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Questions using Mesh/Non-mesh procedures to repair RECURRENT inguinal hernia
What is people’s opinion about Mesh/Non-Mesh procedures to repair RECURRENT inguinal hernia; I had a J & J ETHICON PROLENE HERNIA SYSTEM had for my Hernia surgery in March 2008. It is now RECURRENT and my CT Scan shows I need surgery and may have a SECOND Hernia; I have read HORRIBLE issues with Mesh including the Bard 3dMax that my Surgeon recommends; I am SCARED; I have read about the Shouldice, McVay Repair, Bassini Repair:, and Desarda Repair. Does ANYOne have IDEAS, EXPERIENCE, SUGGESTIONs? Thx, Jeff
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1 Reply
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Very complex situation. We are learning more each year.
There is no single wonderful mesh. Also, it is difficult to predict superiority of one mesh or technique over another for each Individual patient. What we do know is based on population data and our own experiences.
Mesh repair has a lower recurrence rate for hernias than nonmesh repair. If you’ve already had a recurrence, then nonmesh repair has a poor outcome, ie, the rate of failure is higher than with the first repair and mesh repair is indicated.
There are complications with mesh. There are complications without mesh.
In general, if you’ve had a recurrence with the PHS system then you will need a redo surgery also with mesh. There are a variety of mesh options and 3D Max is among the most popular and among the mesh type with the most experience.
If you didn’t have a mesh allergy or reaction with the PHS, you wil not have one with the Bard product.
Really it’s technique that will bring you the best outcome. Typically after PHS recurrence, laparoscopic repair is indicated. However, the posterior leaflet of the PHS may need to be excised laparoscopically. Make sure your surgeon has performed laparoscopic repair for recurrent hernias and also excised mesh laparoscopically.
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