If mesh is so good for hernia repair, then why is there a surge in litigation?

Despite several studies affirming the safety of mesh hernia repairs, over 26 000 mesh-related lawsuits are pending in the USA as of July 2025. These lawsuits stem from alleged design flaws, lack of proper warnings, and severe postoperative complications. While mesh has revolutionized hernia surgery, the surge in litigation and multi-million-dollar out-of-court settlements by mesh manufacturers raise serious ethical, clinical, and legal concerns. This article examines the root causes behind this paradox, outlines strategies for surgeons and manufacturers to mitigate harm and restore trust, and explores the role of emerging mesh-free techniques and artificial intelligence-driven risk prediction tools in shaping the future of hernia repair.