Hernia Mesh Side Effects

Risks and Side Effects Associated With Hernia Mesh

Going back over a decade, the United States Food and Drug Administration (FDA) has been receiving reports from patients complaining about side effects they attribute to their surgically installed hernia mesh. These patients’ symptoms have included serious infections, obstruction of the bowels, severe abdominal pain, and inflammation. In some cases, patients reported these symptoms as having been so intense as to require hospitalization, and many patients have required additional surgeries to address the complications arising from the implantation of the hernia mesh device.

Infection: As with any surgical procedure—particularly those involving implanting a foreign material into the human body—the installation of surgical mesh carries with it a risk of infection, which in some cases can become quite serious, even life-threatening. The risk of infection varies from individual to individual, but those with compromised immune systems—including the elderly and those suffering from additional ailments—are at an increased risk of contracting an infection and of that infection becoming serious.

The risk of infection in recipients of a surgical mesh implant is increased due to the necessity of taking immunosuppressant drugs to prevent the body’s immune system from rejecting the newly implanted material. In particular, these drugs target the body’s production of T lymphocytes, also known as T cells, which aggressively attack the foreign material.

Obstructed Bowels: According to the University of California San Francisco (UCSF) Department of Surgery, a bowel obstruction is “a blockage of the small or large intestine by something other than fecal impaction.” Obstruction of the bowels is a serious condition that can potentially require surgery. Obstruction of the bowels can occur following so-called “mesh migration”, which takes place when surgically implanted mesh becomes dislodged from its original location. Mesh migration results from an issue relating to the materials used to affix the surgical mesh to the living tissue, which necessarily failed prematurely if the mesh became loose within the body. Like the quest for the best possible material for surgical mesh, the search for the best method for adhering surgical mesh to living tissue continues, with human patients suffering the literal pains of this all-too-slow scientific advancement.

Inflammation: According to a recently published review on surgical meshes appearing in the scientific publication Membranes, “Inflammation is the reaction of vascularized living tissue to injury and is the primary biological reaction to implanted medical devices. In the case of implanted meshes, the inflammatory response is presented in four stages that are related temporally and hierarchically.”

These four stages of post-implantation inflammation are as follows: Stage one inflammation: Almost instantly upon implantation, surgical mesh and other prosthetics begin absorbing proteins, which triggers a series of chemical responses that attract a variety of different cell types to the site of the foreign material. The attraction of a certain kind of cell known as a neutrophil to the site of the injury is recognized as the first step of the body’s autoimmune response and the beginning of the first stage of inflammation. During this stage, neutrophils phagocytize (basically, engulf) microorganisms, often dying in the process.

Stage two (chronic) inflammation: When the body’s immune system recognizes that its initial response has failed to eliminate the foreign body and/or return the injured tissue to its original condition, a state of chronic inflammation can result. During this stage, macrophages, plasma cells, and lymphocytes all contribute to the inflammation of the affected area. Stage three inflammation: According to Membranes, “In most cases where chronic inflammation is related to a medical device or biomaterial, the inflammation process will lead to an immune response or foreign body reaction, corresponding to the third stage of inflammation.” The phrase “foreign body reaction” refers to a specific and serious biological response to the presence of the implanted material that varies depending the foreign object’s contours and textures, but which typically involves a combination of foreign body giant cells, macrophages, fibroblast, and capillaries, which encompass the foreign body.

Stage four inflammation: Finally, in the fourth stage of inflammation, also known as the “wound healing phase”, damaged tissue is supplanted by specialized cells that produce “extracellular matrix materials” that, in layperson’s terms, form scars around the damaged tissue.