Surgery with mosquito mesh may reduce the suffering of millions

Mosquito mesh can prevent malaria, but also be used to reduce the suffering of millions of poor people in other ways. Through a collaboration of researchers at Umeå University, Karolinska Institutet and Makerere University in Uganda, it has been shown that mosquito mesh can be used safely in groin hernia surgery. The findings are being presented in a new doctoral thesis.

“Mosquito mesh with the purpose of catching mosquitoes can now be used to prevent the intestines from falling through the hole in the abdominal wall”, says Jenny Löfgren, a doctoral student at the Department of Surgical and Perioperative Sciences, Umeå University, and author of the thesis. “This progress means that even the poor can benefit from the network-based surgical technique used in high-income countries.”

Over 200 million people suffer from groin hernia worldwide. Without surgery, groin hernias can cause much suffering and about 40 000 people die from this condition every year. Groin hernia repair is among the most commonly performed surgical procedures on the planet. Around 20 million hernia repairs are performed every year – but over 180 million are not operated. The majority of those who do not benefit from surgery are poor and live in Low and Middle Income Countries. In Uganda, for instance, over six per cent of adult men have a groin hernia but less than one in a hundred groin hernia patients are operated per year.

Instead of the expensive mesh

In western countries, hernias are mostly repaired using a synthetic commercial mesh. Mesh repairs have proven unequalled compared to previous surgical methods, but the mesh costs 100 US Dollars or more. Such an expense is insurmountable to the world’s poor. According to Jenny Löfgren, this is where the mosquito mesh has its potential, as it can be used instead of the expensive mesh.

Mosquito mesh is already used in groin hernia surgery in some places but the safety and effectiveness of this practice has hardly been evaluated. The current research project compared expensive commercial mesh with mosquito mesh. Almost all the 300 patients were followed for one year and there were no differences in terms of complications, hernia recurrence or patient satisfaction.

“Therefore, our study provides solid evidence that the mosquito mesh can be safely used for the treatment of groin hernia”, says Jenny Löfgren. “Now, a superior surgical method can also be provided for poor patients at a fraction of the cost of the expensive mesh. These findings may benefit the many millions of groin hernia patients living in Low and Middle Income Countries.”

This doctoral thesis will be presented at Umeå university on September 17th, 2015. Supervisor has been Dr Andreas Wladis, MD, PhD, at the Department of Clinical Science and Education, Södersjukhuset at Karolinska Institutet.

• Learn more in a press release from Umeå University
• More about Karolinska Institutet's collaborations in Uganda

Doctoral thesis

Groin hernias and unmet need for surgery in Uganda - epidemiology, mosquito nets and cost effectiveness
Jenny Löfgren, Umeå University 2015, ISBN: 978-91-7601-316-8