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‘The Dissolvables’
I have been noticing a lot of synthetic dissolvables making their way onto the scene lately: Tigr Matrix, Phasix, Bio-A, etc. These are very promising & exciting products for those of us patients that didn’t want a permanent foreign object in them. In fact I even inquired & requested a fully resorbable product before my surgeon put my mesh in, but he told me: “your very well informed but those are years away from being an available option”. If I had been given one of these options I wouldn’t be seeking out removal surgeons now.
Anyhow, I wonder if all of these have been found to dissolve at equal rates in different patient populations?
Most of them seem to dissolve by way of hydrolysis metabolism, like dissolvable sutures do. So when the ingrowth of fibrosis & scar tissue form onto these dissolvables in the first few months, doesn’t it encase the mesh to the point where hydrolysis/metabolism can no longer take place? I mean doesn’t it block bodily fluids from getting to it & metabolizing it at that point when its encased in scar tissue? (leaving it in pieces/fragments looking like a ‘Deep Fried partially Dissolvable’?)This would only matter because these Dissolvables are designed to take over a year(up to 3 yrs for some) to fully resorb & the scarring/ingrowth process occurs long long before that in most cases…
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9 Replies
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Marcello71
if you don’t mind me asking what are the symptoms that you are feeling that lead you to believe it’s the mesh. Did you set a date for removal yet? I’m 4 months post op and having some issues and pain. I want to give it more time and am addressing some other Pelvic abdominal causes for pain. My dr ordered a CT scan with oral contrast that I will
have done soon even though the thought of drinking that stuff makes me sick!
Wishing you well.
Mel -
‘The Dissolvables’
I am nearly certain I’ll have enough peritoneum leftover to close that space without needing more mesh(if the right surgeon does it). I have plenty healthy peritoneum to spare & my body has collagen production on demand capabilities.
However if I do herniate after the mesh is removed, then I’ll just get a shouldice repair at that point, if it comes to that. But that shouldn’t be an issue because:
A) I don’t smoke & I eat healthy.
2) I know to abstain from physical activity(especially coitus unfortunately).
C) I know I won’t be able to lift anything heavy for over a year(or ever again maybe) &
4) I will be fully dedicated to a perfect recovery after removal…This is all beside the point since I won’t ever allow another piece of permanent mesh in my body again after how my body has reacted to it, no matter who does the removal.
Thank you again Dr Towfigh for your advice & support.
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‘The Dissolvables’
If mesh is removed lap/robotically and as a result there is no peritoneum to cover the new mesh repair, then yes, the mesh they place will have to have an adhesion barrier.
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‘The Dissolvables’
Thank you Dr Towfigh but I still haven’t had the mesh removal/repair yet. One of the surgeons offering to do it in another country said he would have to use an adhesion barrier when no American surgeons mentioned needing to use one so I was curious what they were…
I’m starting to think robotic assisted lap removal would be best for me.
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‘The Dissolvables’
Marcello71,
Adhesion barriers are great, if you ask me. There is some evidence that they work in reducing adhesions. However, they are not perfect and they are expensive so many surgeons do not use them. Yes, they all absorb in a short span of time in all patients. We have no evidence to suggest otherwise. We have had plenty of experience reoperating on patients and regularly see that there is no residual anti-adhesive.
Industry reps tend not to post on these patient-focused forums, as it would be considered inappropriately promoting their brand without full disclosure. But I encourage them to chime in on this topic as objectively as possible.
Sounds like you had a great repair. Good luck.
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‘The Dissolvables’
Don’t worry about your mesh Mela cause it certainly isen’t worrying about you, jk. Most do well with permanent mesh from what I’ve been told so don’t let it worry you.
Frankly I thought more surgeons & industry reps would jump on this topic but guess not. But what about adhesion barriers… can we talk about adhesion barriers people? Like ‘Interceed’, ‘Seprafilm’, etc. Do they always fully resorb in a short time span in all patient populations as they’re supposed to?
I ask this because they’re composition(oxidized cellulose, sodium hyaluranate) may be less likely to become trapped or encased in scar tissue to the point of not resorbing fully…
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‘The Dissolvables’
I had my femoral hernia surgery done on Thursday and they placed a regular mesh. They also found an umbilical
Hernia and repaired that too. I don’t think they used a mesh for that. The surgeon said it was small.
I am hoping that everything heals according to plan. I don’t want to stress myself out over the mesh and pray I don’t have mesh problems down the line. -
‘The Dissolvables’
The jury is not yet out on the dissolvables. To date, there is no evidence that they ar equivalent to any nonabsorbables. That said, there may be unique populations and situations which would benefit from them
Also, yes. We suspect that the rate of absorption does vary among patients.
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‘The Dissolvables’
I’m having surgery Thursday and didn’t even consider asking about a dissolvable mesh. I hope I’m not doing the wrong thing. Ughhhh
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