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ABSTRACT
Patients in New Zealand have now developed a fear of mesh abdominal wall hernia repair due to inaccurate media reporting. This article outlines the extensive literature that confirms abdominal wall mesh hernia repair is safe and effective. The worsening confidence in the transvaginal mesh prolapse repair should not adversely affect the good results of mesh abdominal wall hernia repair. New Zealand general surgeons are well trained in providing modern hernia surgery.
An abdominal wall hernia is a weakness or defect in the abdominal wall that allows abdominal organs to protrude through. For the purpose of this paper the term abdominal wall hernia will include ventral abdominal and groin hernia. Hernias sometimes cause no symptoms, however, many will cause symptoms including pain, bowel obstruction or bowel ischaemia. Hernias can significantly reduce quality of life and even cause death. For patients with significant symptoms, treatment is required as hernias don't get better by themselves and generally they will enlarge and deteriorate over time.1
Surgical repair is the only effective treatment for hernias. The two main techniques are simple suture repair of the defect versus closing the defect with mesh reinforcement. Suture repair has been available since anaesthesia was invented in the 1800s.2 However, with the introduction of simple suture hernia repair it quickly became apparent that hernia recurrence with this technique was frequent. This then led to hernia repair with tissue reinforcement using mesh. The earliest mesh repair was in 1900, where a silver wire mesh was used. During the following 117 years, there has been a continuous improvement in mesh technology. Synthetic meshes were developed after World War II. Over the last 20 years, mesh abdominal wall reinforcement has become the international accepted standard of care.3 Modern hernia mesh is purpose designed and has become very sophisticated.
In a 2002 Cochrane systematic review of mesh versus non-mesh groin hernia repair, there was no difference in complications between groups.4 There was a suggestion that patients in the mesh repair group had an earlier return to normal activities and they had less persistent pain. Due to a New Zealand patient fear of groin hernia mesh surgery, patients are now requesting sutured groin hernia repair as an alternative. The best non-mesh sutured open groin hernia repair is...