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Hernia mesh registry gaining traction?
Good intentions this should interest you and others.
not only do some of the surgeons in the article make the point that mesh needs to be studied more as wha
studied more long term to see what it does in
the human body but also as to the selection of
mesh, which ones work best and which ones
are better or worse for different subset of
patients.
The article mentions that there are over 300 types of meshes!!!
It boggles me how surgeons can quote reoccurences
percentages with mesh or pain percentages with
mesh so neatly when there are 300 different types.
How can mesh be so easily generalized form one to another to quote
these percentages and stats?
Just seems so obviously wrong and unethical.
No brainer every mesh implanted should
ne tracked and monitored.
only then will we get an idea of the true stats of pros and cons
of mesh as well as which ones have major issues and
design flaws.
So interested in dr. Towfigh’s And any others
feedback. -
6 Replies
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quote Jnomesh:The article mentions that there are over 300 types of meshes!!!
It boggles me how surgeons can quote reoccurences
percentages with mesh or pain percentages with
mesh so neatly when there are 300 different types.
How can mesh be so easily generalized form one to another to quote
these percentages and stats?
Just seems so obviously wrong and unethical.
No brainer every mesh implanted should
ne tracked and monitored.I can’t help but think that having over 300 different types of mesh is a result of over-engineering, and perhaps there are other incentives related to patents and pricing as well.
Regardless they all need to be tracked on implant and, if relevant, on removal too. Opacity in healthcare outcomes is not a good thing.
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quote Good intentions:Dr. Bruce Ramshaw even can’t resist defending what’s happening and seems in denial. His statement from the article is surprising. I can’t see a reason for making such a blunt statement except to defend the industry.
“The relationship between mesh and chronic pain is poorly understood, Dr. Ramshaw said. “Let me be clear: Mesh doesn’t cause chronic pain but it may be a contributing factor as part of the many factors that can contribute to chronic disabling pain.”
That’s the same logic as “the fall doesn’t kill you, it’s the sudden stop at the end”.
I wrote the comment above then went back over what I knew about Dr. Ramshaw. He seems to undecided about the whole “mesh” situation. He has written quite a bit about post-repair pain, and does remove mesh. But sometimes he seems to imply that the problem is psychological. It’s hard to tell what to think about his comment, it might be one of those Freudian slips, from wishful thinking. I don’t know.
Here is a link to his UT page, and a recent video from the last SAGES meeting. He seems like a guy you would want repairing your hernia.
https://www.youtube.com/watch?v=Pffj-GAEMRs
Bruce Ramshaw, MD, FACS | The Department of Surgery
http://gsm.utmck.edu
The University of Tennessee, Graduate School of Medicine is located in Knoxville at the University of Tennessee Medical Center. The Graduate School of Medicine is part of the University of Tennessee Health Science Center and offers residency programs, fellowships, and opportunities for medical students. -
Thanks Dr. Towfigh. I will pass this on to my explantknf surgeon and it is a start but obviously a lot of data will be missing because it is not only voluntary but a lot of people don’t know about it unless they visit this forum.
Still seems logical that surgeons should be mandated to report patients complaints and mesh removals otherwise true outcome measures can not be measured. -
One of the stickies on our HomePage discusses the AHSQC. I highly encourage that you ask each of your hernia surgeons to become a member and input their data into this quality collaborative. It tracks outcome by exact mesh brand and model in addition to a whole lot of other factors it tracks. Plus, patients can input how they are doing, for long term outcomes data.
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Dr. Todd Heniford, on the other hand, is the type of leader that needs to be supported.
“Surgeons have to ask: Are we protecting patients or are we protecting industry? Are we protecting ourselves?”
There are several other doctors quoted who seem rational and focused on patient welfare. Overall the article shows that at least the discussion is continuing. Let’s hope they can make some progress.
Thanks again Jnomesh for posting it.
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That is promising. Thanks for posting this. I pulled two of the linked articles out, below, the British Hernia Society’s response to a BBC report, and the FDA’s press release.
The BHS response is very disappointing and focused on protecting their image, it seems. The response is surprisingly unprofessional, tone deaf, and uninformed, considering the BHS’s role in guiding the efforts of their membership. Hard to believe that it’s part of an official response. They seem to be defending the industry instead of the patients.
An actual quote, with exclamation mark, from the BHS – “One of the patients developed groin pain many years after the mesh hernia repair – yet the mesh was still blamed for the problem! “
https://mailchi.mp/23a275fbe343/j114lk1gnu
The FDA press release looks good, but it’s an extension of something that started six years ago, in 2012. The government works very slowly. Lots of talk but little action.
https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm626286.htm
Dr. Bruce Ramshaw even can’t resist defending what’s happening and seems in denial. His statement from the article is surprising. I can’t see a reason for making such a blunt statement except to defend the industry.
“The relationship between mesh and chronic pain is poorly understood, Dr. Ramshaw said. “Let me be clear: Mesh doesn’t cause chronic pain but it may be a contributing factor as part of the many factors that can contribute to chronic disabling pain.”
That’s the same logic as “the fall doesn’t kill you, it’s the sudden stop at the end”. It’s like he is completely unaware of the people who have been cured of their pain by having the mesh removed. And did not have pain before the mesh was implanted. The cause-effect relationship seems clear. I wish that he did not have such a high profile in the situation, he seems to be hindering more than helping. I think that his comment also minimizes the effect of constant low level pain and discomfort. He shifts the focus to extreme disabling pain, avoiding the issue of degradation of quality of life.
He is also at the University of Tennessee, where Dr. Voeller teaches, who is also of the opinion that the problem is too big to measure, and that’s why nothing can be done. They seem to be protecting the status quo, despite the evidence. And teaching a close-minded sort of approach to surgery. It doesn’t seem right that they are both professors, and both very vocal in their opinions. I wonder if the device makers are big contributors to the department.
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