Our parents are now in their 80's and had hernias repaired under the old tension methods and are doing great. Tell me what's wrong with that? I know many others who had the old tension method. Sure it took longer to do and they used to have them spend a few days in the hospital but they all came out o.k. None of this persistent pain that I see now. There is a Dr. Kevin Petersen in Las Vegas who does a tension McVay repair.
What's wrong with that?

Hi, Henry I am 52 and had my first Ventral Hernia repaired in 2003 recurrence in 2008 with problems in between which doctors deined were related to hernia. Method was chosen by the doctor choosing, of the tension method.After telling me he was going to use mesh. So something after he opened me up he went to the tension method of vest over pants Mayo . with the Ethibond sutures., the sutures use to be made of stainless steel wire. or heavy cotton thread. all before the world of plastic... polyproylene. have the techniques of stitching changed over the years with the different types of mesh????? I think with the fast pace of life anymore, we don't eat enough organic food, everything is either fast food junk food, prepackaged,can. I don't think very many eat meals made from scratch any more, like the old days when moms stayed home, go to grandma-grandpa's home meals. Which all has an effect on the muscle tissue. I just read this past week that the USA is the biggest nation of obese/obesity people. With Mississippi, Alabama, the two top states. I am scared of going the mesh route after reading the postings. But just how many recurrence tension hernias can one person have before all themuscle tissue is weaken full of holes like swiss cheese.?? I have researched alot of different possible reasons, waiting to see what other's and doctors come back with. Doctor Goodyear posted a repost on Herniosis so I looked that topic up which I myself find it does fit in with family genes. but also every other ad on tv is activia yogurt. stomache, acid relief...... now the word Fibiomyalgia, so crossing both words herniosis Fibiomyalgia and you will see how thay fit into the possible reason for hernia's the break down of immune system, to much fast food to much sugar.

We have to keep in mind that in the past when people suffered from hernia repairs gone bad they essentially suffered in silence. There were no forums such as this; not many studies; lack of follow-up; lack of formal hospital reporting/quality improvement efforts; no FDA reporting since there were no prosthetics (read mesh) used; etc. Fifty years ago it was virtually unheard of for a patient to be operated on for a recurrence of their hernia. Even though such recurrences were VERY common, patients were encouraged to wear trusses. Also, back then there were lots of problems with anesthesia and extremely high infection rates. The advent of mesh has demonstrated significantly lower recurrent rates and there are constant improvements in mesh and more refined surgical techniques. From all that I have read, most herniologists agree that most of the problems with mesh have to do with it not being properly placed and affixed. Also, there can be problems with an exaggerated foreign body reaction in some patients and the consequences of that. But todays lighter weight, yet strong meshes, with their advanced contours, coatings, weaves, etc. have produced far fewer problems especially in the hands of an experienced hernia expert. While the McVay, Shouldice, and other tension techniques work fine for a lot of people I personally cant get past the fact that these methods borrow already thinned out tissue from around the hole of the hernia defect -- and while it might cover the defect it now leaves these surrounding areas more weakened, vulnerable, and hernia prone.

Hi, Jerry Happy 4th of July. I agree with you about your comment. That with all modern technology the medical world has advance from the older methods, but yet rather it be tension or mesh it's how do we as patients strenght the tissue that the mesh or sutures are fasten to without tearing surrounding tissue, and causing a new recurrent hernia??? Is it the suture tension that tears the tissue over time?? Has their been any other technology of fasten mesh to the muscle tissue other then sutures?? with every neddle hole for a suture don't it also start a weak point for possilbe hernia???

I completely disagree. I know someone that had the old tension method- a salmon fishmerman who's first tension surgery caused a recurrence. He went back a few weeks later and it was redone with no problem. I am not being convinced or sucked into this nonsense that is put out by Dr. Goodyear. That is why Dr. Ramshaw will often times remove a mesh and do a tension repair for a recurrent hernia or try Parietex. The same goes with Dr. Shirin Towfigh.

