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Laparoscopic mesh removal vs open removal
-I can’t find any studies on outcome of removal of mesh that is placed with either TEP or TAPP, and that is removed laparoscopically. What are the experience you surgeons have, is there any difference compared to open removal after open repairs? I guess laporoscopic removal for laparoscopic placed mesh is the best solution?
I would also like to hear the experience of people that had their meshes removed.– If the patient still have pain or worse pain after mesh removal, have you experienced that they respond better to other treatments after the removal, like nerve blocks or steroid injection?
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3 Replies
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Laparoscopic mesh removal vs open removal
Not sure if I can be of much help on the subject.
My ordeal started early in 2011 with a quote right inguinal hernia and surgery. Not sure if I ever had an inguinal hernia. Right after my surgery things did not seem right and had a slow recovery until 6 weeks post surgery while when driving I had what I would call a knife slicing or ripping feeling in the surgical area internally and extreme pain. The Dr. office downplayed this change in recovery as just normal but the pain was intense and did not get better and even affected my walking. For 2 years I did everything to resolve the pain and suffering. The hospital and the Dr.’s never ordered an MRI to find out what was wrong. In mid 2011 I had extreme pain on the left side and a CRT found a small inguinal hernia. Finally I had my insurance changed in 2012 for $1,500 deductible I could go any place for surgery. I met with three surgeons that were highly recommended on other hernia websites. I decided on one Dr. and we agreed to fix the left side via lap and remove the mesh on the right side via open(original was open on this side) at the same time early in 2013. The findings post surgery were surprising since he found a femoral hernia on the right side during the lap portion and fixed that and still removed the mesh via open surgery( I only wanted to under the knife once). In recovery I could tell things were better and within days I was walking without the pain I had before the surgery and could walk normally again. In fact within a week I was shooting a vintage car race at Sebring and climbing over the short chain link fences in my way(no Dr.s orders against this but I am sure not approved)
My removal surgery went very well but since I think most if not all of my pain and feeling being very tight in the area was from the femoral hernia. That’s why I think my case is different than most suffering from PHP. But I did go through all current medical hoops for PHP to relive the pain and some that most have not, like ART(long list). If the Dr. had ordered a MRI it could have been found right away that I had a femoral hernia and fixed but they kept stating they wanted area to be completely healed before they would agree to any imaging and than they never did. I never had any visible bulge for any of the hernias I had.
Good luck, I know this is extremely frustrating and hard to get answers and find a great Dr. to help.
Many thanks to Dr. Towfigh for this forum.
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Laparoscopic mesh removal vs open removal
Thank you. This gives me hope, that if the mesh has to be removed, I can get my life back.
Is there any difference on what kind of mesh is placed? Is Parietex mesh harder to remove than Polypropylene mesh? -
Laparoscopic mesh removal vs open removal
Great post!would be great for patients who successfully had mesh removed to share on this thread.
You are right! Up until this weekend, there has been no data regarding the risks and benefits of lap vs open mesh removal.
I just Presented our data answering exactly this question while at the American Her ia Society meeting. I’ll post the results on my Facebook page @DrTowfigh and tweet it @Herniadoc.
In short, 83% had cure or significant improvement after mesh removal. I remove all laparoscopically placed mesh laparoscopically, not open. I also presented our data at SAGES meeting two weeks ago. We compare laparoscopic vs robotic techniques and concluded that robotic technique for mesh removal was superior to laparoscopic.
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