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Hernia decisions
I got a kugel patch back in 2003 for a right inguinal hernia. It caused a lot of pain for many years and I looked at having it removed but nobody would consider it back then. I still have a foreign body sensation and it can get irritated again with activity or a lot of bearing down/coughing. I didn’t even know removal was an option until I found this site. I have seen several good doctors recommended on this site. I am leaning toward Dr Belyanski and he has said he would robotically remove it and also fix my left side inguinal hernia which is now bulging. My only concern is that he would use mesh to fix the left side and says he would probably have to put in mesh to reinforce the right side after removal. It seems for some people, there is a scar plate left so no new mesh is necessary. Maybe since the kugel patch is put in by open fashion, there is the incision to worry about? He said the newer mesh is lighter weight than the older mesh (esp my Kugel patch) and is better tolerated. He seems like an excellent doctor and I have no reason to doubt him but since I previously had issues with mesh, I still worry. Has anyone on this forum had their mesh removed and then had to have new mesh put in? Is hybrid mesh a better option here? I was also considering having a tissue repair on my left side and then see what happens with the right side after removal. Can you leave a hernia after mesh removal and then fix it by tissue repair. Finally I am a 54 year old male with a slim build. I have read that the older a patient, the more likely a chance for recurrence/complications after tissue repair. Lots of issues to decide here but mainly looking to see 1) if there are any people that have had new mesh after the old mesh was removed. 2)Has anyone had a tissue repair after their mesh was removed and 3) any guys over 50 who had tissue repairs and either good outcomes or complications. Thanks for any input.
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2 Replies
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Here is a paper that describes how the lightweight concept might actually be making things worse.
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Dr. Belyansky has commented on Twitter about plugs being “evil”. It sounds like he might believe that the other mesh forms are okay. The “lightweight” mesh concept does not have much long-term data supporting it. I think that it was an idea that could easily be introduced to market using the 510(k) process so They did it. Dr. Bendavid has published very well thought out papers showing how the “lightweight” concept itself was flawed and might actually create more toxic environment for nerves.
I am an older low body fat male who had Bard Soft Mesh implanted. Soft Mesh is Bard’s lightweight version of their “Gold Standard” mesh. I was physically active and the lightweight mesh was never right. I knew it needed removing at close to two years after implantation, after trying to live with it for that whole time. I had it removed at three years. https://herniatalk.com/forums/topic/one-year-seven-months-since-mesh-removal/
The plugs are more difficult to remove I think because they make a bigger chunk that leaves a bigger void behind. More three dimensional, than the two-D flat prosthetics. The “scar plate” has to be removed with the plug.
I think that you could find a doctor who will remove the mesh and do a suture-based repair. Dr. Billing for laparoscopic, or Dr. Brown for open.
Good luck.
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