It's fine to disagree but it takes more than an anecdotal account of one person's experience to convince me. I'd rather go with the scientific studies using reliable and valid methodologies, high sample sizes, and long follow-ups. These studies repeatedly show that mesh repairs, especially if done properly, have an extremely low rate of recurrence as compared to tension repairs. As far as getting mesh removed and then doing a tension repair I can't even imagine how that would hold up! Mesh just doesn't peel off - it has to be cut away from the tissue and scar tissue in which it is embedded - and there is even ingrowth through the pores of the mesh. This significantly weakens the area as well as the surrounding areas where the mesh overlapped and where the tissue was already weakened. The patient gets their original hernia back -- only this time it is far worse - with nerve damage also being quite likely. Without using mesh, the surgeon has to cover these damaged areas with tissue that is stretched and pulled from even farther areas that are now left weakened in someone that we already know is hernia prone. Tell me how that works? And don't just give me fisherman tales! Also, do you really think Dr. Goodyear would tout a method or technique that wasn't the very best he could offer for his patients?

I am old enough to know many many people with the old style repairs. What's wrong with that!!
The McVay, etc. were under the surgeons belt in the 50's and 60's. I did not know of any that had trouble. I just used the fisherman as an example. I don't hear of many people from the Shouldice Hospital complaining on this board, nor anyone from Dr. Petersen complaining on this board, nor of Dr. Grischkan, I don't hear of anyone complaining of the "stitch" tension repairs done by Dr. Ramshaw. Mesh is a foreign substance. It can be rejected!! And when it does it makes sense to switch to the old fashion way. And that's exactly what some of these surgeon do. That's all.

Please! Mesh is inert and can NOT be rejected! The recurrence rate before mesh was 20 % using tension techniques. The rate of post hernia pain syndromes is NO higher with the use of mesh. You have no idea what you are talking about.

Hi, Jerry, Hernia MD, I guess I am one of the unluck people that the tension method of Mayo vest over Pants on a V-Hernia with two prior surgeries 1982 1987 hernia 2003, recurrence 2008 red tape of SSI disability has not been fixed yet. didn't hold up after 5 years, for I have recurrence of the same but in upper right side. So I have to agree with both of you on the reucrrence of tension method does not work when other surgery has been done.With no warning from the surgeon of not going back to the type of work which I had been doing. Which seems to have a part from the studies I have read and down loaded. Hernia MD; in Jerry's statement of what mesh does to people, how do I know that this wouldn't happen to me??? We know that the first bad mesh was because of the busted ring on the (BKD) mesh, but also I have read that their was other counterfeit mesh on the market. So if ones body doesn't reject it, then what causes the mesh to do what does.? Is it the wrong suture, wrong stitching method for that type of patch? Like a beginner seamstress/ sewer, which has to learn the steps of sewing machine; learning the right neddle size, right thread, right tension, the proper stitch, for the material which is to be sewed or mended. With the health Care being what it is, I cann't keep havig this happening again. I don't have much of a life as it is.

Tissue incorporates into the mesh. Heavy weight mesh contracts as a result of this. The newer, lighter weight meshes, have less contraction. The reason hernia surgeons like to place a large piece of mesh is to compensate for the contraction.

Well I know a guy who has had so many tension repairs there is nothing that can be done for him anymore. His tissue is so weakened, and thinned out there is nothing to work with. Mesh isn't even an option cause mesh works with the good tissue.

Being it seems that the problem lays in how the mesh is put in place with suture and tension, and with all pushing pulling putting more tension on the sutures and on the tissue. Is their no give or like elasticity? to cut back on the muscle tension?Has their ever been an breathable,but yet elasticity a all natural bonding adhesive glue that could be used instead of sutures??? We already have plastic in us, women have silicone breast implants. gold/silver teeth caps. whats one more medical invention going to hurt?

To compensate for the tendency for mesh to retract, and thereby cause perhaps some degree of pulling, some experienced surgeons allow for some laxity in the placement of the mesh. There are even some mesh patches that have a built-in dome that will flatten out as the mesh retracts. At least in theory these sound like great ideas.