Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Hernia Surgeon · Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
In short
- Mesh from an old hernia repair rarely stops another operation, but it changes the route the surgeon takes and the time it takes.
- Tell every surgeon and anaesthetist about the mesh, and carry the old operation note, because its position decides how the next operation begins.
- Mesh is almost never removed to allow another operation. It is worked around, and only a part is cut if it blocks access.
Mesh is meant to stay. It becomes part of the belly wall within weeks.
So the question comes up later, when something else needs an operation. Does the mesh get in the way?
Usually it does not. But the next surgeon needs to know it is there.
Why the mesh matters to the next surgeon
Mesh does not sit loose. Scar tissue grows into it and sticks it to the layers around it.
That scar is the issue, not the mesh itself. Cutting through stuck tissue is slower, and bowel can be caught in it if the mesh was placed inside the belly.
A surgeon who knows the mesh is there plans the way in before starting. A surgeon who finds it by surprise has to change plan on the table.
Where the mesh sits changes the answer
Groin mesh and belly-wall mesh are different problems.
Mesh in the groin is low down and off to one side. Most other operations never go near it.
Mesh in the midline, after a repair of a scar hernia, sits right where many abdominal operations begin. That is the one that changes the route.
Mesh placed inside the belly cavity is the one that most often has bowel stuck to it.
What old mesh changes in a later operation
| Later operation | What the mesh changes | What usually happens |
|---|---|---|
| Gallbladder removal | Little, if the mesh is in the groin | Keyhole surgery as normal |
| Caesarean section | The scar and the layers below it | Open as usual, with care at the old repair |
| Bowel or prostate surgery | Access through a groin or midline mesh | Entry is planned away from the mesh |
| A second hernia repair | The plane the first mesh occupies | A fresh plane is used, often from behind |
| Emergency surgery | Time, not the decision | The operation goes ahead regardless |
Due for another operation and you already have mesh? Bring the old operation note and we can plan the route.
Will the mesh be removed?
Almost never, and not to make room.
Taking out mesh that has healed in means taking out the tissue holding it, which leaves the hernia open again. It is done for a deep infection or for pain, not for access.
If a small part of the mesh is truly in the way, that part is divided and the rest is left. The gap it leaves is repaired at the same sitting.
What to carry
Three papers answer most of this.
The operation note names the approach and where the mesh went. The mesh or implant card names the material and the size. Any scan done since will show the mesh as a thin line.
Keep them together and bring them to the pre-operative visit, not on the morning of surgery. Read what each line means on our guide to the operation note.
Telling the team
Say it twice. Once to the surgeon, once to the anaesthetist.
It belongs on the consent discussion too, because a longer operation and a slightly higher chance of bowel injury are part of what you are agreeing to.
Frequently asked questions
Can I have another operation if I already have hernia mesh?
Yes. In almost every case the mesh is left alone and the surgeon plans the way in around it.
Does the mesh have to be removed first?
No. Removing healed mesh reopens the hernia, so it is taken out for infection or pain, not for access.
Will the operation take longer because of the mesh?
Often a little longer, especially if the mesh is in the midline or has bowel stuck to it.
What should I tell the surgeon?
That you have mesh, where the repair was, and the year. Carry the operation note and the mesh card.
Related pages
The main page on this site is hernia surgery in Ahmedabad. These cover the neighbouring questions.
Where to find us
Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Bring your reports. Second opinions are welcome.