Best surgeons for mesh removal?
07/09/2020 at 6:39 am #26941
Hello fellow sufferers and hernia experts.
I had my open mesh repair surgery 17 Months ago with the lichtenstein technique. Since the surgery im in chronic pain and close to suicide. I searched for surgeons around the World and before i go in another Operation i hope someone can give me some advice and answers. Please Correct me if im wrong with the following list.
Surgeons i found.
Dr. Petersen in Las Vegas
Dr. Igor Belyansky in Maryland
Dr. Shirin Towfigh im sure everyone knew her here.
Dr. Kang in Korea removed around 50 Meshes he said on YT.
Shouldice Hospital in Ontario Canada.
Dr. Ulrike Muschaweck in Germany.
Dr. Robert Thomas in Desarda Hernia centre in USA. He said 2019 “20% of patients will continue with pain after the surgery but majority will have less pain from the surgery”
I don’t know who from all these surgeons i should choose.
I live in Germany so Muschawek could make sense. I read on her website that: “The IONR technique made it possible, to eliminate the chronic pain in 98 percent of all cases – referring to patients who suffered chronic groin pain after an inguinal hernia surgery.”
Can this be really true? 98% sounds too good to be true. This IONR (intraoperative nerve response) sounds like an improved triple neurectomy. Is there any one of these Surgeons who don’t do a neurectomy or is it common/necessary too cut the nerves. I read a lot of horror storys about mesh removal and triple neurectomy so i don’t know what to do. I can’t live with the mesh pain right now if i don’t go in another surgery for pain relief i will choose the easy way out with a noose.
- This topic was modified 9 months ago by Lucas S.
07/09/2020 at 8:31 am #26943AlexanderParticipant
Dr. William Brown in California removes a lot of mesh that was placed with a lichtenstein technique
07/10/2020 at 7:02 am #26951
Hey Lucas –
I know Dr. Belyansky avoids cutting nerves at all cost, but for mesh placed openly it really needs to be removed openly. And open mesh removal typically requires at least one nerve being cut, sometimes more, as I understand it. The surgeons will tell you that they cut the nerves high up enough that it only involves sensory function (i.e. at worst it should just make things numb). But clearly there are many patients that continue to have pain or report functional issues. I don’t myself understand the discrepancy, and perhaps even the surgeons themselves aren’t sure. But there are also many that have good results from neurectomy, some on this very forum. I’ve seen people post after removal and neurectomy who claim they are happy and feel they have their life back. So it’s not all doom and gloom.
Probably best to try and consult with as many of these surgeons as possible and see what they say. I would definitely recommend any of the surgeons on this list save for Petersen.
Maybe you can describe your pain. I continued to have quite a bit of soreness myself for about that long, and it mostly went away by 2 years amazingly. I think some of it had become psychosomatic for me, and a centralized sort of pain perhaps caused by obsessing about it. Doesn’t mean the pain wasn’t entirely real, but possibly there wasn’t necessarily a structural reason for it. Can’t be sure, though. Pain is a complicated thing, involving both mind and body. And my pain was soreness. Sharp and shooting nerve pain may be different. I now have almost no pain or soreness. The only issues remaining for me are tightness in the groin and hip that are distracting, and a strange feeling when laying on my back.
Hope that helps. You have lots of options, and results with a highly experienced surgeon are usually very good (80% or higher see improvement if not complete recovery). Stay strong.
Feel free to reach out.
07/13/2020 at 7:36 pm #27253JamesDoncasterParticipant
Although my mesh repair done as a laparoscopic procedure, I can identify with your experience. I had chronic pain after hernia repair and also had serious thoughts of committing suicide. After 6 months of pain I had my mesh removed. I am doing much better now (5 months post mesh-removal).
Two other surgeons that remove mesh (not previously mentioned) are Andrew Wright and Peter Billing, both in Seattle.
I also wanted to add that, I have heard some anecdotal experiences from patients that had mesh removed from Dr Peterson and they are not doing well. So, it may be prudent to seek a surgeon other than him.
