News Feed Discussions Did I have TEP or TAPP?

  • Did I have TEP or TAPP?

    Posted by mitchtom6 on May 22, 2019 at 4:44 pm

    All,

    I have been unable to determine, based on my operative report, whether I had TEP or TAPP.

    I will attach a screenshot of the operative note, which describes the procedure. I am hoping an expert could answer.

    Some of you have read my story on a previous post. It is looking more and more like I will go under the knife. Whether I am having mesh complications, a recurrence, or both, is to be determined. My next Dr Appt is on June 10th and I am looking forward to it.

    This ordeal has taught me to take nothing for granted. I would give almost anything to go back to normal. Yet, at least I still have my eyes to see, a house to live in, and a wife and young son who love me, despite my condition – thank the Lord. There are lots of folks who do not have those blessings. I am also grateful that I have been able to afford my medical journey so far, although it is hurting the wallet. Regrettably, I switched to a high deductible health plan one month before this issue started, and it has cost me about $7000 so far this year, with no answers for any of it. There are many people in the world – indeed, countless people in the USA alone, who cannot afford treatment and wouldn’t have even made it this far.

    Thank you for your assistance.

    Thank you


    Attachments:

    Good intentions replied 5 years, 6 months ago 4 Members · 6 Replies
  • 6 Replies
  • Good intentions

    Member
    May 23, 2019 at 10:57 pm

    Sorry [USER=”2854″]localCivilian[/USER] I can’t find the reference. It’s just something I’ve read in the past, about absorbable sutures. They don’t always dissolve at the rate that they are expected to. I think that I read it in a report about what surgeons have found when they were entering an area that had had previous procedures. It might have been a video. Sutures that should have been gone were still there.

    If I find something I’ll post it.

  • localCivilian

    Member
    May 22, 2019 at 11:24 pm

    [USER=”2029″]Good intentions[/USER] What do you mean by absorbable tacks becoming encapsulated? Curious because absorbable tacks were used for fixation of my repair.

  • Good intentions

    Member
    May 22, 2019 at 5:56 pm

    Thanks [USER=”2856″]mitchtom6[/USER] . Looks like you had Medtronic’s Progrip mesh secured with what are essentially absorbable staples. J&J’s (Ethicon) Securestrap. There is a drawing in the second link. It looks like your hernias were small.

    Odd that he used fixation on supposedly self-fixating mesh. That’s the big selling point of Progrip, self-fixation. But after 4 years the tacks should have been absorbed so it seems unlikely that that would be part of your problem. Although, I have seen studies that suggest absorbable tacks often don’t degrade and get absorbed, they get encapsulated instead. Of course, I’m not an expert.

    The surgeon did not note the size or type of the device. That should be recorded, with serial number, at the facility where the work was done. Generally they use large pieces though, to allow for shrinkage. It looks like they might also have a “3D”product. “Anatomical”.

    Here are some links describing them. J&J’s “International Hernia Mesh Registry” is really just a study of J&J products, apparently to generate marketing data.

    Progrip – https://www.medtronic.com/covidien/en-us/products/hernia-repair/progrip-laparoscopic-self-fixating-mesh.html

    https://www.jnjmedicaldevices.com/en-US/product/ethicon-securestrap-absorbable-strap-fixation-device

    https://www.jnjmedicaldevices.com/sites/default/files/user_uploaded_assets/pdf_assets/2018-09/008101_180511_PROCEED_Hernia%20Evidence%20Summary_Digital_UPDATE_325_CA%20%281%29_9.pdf

  • mitchtom6

    Member
    May 22, 2019 at 5:17 pm

    Thank you for the responses, I am appreciative.

    Here is a re-upload, this time with the entire note, for whomever may be interested.


    Attachments:

  • DrBrown

    Member
    May 22, 2019 at 5:01 pm

    Dear mitchtom6.
    The operative note is incomplete, but it appears that you had a TEP hernia repair.
    Regards.
    Bill Brown MD

  • Good intentions

    Member
    May 22, 2019 at 5:01 pm

    That looks like TEP. I am not an expert but the notes are similar to mine, and the balloon is used to bluntly dissect or split the layers, then inflated to create space for the mesh and work on the hernias.

    Is there more information about what they found and the type of mesh used? There should be notes about fixation also.

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