Should surgeons use hernia mesh? RCS responds to questions on Victoria Derbyshire programme

Responding to the Victoria Derbyshire programme on hernia mesh aired today, a Royal College of Surgeons spokesperson, said:

“It is sadly the case that around one in ten patients1 experience pain following an inguinal hernia repair.  Recent studies suggest the risk of pain following an inguinal hernia repair is similar, regardless of whether the operation uses mesh or the alternative non-mesh operation.  If you are one of those affected, it is incredibly distressing, and you should certainly return to your doctor and seek further help.

“The dilemma is that doing nothing also has its risks, such as reduced mobility and/or pain.  As surgeons, our duty is to explain the options and risks to patients, so they can weigh them up and decide what the best course of action is for them. Surgeons should always include the option of doing nothing as part of the range of options. However, many patients do want an operation, even knowing the risks. This is because untreated groin hernia can become increasingly painful, especially with sport and exercise or heavy lifting. There is also the possibility of the hernia becoming stuck, or worse, the bowel getting stuck in it, and having its blood supply literally strangled.

“The surgical community is continually working to improve techniques and to better understand the effects of different procedures. There have been a number of scientific studies looking at the use of mesh in hernia repairs. In view of patients’ experiences we are keeping a close eye on emerging evidence and studies, to ensure our guidance and understanding of the risks remains current.

“The Royal College of Surgeons of England is also campaigning to improve regulation and monitoring of new devices and implants. Together with the British Hernia Society, we are calling for a mesh registry to help track and understand the effects of mesh following operations.

“The priority for every surgeon is to alleviate a patient’s symptoms and improve their quality of life, so to hear that patients have experienced poor outcomes, and feel they have not been listened to, is very concerning. Any patient unhappy with the medical care they have received has the right to complain, have their complaint investigated and to receive a full and prompt reply. There is more information about making a complaint on the Royal College of Surgeons’ Website and on NHS Choices.”

Notes to editors

1. Although a 2018 study found no significant difference in the rates of chronic pain associated with mesh and non-mesh groin hernia repairs, the rate of 10-12% of patients experiencing chronic pain is concerning. Undoubtedly, because of the large number of operations undertaken, there are a large number of patients who experience complications following the use of mesh implants to repair groin hernias. In England, there have been 1,387,874 hernia repair procedures carried out since 2007/8 (NHS Digital data, obtained April 2019).
2. The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.
3. For more information, please contact the RCS press office: telephone: 020 7869 6047; email: pressoffice@rcseng.ac.uk; out-of-hours media enquiries: 07966 486832.