07/15/2020 at 12:02 pm #27361
Thanks a lot for all these Replies they are all really helpful.
I read about Dr. Koch and Dr. Reinpold in this forum and I will keep them in mind too. I can’t find a post here with an operation experience with Dr. Muschaweck because she seems more expensive than most of the other surgeons but maybe I would still try it.
When I choose a surgeon what should I pay attention to? Just the success rate and price/distance or more?
07/16/2020 at 4:56 pm #27448JnomeshParticipant
I had my mesh removed by Dr. Igor Belyankski-Although he removed open placed mesh his expertise is definitely in robotic/laparoscopic removal of mesh placed this way.
I would also add Dr. kprata tontour just-I am seeing a lot of good testimonials from patients who have had removal with him and most of them open removals.
The best thing you can do in my opinion and what I did was seek out as many people who share similarities to you (open placed mesh and pain symptoms) and have had removal with the above surgeons. Narrow it down to 3 surgeons. Then interview the 3 surgeons mad listen to what they have to say. Between the patient testimonials and the meetings with the surgeons I believe you will have a gut feeling of who to go with.
07/18/2020 at 9:30 am #27451
I’m guessing with Dr. krapata is this one? https://my.clevelandclinic.org/staff/20162-david-krpata
Yesterday I went to a Hospital with a good radiologic, and they found out I have a recurrent hernia on my left side which causes the most Pain. Isn’t that really rare I thought the recurrent rate is around ca. 0,5% with the Lichtenstein technique. Now they want to put another mesh inside me with the laparoscopic method. When they perform the surgery, they want to infiltrate the Nerve which bothers me to keep it quiet. What do you guys think? I’m not looking forward to this or could this be a good solution? The Mesh gives me Dental Problems too. The senior physician of surgery told me there that the tissue is too weak after a removal for a tissue repair that’s why they want to use the laparoscopic method on me.
After Reading this Story: https://www.gutresolution.com/hernia-mesh-a-story-of-deception-tragedy-and-hope/
I don’t want another mesh because as you can read in the link. “Additionally, polypropylene mesh increases oxidative stress in the body. A cursory search on Wikipedia states that in humans, oxidative stress is thought to be involved in the development of: ADHD, cancer, heart disease, Parkinson’s disease, Alzheimer’s disease, autism, chronic fatigue syndrome,” etc.etc.
I will contact one of the named surgeon above soon.
07/18/2020 at 5:45 pm #27483
You don’t really need to go outside of this forum to learn about laparoscopic mesh problems. Most of the bad stories are about that method.
As this COVID-19 crisis continues the parallels between the two situations just seem more and more clear. The industry ignores the bad that’s happening and keeps pushing toward what it wants – profitable business. Ignoring the science, and the clear set of facts in front of it.
Seriously Lucas, just read the posts on this forum. Nothing has changed, there is no “best” mesh implantation method. There are stories from people who had mesh implanted 20 years ago and from people who had it done 20 weeks ago. If you’re having problems with an open repair mesh you’ll probably have problems with a laparoscopic repair, except they will make the mesh much much more difficult to remove. Your body is not “incorporating” the mesh, it’s rejecting it. It won’t matter how it’s implanted.
Good luck. Don’t be swayed by the white coat or the position in the practice. My surgeon was the head of surgery at a very large clinic. But he was run-of-the-mill as far as results.
- This reply was modified 8 months, 3 weeks ago by Good intentions.
07/18/2020 at 6:14 pm #27488
One more thought for you Lucas. The mesh surgeons will put much effort in to making some sort of mesh work for you. Where “work” means no recurrence. You can see that they are already planning to cut nerves (I assume that’s what “infiltrate” means, destroying the nerve), to remove the pain, even though the hernia itself should be the source of the pain. They want to change your body so that it will accept the mesh, instead of using what’s best for your body.
The inflammation from the mesh will weaken the tissue. So, the mesh itself becomes the reason to use mesh. It’s a circular argument that just leads back to mesh. More mesh. If the mesh is removed the tissue will get stronger. Only then, after a period of healing, can they assess tissue quality properly. But that takes time and mesh is about speed.
