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Absorbable mesh
The potential bad effects of mesh are well known. How about the absorbable types? Do these have the same bad effects?
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13 Replies
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[USER=”2766″]Katherine[/USER] Your mesh was completely reabsorbed and it is not there anymore?
Here in Switzerland they offer absorbable meshes coupled with a specific surgery procedure for hernias e.g. inguinal hernia and others. A network of doctors specifically mentioned athletes but did not mention sports hernia… -
[USER=”3098″]deeoeraclea[/USER] there May be specific instances where biologic mesh can be used as an extra support to a solid tissue repair.
my reference is to pure biologic mesh. I am a fan, however, of hybrid mesh, such as Tela Bio’s Ovitex. It has 4% synthetic component which seems to be enough to prevent a hernia recurrence but not enough to instigate an inflammatory or autoimmune response.
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[USER=”1391″]UhOh![/USER] very well said.
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[USER=”2766″]Katherine[/USER] Right. Not all Biologics are the same. Some are so processed they act like synthetic mesh.
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I had absorbable mesh in my sacral laminectomy when I had my Tarlov Cyst surgery. I realize this is totally different from hernia surgery, but I developed an autoimmune reaction to it and am still suffering 8 years post surgery. I wouldn’t wish what I experienced on anyone. I think any foreign body can potentially cause a reaction.
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quote drtowfigh:We have a lot of experience with absorbable mesh. And we know from that experience that they do not work for definitive hernia repair. The biologic mesh resorbs and hernias recur
Would it be fair to say that part (most?!) of the problem is attempting to use absorbable mesh as a 1:1 substitute (including repair technique) for permanent mesh? It seems obvious (to me, from a product standpoint) that these are fundamentally different products: one is a permanent prosthesis, the other a temporary healing aid, so they should be used differently.
Hypothetically (and only a doctor could tell me if this is a valid example), if tissue quality is an issue, using absorbable mesh in conjunction with a suture repair technique in order to provide structure during healing.
I’ve said this before, but from a pure product development angle, the biggest failure of mesh seems to be an attempt to “be all things to all people” by serving a dual purpose (a permanent prosthetic and a healing aid) without being optimized for either of those purposes.
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quote drtowfigh:We have a lot of experience with absorbable mesh. And we know from that experience that they do not work for definitive hernia repair. The biologic mesh resorbs and hernias recur
Would it be fair to say that part (most?!) of the problem is attempting to use absorbable mesh as a 1:1 substitute (including repair technique) for permanent mesh? It seems obvious (to me, from a product standpoint) that these are fundamentally different products: one is a permanent prosthesis, the other a temporary healing aid, so they should be used differently.
Hypothetically (and only a doctor could tell me if this is a valid example), if tissue quality is an issue, using absorbable mesh in conjunction with a suture repair technique in order to provide structure during healing.
I’ve said this before, but from a pure product development angle, the biggest failure of mesh seems to be an attempt to “be all things to all people” by serving a dual purpose (a permanent prosthetic and a healing aid) without being optimized for either of those purposes.
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quote drtowfigh:No. There is no data that shows lower chronic pain with biologic mesh.
Mesh is not the only cause of most pain. It’s often technique and surgical handling that contributes. Or it’s multifactorial.
the best is to find a hernia specialist skilled in all aspects of repair to help determine which technique and mesh/no mesh is best suited for your specific problem.
[USER=”935″]drtowfigh[/USER] Out of curiosity, is it your view that there is no possible benefit to using a biologic mesh? Or, is it your opinion that there may be a possible benefit, but that we do not yet have statistical evidence to support it?
I ask because, the lack of data supporting a hypothesis does not, in general, rule out a hypothesis. And, while there are many possible causes of chronic pain after a hernia repair, one possible cause is simply the presence of the mesh. It would stand to reason that, in cases where the presence of the mesh alone is the cause of pain, a biological mesh would result in less chronic pain. In order words, there is a logical hypthesis for why a biologic mesh would cause less pain. This hypothesis could, of course, be incorrect.
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No. There is no data that shows lower chronic pain with biologic mesh.
Mesh is not the only cause of most pain. It’s often technique and surgical handling that contributes. Or it’s multifactorial.
the best is to find a hernia specialist skilled in all aspects of repair to help determine which technique and mesh/no mesh is best suited for your specific problem.
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[USER=”935″]drtowfigh[/USER] As one who has suffered quite a bit of pain after getting a polyester mesh put inside of me, I would gladly have traded a higher probability of recurrence for a lower probability of chronic pain (in fact, I requested an absorbable mesh before my procedure but was told it was not an option).
Is there any data that shows that absorbable meshes results in a lower probability of chronic pain? Logically, it seems as though, if the mesh is the cause of pain, then an absorbable mesh would reduce chronic pain. But, I do not have any statistics to back up this hypothesis.
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We have a lot of experience with absorbable mesh. And we know from that experience that they do not work for definitive hernia repair. The biologic mesh resorbs and hernias recur
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I am surprised this topic did not get more hits….are these meshes not used yet?
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since it is reabsorbable, in order to last a limited time to carry out its function, so the question you ask seems pertinent … if in the long time it will not produce effects because it is reabsorbed, what can happen in the time of reabsorption? except for personal experiences, it’s a question for doctors
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