Clinical Value of Hernia Mesh Pathology Evaluation

Area of Science:

• Surgical Pathology
• Biomaterials Science

Background:

• Hernia mesh removal is increasingly common.
• Current practices lack standardized mesh specimen handling and consensus on pathology findings' clinical value.

Purpose of the Study:

• To evaluate the clinical utility of microscopic surgical pathology for explanted hernia mesh specimens.
• To determine if pathology findings correlate with clinical indications for mesh removal.

Main Methods:

• Analysis of 115 hernia mesh specimens from 101 patients (2013-2018).
• Categorization of patients into "mesh reaction" and "mesh non-reaction" groups based on clinical indication for removal.
• Microscopic evaluation of all mesh specimens.

Main Results:

• Patients with mesh reaction were younger (39 vs 56 years) and more often female (71% vs 39%).
• Despite differing clinical symptoms, microscopic pathology findings were similar between groups.
• No significant correlation found between microscopic pathology and clinical indication.

Conclusions:

• Microscopic surgical pathology evaluation of explanted hernia mesh offers no clinical value.
• Pathology findings from explanted mesh do not support clinical claims.
• Recommend gross examination only for documentation, avoiding consumer costs associated with microscopic analysis.