My main point is that once these surgeons become mesh surgeons they, apparently, feel the need to defend the mesh. Find a mesh removal surgeon and talk to them before making a decision.
07/19/2020 at 8:12 am #27522reverseratParticipant
@Good intentions, how can you be so sure the mesh is the issue? Lucas clearly said he has a recurrence.
Picture this potential scenario, for example: The hernia recurs, and the hernia sac rubs against parts of the mesh while the sac moves around outside the abdominal wall. It’s clear this would be painful, but when the recurrence is fixed (and old mesh removed?) the new mesh might no longer cause issues. Of course, it’s imperative that the issue is identified with 100% certainty (bear down ultrasound, etc.)
“The inflammation from the mesh will weaken the tissue” do you have proof of this statement or is it your own conjecture? I’m not saying your’re wrong, hernia mesh can cause serious issues without a doubt, and your argument about the medical industry and mesh has merits, but you seem to be so focused on the mesh causing issues you can’t see a person’s situation as a whole.
07/19/2020 at 9:50 am #27528
The foreign body response is an inflammatory process. In “theory” it leads to “incorporation” of the mesh, which is really just encapsulation of individual mesh fibers. Chemistry is a molecular process, the fibers are huge in comparison.
Inflammation is a process that breaks down tissues to make room for rebuilding tissue. If you study the process as a whole you can understand how the mesh manages to move, and why recurrences happen. Also, in my case, why the mesh was surrounded by edematous tissue.
Here is one reference and an excerpt, below. The fact that Lucas supposedly has a recurrence from a procedure with a supposed 0.5% recurrence rate suggests that his inflammatory response is stronger than the patients who have supposedly “good” results. An educated doctor will already know all of this. A surgeon that removes mesh will know this. I think that he when he finally talks to a mesh removal surgeon that they will say what I’m saying. His body is rejecting the mesh and it wil need to come out. If he talks to a surgeon like Dr. Brown they will also offer a pure tissue repair that will have better odds of success, both recurrence and pain, than any mesh repair, based on his individual characteristics.
“At the tissue level, inflammation is characterized by redness, swelling, heat, pain, and loss of tissue function, which result from local immune, vascular and inflammatory cell responses to infection or injury . Important microcirculatory events that occur during the inflammatory process include vascular permeability changes, leukocyte recruitment and accumulation, and inflammatory mediator release “
07/19/2020 at 10:15 am #27532
I would consider a visit with Dr. Muschaweck considering you are in Germany and perhaps it is paid by the public health system or your insurance?
As for the mesh vs non mesh, I have read many posts in different fora, and I am still to come across a post of a person who had a mesh problem that was solved with yet more/another mesh (I may be wrong of course, I am no doctor)…
07/20/2020 at 8:20 pm #27661
Thanks a lot for all these Replies.
I’m pretty sure I don’t go the laparoscopic way. I will collect my results and write a short precise E-mail to some of these surgeons.
My only Problem with Muschawek is that they maybe still could use a mesh. They decide most of the time the technique during the surgery. If the Hernia is too big they maybe use a mesh again. I’m pretty sure the pain comes from the mesh (ProGrip Self-Gripping Mesh btw.) but of course I will have it checked.
The reviews about Dr. Conce and Muschawek where overly positive on a website called Jameda. But I don’t trust this rating portal my last surgeon had very positive reviews too on Jameda and when I read the reviews I relied on last time I feel scammed. It is such a heavy decision to find the right surgeon it really gives me anxiety/paranoia. I will look out for a Facebook group for more experience.
Thank you all for answering Questions and Helping in this Forum, not all heroes wear capes.
07/22/2020 at 12:41 pm #27675
If you are in Germany, that would lend itself to Muschawek, I would think. At a minimum, get a consultation and ask about the IONR technique.
She removed mesh from Dai Greene, an olympic hurdler, who was able to go back to a competitive level after being sidelined for 5 years from mesh complications.
Your mileage may vary, of course. But she seems as well-qualified as anyone in the field.
