Hernia Repair--A Personal Encounter

Three or four years ago, Bob White, editor of the South Brevard, Florida Ostomy Newsletter, decided that another day with the pain in his lower right quadrant was just too much. So he went to his old friend, Dr. Ray Armstrong. As Ray explained later, when he opened up the area, he decided that sutures were not the answer to close the gaping holes he was looking at. Instead he fixed in place a relatively new surgical mesh. The mesh sealed the hernias without pulling their edges together as sutures would do, a procedure that had been in place for years. As he explained it, the mesh sealed the hole without subjecting the edges to the stresses inherent in pulling them together with sutures. Eventually, the hernias would be closed with new flesh and scar tissue.

Bob is now happy to report that Dr. Armstrong was correct. He has had no further problems. Why is this newsworthy?

An article published recently in the New England Journal of Medicine formally reports that Dutch researchers have announced that a group of 200 patients in need of such surgery had been randomly assigned to either sutures or the mesh procedure. Their findings--after the surgery, 48% of the suture group had had hernia recurrences, while only 24% of the mesh group did. The researchers "speculated that stitching could subject the surrounding tissue to excessive tension."

Thank you, Ray, for being, as always, a little bit ahead of your time.