suggested it not be used for permanent body implants. Most, if not all, mesh manufactures have ignored their warning.
Hernia meshes can be implanted in three different ways:
- Overlay
- The mesh is placed between the skin and abdomen.
- Inlay
- The mesh is placed within the abdomen itself.
- Underlay
- The mesh is placed between the abdomen and the thin lining that covered the abdominal organs, or peritoneum. Most problems arise when this method is used.
Failure to properly place the mesh during implantation has lead to numerous complications, too. Bowel erosion typically occurs when polypropylene makes contact with the bowel itself.
To sway public opinion in their favor, mesh constructors have recently started to cover meshes with a thin coating of fatty acids or collagens (composite mesh). These, however, absorb into the body in just a few years, rendering the coating useless.
What’s more, the Food & Drug Administration (FDA) has approved none of these coatings because they do not need to; they would only have to do so if the mesh was made by a different variety of plastic. Producers can use the same, cheap plastic and mark up their new products, claiming that they are “improved”. Composite meshes cost up to 20 times higher than the other varieties.
Many attorneys are afraid to take hernia mesh cases, on account of research articles that dispute many of the aforementioned claims. However, there are several issues with these exposés that damage their credibility. The mesh manufacturers themselves have funded many of the recent studies. This creates an obvious conflict of interest. Furthermore, the studies do not take place over a long enough period of time. Many complications occur ten to fifteen years after the surgery.
Ethicon withdrew some of their mesh products from the market in 2016. Although there has yet to be an official FDA recall, even they are skeptical as to the reliability of these products.
Patients are becoming more aware of their cheap mesh, and the fact that the problems they are having are not from the surgery, but from the mesh. Hernia mesh lawsuits have been filed across the country and we expect more to follow.