07/22/2020 at 12:59 pm #27676
Actually, as I re-read about olympic hurdler Dai Greene, his case seems to have an additional similarity- he, reportedly, had a recurrent hernia after an initial mesh repair. I would consider that a pretty powerful testimonial. In any case, we are rooting for you. Wishing you a full recovery, and a return to normalcy. In the meantime, consider getting an antidepressant to help get the mental component under control. You are in a very distressing scenario that very few people can fully relate to. After holding out for far too long, I reached the end of my rope and starting taking Cymbalta, which has helped tremendously. That, coupled with the passage of time and a cortisone injection, has made my situation much better. I still have the mesh in me, but it has become manageable.
07/23/2020 at 7:09 am #27680
Hey Mitch – is your pain and discomfort mostly gone, or are you just able to deal with it better now?
07/24/2020 at 7:33 am #27683zachariaParticipant
I know Dr. William Brown in California, he is good. I always recommend him to my friends.
07/24/2020 at 8:23 am #27684
It’s still there, but to a lesser extent. I’d say it’s about 25% or less of what it used to be 1.5 years ago. Occasionally, it will flare up if I do something a little too strenuous. I had a cortisone shot done about a month ago, after I had really aggrivated the area, and it was incredible. I felt 100% healthy, which lasted for a few weeks. The discomfort is creeping back now, but it’s still improved. The Cymbalta also helped with the pain, after a few weeks, and it may have played a part in reducing my chronic spasms.
08/03/2020 at 8:13 am #27735AnonymousInactive
Just to correct the comment about Dr Belyansky. He does cut nerves. He cut mine and left me pretty impaired. I didn’t ask all of the right questions but he didn’t provide all of the right info. Don’t make the same mistake I did.
08/03/2020 at 11:04 am #27738Momof4Participant
Yes, I agree with the comment about cutting nerves. I had a Lap triple neurectomy and asked specifically if there were any side effects in addition to the numbness and was told none. Doctors and patients alike now know that is not the case. There is some motor component to those nerves, especially when the neurectomy is performed laparoscopically. It has caused significant laxity and bulging in that area!
08/03/2020 at 11:10 am #27739AnonymousInactive
I actually had testicular involvement with loss of cremasteric function. Very uncomfortable and intrusive. In pain constantly. I had no idea this would happen.
08/03/2020 at 11:18 am #27741
Do some doctors still cut nerves as a prophylactic measure? I find this thought very disturbing….
08/03/2020 at 11:21 am #27742AnonymousInactive
Yes I had it done. I’ve never been the same.
08/03/2020 at 1:55 pm #27744AlexanderParticipant
Doesn’t the Shouldice clinic normally “take” the ilioinguinal nerve prophylactically in their surgery?
08/03/2020 at 2:44 pm #27746AnonymousInactive
Sorry I don’t know. In my case the genitofemoral nerve was cut to allegedly get the mesh out. It caused all kinds of testicular problems which I still haven’t rectified.
08/03/2020 at 4:30 pm #27747AnonymousInactive
If you watch Muschaweck’s conf videos on YouTube she states she cuts nerves up to 30% of cases with her minimal repair; Neurolysis and neurectomy of the gfn or iln. That is for an original repair, with revision (mesh complication) it’s probably 90% or higher. IONR is a fancy marketing way of saying neurectomy.
I consulted belansky after all the hype about him in fb groups. When I asked him about the loss of cremasteric reflex with the neurectomy of gfn, he was surprised how I knew so much and asked me if I was a “nurse” (slightly condescending) Once he realized I wouldn’t consent to a surgery with neurectomy he told I should go see the “guy in Vegas” or to UCLA; home of triple neurectomy.
Speak to many patients who’s gone through with mesh removal and neurectomy then determine whether benefit outweighs the risk of functional deficit.
08/03/2020 at 10:20 pm #27748
I wonder why Dr. Muschaweck would do that….I know the position of the nerves can change a lot depending on the individual🤔 also if I understand correctly it also depends on how much/where the nerves are cut; or is it just one nerve? If Shouldice involves major nerves cutting then for me it is off the table period!
