Best surgeons for mesh removal?

[Good intentions]

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.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805548/

“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 [5]. Important microcirculatory events that occur during the inflammatory process include vascular permeability changes, leukocyte recruitment and accumulation, and inflammatory mediator release “

[reverserat]

@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.

[Good intentions]

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.

[Good intentions]

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 3 years, 9 months ago by  Good intentions.

[Lucas S]

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.

[Jnomesh]

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.

[Lucas S]

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?

[JamesDoncaster]

Hi Lucas.

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.

[ajm222]

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.

[Alexander]

Dr. William Brown in California removes a lot of mesh that was placed with a lichtenstein technique

[Ben999]

You mean what patient or what surgeon?
The patient is Lucas.
I’m not sure I can name the surgeon for legal reasons as I sued him and there’s a case going on right now.
I guess I can say that his clinic is near Coburg, Germany

[mitchtom6]

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.