My view, emphasized by my experience after mesh removal, is that chronic pain is signaling chronic damage. I was and still am physically damaged from having the mesh inside me. Many surgeons, apparently, know and accept this damage and have mentally justified it as normal and “how mesh works”. The foreign body inflammation is what causes the tissue “ingrowth” and “incorporation”. I put these terms in quotes because I think that ingrowth is actually individual fiber encapsulation and incorporation means, essentially, becoming one with the body. There is no ingrowth and there is no incorporation. But the terms sound comforting and healthy. Much of what is happening today is because there is too much hope and not enough objective analysis.

I think that the reality of the situation is that the body is constantly trying to encapsulate and isolate the individual polymer fibers, causing an inflammatory response wherever there is mesh. Since many surgeons are on the bandwagon of the more mesh the better, the inflammation problems are increasing in kind, and that’s where much of today’s problem comes from.

In short, we need parallel efforts on understanding and controlling the damage. Pain management’s purpose is to fix the mistake, the inherent flaws of a bad product. It should not really be considered as part of the repair. There is not supposed to be pain.

Sorry, I know that’s not why you posted. I use the forum to collect and amplify my thoughts, and your post coalesced a few. I have not been able to rationally justify what is happening in the hernia repair field. It has all of the hallmarks of a project that started out with promise for true health care but grew uncontrollably because the financial aspects overshadowed the reality of what was happening.