08/03/2020 at 10:24 pm #27749
Btw are nerves also cut during an open mesh repair?🤔
08/04/2020 at 4:23 am #27750AnonymousInactive
I’m not going to bash Belyansky in a public forum. I’m happy to tell people privately how he injured me. He does cut nerves.
08/11/2020 at 7:57 am #27758
I had a consultation with Dr Belyanski about a year ago. I asked him about cutting nerves. He does not cut nerves by default, but will do it if there is a mesh entanglement issue.
Honestly, I don’t know how else you could do the surgery. If nerves are wrapped up in the mesh, certainly you would have to do something to resolve that issue. The alternative would be to just leave it like that, which sounds like a continuation of pain and discomfort for the patient.
Regrettably, this can create other issues, it sounds like.
Wishing you all a full recovery.
08/11/2020 at 9:06 am #27759AnonymousInactive
I fully understand that. But I think that he has an obligation to explain fully ALL of the ramifications of cutting the nerves, I am not a doctor and I shouldn’t be expected to research what each nerve does and what muscles are innervated, he cut the GFN nerve and now my testicle hangs by a thread because he destroyed the cremasteric reflex and the Dartos muscles which control the scrotum.if I knew that was going to happen I would have at least pondered the surgery more closely, plus his post op treatment sucked, once he got bored he Discharged me to figure it out on my own. Don’t defend him to me please
08/18/2020 at 12:17 pm #27831AnonymousInactive
Agree with Droppain, these prominent hernia surgeons have an obligation to explain fully ALL of the ramifications of nerve cutting (neurectomies) instead of being cryptic and obtuse about it. They’ve done enough to know all the side effects and to not fully disclose in order to steer unsuspecting patient into surgery is a disservice and ethically questionable.
08/18/2020 at 3:01 pm #27833
I am wondering, do surgeons also cut nerves when placing a mesh with open surgery? Or is this only a pure tissue problem?
08/18/2020 at 3:15 pm #27834AnonymousInactive
I don’t know the answer to that. Maybe one of the doctors will answer
08/27/2020 at 1:48 pm #27898AnonymousInactive
Did not know genital branch also innervated the dartos muscle or such thing even existed…
08/27/2020 at 2:55 pm #27900AnonymousInactive
Apparently my surgeon didn’t
Know about it either
03/19/2021 at 9:47 am #28767
Has anyone used Dr. William Meyers at the Vincera Institute for mesh removal surgery? He was recommended to me as an expert in groin anatomy and repair of “sports hernias” and after seeing 9 surgeons around the country following mesh hernia repair almost a year ago, left with chronic and debilitating nerve pain, I am increasingly desperate to find someone who can resolve what must be related to the mesh.
03/20/2021 at 12:43 pm #28778
I went to Vincera but saw Dr Poor his associate. Tough place to do business with long wait times. It’s a mob scene.
I’ll throw Dr Jacobs name into the mix. He is in NYC but charges for his services. He quoted me $12,000 a few years ago. Dr Belyansky ultimately removed my mesh and I have still not recovered and probably won’t at this point. And yes – he DOES cut nerves. Don’t be fooled. He’ll tell you later on he had to do it but I seriously doubt it and will never know. Meanwhile I’ve spent the last year trying to find someone who can undo his damage. He gets high marks on this site but not from me.
03/20/2021 at 12:47 pm #28779
I’ve been sitting on the sidelines mostly this past year – reading other people’s stories. I had my hernia mesh removed last year and I was one of the unlucky ones. Bad outcome. I had two previous hernia repair attempts; one in 2018 to place mesh laparoscopically for a left inguinal hernia and then a “groin exploration “ to try to figure out the reason for my post op pain. Nothing worked and I was passed from one doctor to the next. Surgeons, Urologists, pain management specialists, psychologists. I tried everything including acupuncture. Injections, therapy, medication. Still the pain persisted. Eventually I sought out one of the best mesh removal surgeons in the country. I understood most of the risks and I had the mesh removed. Nerves were cut also. I now regret it everyday. It was horribly invasive and destructive. My spermatic cord and testicle were irreparably injured. My pain is worse than ever. I long to turn back the clock. It was A horrible decision. The surgeon is long gone having discharged me and leaving me to figure this out on my own. If you’ve had a successful removal – congratulations. If you’re thinking about having it done, pick a top flight surgeon, ask lots of questions and get multiple opinions. The damage can’t always be undone!
