Adhesion as a Complication of Hernia Repair Surgery

Adhesion is a complication of hernia repair surgery using mesh implants that can result in injuries. If you are a victim of adhesion associated with an implant, you should contact your doctor immediately. Once you are well, you should then contact a personal injury lawyer to determine if you should pursue a lawsuit for injuries caused by the hernia mesh device.

Defective mesh implants have been the subject of lawsuits in recent history. A common injury named in these lawsuits has been adhesion. Our personal injury lawyers want to make sure you are well-informed about what adhesion is and how it could be related to your hernia repair surgery.

Hernia mesh operating room
Adhesion is a complication of hernia repair surgery using mesh implants that can result in injuries.

1. What is adhesion?

After surgery or other trauma to the body, the body's normal reaction is to repair itself. Repair cells cannot identify one organ from another. If one organ or tissue comes in contact with another organ or tissue, scar tissue can form to join the two surfaces. An adhesion is that band of scar tissue that binds the tissue or organs together. The band of scar tissue is a layer of tissue that can be as thin as plastic wrap or thick and fibrous.

Adhesion can occur anywhere in the body, but it is most common in the areas of the:

  • Abdomen
  • Pelvis
  • Heart.

Most adhesions do not cause complications, but when they do, it can be painful and cause serious health risks. 1

2. How do adhesions result from hernia repair with a mesh implant?

Adhesion can occur when the scar tissue forms around the mesh implant and joins the implant with other internal tissue or organs. When the implant and internal organs bond, the organs can sometimes bunch up and cause medical problems.

Most adhesion cases related to hernia mesh occur in the abdomen region, resulting from surgery to repair umbilical, epigastric, incisional, hiatal, or ventral hernias.

3. What are the complications of adhesions related to hernia repair?

Adhesion can begin a few days after the surgery. Some adhesions, however, develop over time, from months to years. Many manufacturers coat the mesh devices to prevent adhesion. But over time, the body absorbs the coating and the device makes contact with the intestines. 2

There are several complications that result from adhesion after hernia repair in the abdomen region. These may include:

  • Small bowel obstructions, which is the most common complication
  • Chronic pelvic pain, which can develop over time
  • Tissue death, which occurs when adhesions form fibrous bands around the entire segment of the intestine, causing blood flow to constrict.

4. What are the symptoms of adhesion caused by hernia repair?

In many cases, abdominal adhesions go unnoticed. In other cases, the pain is mistaken for appendicitis, endometriosis, or diverticulitis. If you have had a recent hernia repair in the abdominal region, then the following may be symptoms of possible adhesion:

  • Severe abdominal pain
  • Pelvic or chest pain that does not resolve quickly
  • Unexplained fever
  • Unexplained back pain
  • Cramping
  • Continuous vomiting
  • Bloating
  • Loud bowel sounds
  • Swelling in the abdomen area
  • Inability to pass gas
  • Constipation
  • Lightheadedness or fainting.

If you have any one of the symptoms after hernia repair surgery, consult your doctor immediately. If abdominal pain is accompanied by any other of these symptoms, go to the emergency department immediately.

5. What are some of the injuries that adhesion cause?

Adhesions pull on connecting tissue and organs. Likewise, adhesions can blog other organs. Injuries include:

  • Chronic abdominal and pelvic pain
  • Infertility
  • Problems with urinating
  • Digestive problems
  • Bowel obstruction.

6. How are adhesions diagnosed and what is the prognosis?

Typically, adhesion can only be diagnosed via surgery. If during the hernia repair surgery, an adhesion was discovered, it could be fixed during the same surgery. If an adhesion develops after surgery, only the symptoms of that adhesion can be diagnosed by a doctor.

For example, you may be experiencing small bowel obstruction. A doctor can confirm that diagnosis through an x-ray of the abdomen. The doctor cannot identify adhesion via the x-ray and diagnose it as the cause of the small bowel obstruction.

7. How are adhesions treated?

Adhesions are usually treated through surgery. Two common procedures include:

  • Laparoscopy. This procedure uses a small camera that is inserted through a small incision in the body. The camera is used to identify any adhesion If identified, the adhesion is cut and released.
  • Laparotomy. This procedure involves a larger incision so the doctor can see the adhesion directly and treat it. This technique varies depending on the exact circumstances.

Adhesions that are corrected via surgery have a high risk of returning. When the band is separated, either by a surgical cut or another method, the two freed ends can adhere to other tissue or organs. The solution, therefore, can become another problem.

With regard to adhesion and hernia repair, adhesion often combines the mesh to tissue or organs. In these circumstances, the mesh must also be removed. And mesh removal has its own complications.

8. Are there any types of mesh more prone to adhesion?

Because of the surgery and the manner in which the body repairs itself, any mesh product can be the subject of adhesion. Some mesh products, however, are more prone than others. A recent study provides examples of what types of mesh are prone to adhesion. 3

Type of Mesh

Adhesion Rates

Manufacturers

Polypropylene

50% of cases - 74% mesh surface area covered by adhesions within 7 days and 48% after 30 days

C.R. Bard, Inc.
Davol, Inc. (subsidiary of C.R. Bard)
Ethicon

Coated (Sepramesh)

55% mesh surface area covered by adhesions within 7 days and 25% after 30 days

C.R. Bard, Inc.
Davol, Inc. (subsidiary of C.R. Bard)

Coated (Parietex)

78% covered after 30 days

Medtronic

9. When should you contact a personal injury lawyer if you believe you have sustained an adhesion due to a defective mesh implant?

Always contact experienced personal injury lawyers if you believe you are the victim of a defective product. In the case of hernia mesh, if you have suffered significant harm, contact our office and we will thoroughly review your case and outline all of your options. We have offices established in California and Nevada, but we represent clients throughout the United States.

References

  1. Emedicinehealth. Adhesions (General and After Surgery).
  2. Schreinemacher MH, Emans PJ, Gijbeis MJ, Beets GL, Bouvy ND. “Degradation of mesh coatings and intraperitoneal adhesion formation in an experimental model.” Br J Surg. 2009 Mar;96(3):305-13. doi: 10.1002/bjs.6446.
  3. Van't Riet, Martinje, MD, de Vos van Steenwijk PJ, MD, Bonthuis F, MD, Marquet RL, PhD, Steyerberg WE, PhD, Jeekel J, PhD, Bonjer HJ, PhD. “Prevention of Adhesion to Prosthetic Mesh. Ann Surg. 2003 Jan; 237(1): 123–128.

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