In current medicine it is extremely common for persons who have developed ventral hernias due to prior surgery, child birth or injury to undergo a hernia repair operation where the surgeon elects to use a mesh patch to repair the hernia. History has dictated that this is a relatively safe procedure if done properly using generally accepted procedure, but can be extremely dangerous or even deadly if done improperly.
One main side effect that is commonly caused by surgical malpractice is the dislodging and migration of the mesh patch. This migration can lead to the mesh patch becoming infected or causing intestinal blockage due to the patch wrapping itself around loops of the small intestine.
First, a surgeon must make sure that he is using a mesh patch which is big enough to accommodate the hernia that he is attempting to repair. The patch must be significantly bigger than the hernia itself so that it will totally cover the hernia and provide enough room around the actual hernia to prevent loops of small bowel from pushing their way through the hernia and lodging themselves between the hernia and the affixed mesh patch. If the loops of bowel push their way into that area due to a patch which is too small to prevent the escape of bowel it can cause that piece of bowel to become constricted causing a blockage in the bowel. For example, the accepted standard of care for a Bard Composix® Kugel® mesh patch that is at least 5cm larger than the defect on all sides. If a surgeon measured the hernia defect as being as being 10cm. This measurement requires a surgeon to use a mesh patch that extends at the very minimum 5cm beyond each end of the defect. If the defect is 10cm the surgeon was required to use mesh patch that is at least 20cm at its widest point. A surgeon would be negligent if they incorrectly used an 11x14cm mesh patch which didn’t provide for sufficient underlap between the mesh and the abdominal wall defect.
Another common mistake made by surgeons is improperly affixing the mesh patch to the abdominal wall. The surgeon must do this correctly to prevent undue tension on the mesh and the fascia. A surgeon may staple the patch to the abdominal wall over the defect (hernia). Many times by adding additional sutures to the fascia may lead to undue tension which in turn may cause the mesh to buckle and become loose. This loose space can cause the small bowel to migrate into the area between the polypropylene side of the mesh and the fascia defect. The polypropylene side of the mesh is very sticky and a migration of the bowel to that side of the mesh can also lead to multiple adhesions of the small bowel to the mesh and a small bowel obstruction. In other word the bowel will adhere to the sticky mesh and may cause bowel obstruction.
The above are just two common mistakes made by surgeons during a hernia repair surgery using mesh. If you have been injured as a result of a hernia repair using a mesh patch please contact our office. It is possible that you were the victim of medical malpractice or that the mesh used in the operation was defective.