03/20/2021 at 10:13 pm #28781drtowfighKeymaster
There is no need to travel. There are wonderful surgeon options in Germany: Muschaweck, Conze, Koch.
For mesh removal during a Lichtenstein, selective neurectomy may be necessary, as the process of mesh removal itself may cause nerve injury.
I’m not an advocate of laparoscopic triple neurectomy. As @momof4 mentioned, it can denervate the abdominal wall, resulting in potentially irreversible asymmetric bulging.
03/21/2021 at 8:44 am #28789
Another Dr. I’ve seen who specializes in post-op pain is Dr. David Chen at UCLA. After nearly a year, I need to make a decision soon and if anyone’s had experience with Dr. Chen it’d be helpful to hear your experience.
03/21/2021 at 10:11 am #28790
This will be difficult to determine but try to find a surgeon who can afford to, and will, take the time to get the mesh out without cutting things that don’t need to be cut. As Dr. Ramshaw recently wrote, the medical industry today is about throughput. Get the patients in and out quickly. This is actually a big reason for the rise in mesh implantations, I think. It’s simple and quick.
If a surgeon has scheduled an hour for mesh removal and has patients waiting for him/her after your procedure then the decision to take the time to tease the nerve away from the mesh or cut it leans toward cutting if it looks like they are running behind schedule.
When I had mesh removal by Dr. Billing, he planned for up to three hours to remove the mesh, per side.
In an ideal world, the requirements for removing a mesh device would be considered before implanting the mesh device. But the reality today is that it’s somebody else’s problem after it’s implanted. Good luck.
03/21/2021 at 10:23 am #28791
This is actually a question a patient should ask the surgeon before mesh surgery i.e. if problems arise, will you be able to remove the mesh, and if not do you have a plan to tackle the problems? (referral to a colleague etc)…
03/22/2021 at 6:24 am #28802
Re: Dr. Chen – I have heard mixed things. He seems to be a big proponent of cutting nerves to improve pain and people have very different experiences with this – some good, some really bad. I initially had thought he was one of the top people for these issues, but others have told me they’ve seen a number of bad outcomes from surgery with him. So I can’t say for sure from my own experience, but I would advise caution.
03/22/2021 at 7:36 am #28803
Thank you ajm222 for this input. I cannot afford to make the wrong decision about who to see next. It’s so discouraging to me that the most common surgery performed today is so difficult to find reliable help for when something goes wrong.
03/23/2021 at 3:23 am #28806
That’s right. Until you are as sure as you can be I would wait. In my case choosing Dr Belyansky was a mistake; one that will haunt me for a very long time. While he has helped many others here, in my particular scenario he was the wrong choice. I’m still trying to pick up the pieces a year later.
03/29/2021 at 5:42 am #28822
Can people tell me whether they’ve had experience with Dr. William Brown in CA? I am contemplating mesh removal surgery for chronic pain and have heard very good things about Dr. Brown. I’m eager for any and all input.
03/29/2021 at 11:28 am #28823
My decision making clock is ticking and I hope to hear back.
03/29/2021 at 1:20 pm #28825
03/29/2021 at 1:20 pm #28826
If you can get up to the Seattle area Dr. Peter Billing is a good choice. He removed my mesh. Dr. Andrew Wright at the University of Washington is also good, apparently. Someone who has posted here had him remove theirs.
- This reply was modified 1 week, 5 days ago by Good intentions.
03/29/2021 at 3:13 pm #28828Ben999Participant
I’m wondering if you suffered the exact same fate I did. There was a young guy with your name who got surgery the same day I did, by the psychopath who crippled me. Country and time of surgery fit.
03/30/2021 at 9:08 am #28833
Ben – who are you referring to?
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