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quote Jnomesh:Hi dr. Towfigh.
i have spoken to a few people who have had mesh removal and didn’t want new mesh implanted if the area was weak or if there was a hernia present post removal. These people were offered absorbable mesh (tiger mesh) as a compromise.
it got me thinking: dr. Kang has weighed in on this forum and he mentioned one problem with using permanent mesh (besides the nasty side effects it can cause) is that he feels the hernia defect isn’t closed or repaired when using permanent t mesh thus the defect is never properly repaired/closed and relies slowly on the scarification that the mesh causes to prevent a recurrence and some additional reinforcement that the mesh also offers.
He feels that this may be one of the reason a hernia may recurr with the use of mesh because the defect was never closed. Then you have a faulty piece of mesh inside with the most likely solution to have another piece of permanent mesh implanted the opposite way it was put in to fix the hernia.
so my question is : for people who don’t want permanent plastic based mesh implanted or for people who it is determined their hernias are to big or not enough strong surrounding tissue for a natural repair what about using a combination of a pure tissue repair (closing the hernia defect ) and placing a absorbable mesh that fully dissolves over say a year as a viable alternative to a permanent mesh repair for those that don’t want mesh.
This way the defect is closed and the absorbable mesh gives another layer of protection during the first year of healing which is the most important time frame after a hernia repair.
Seems like this idea could bridge the two sides of the debate between permanent mesh and non mesh repairs for concerned patients who today are primarily offered only one solution by most surgeons: permanent mesh.
The absorbable mesh also would offer some insurance for surgeons who aren’t experts on pure tissue repairs ( ie don’t do many) that in case they don’t do a perfect tissue repair they have the absorbable mesh as a “back up” or insurance to help fix the hernia.
curious as to your thoughts Dr. Towfigh and any other surgeons on the forum as well as any other members feedback.Thanks
Dear dr. drkang That is your experience please with tissue repair combined with absorbable mesh for hernia repair. Point is tissues are week after removal and recurrence chances is HI….Did YOU TRY THIS APPROACH?
For everyone else chronic pain still problem with that mesh as well….but outcome is better..
https://www.ncbi.nlm.nih.gov/pubmed/28492358