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Hernia bilateral + DFSP on the groin = mesh or desarda?
Hi All,
I am a man 52. last year I was operated (Mohs surgery) with DFSP, the rare form of skin cancer. They had to go pretty deep during the Mohs operation, so I do not have too much “content” under my skin on the groin area. A month ago I was diagnosed with double bilateral hernia too. Fun. Now thinking of the appropriate way of operation, I am not convinced about mesh at all (worried that it might trigger the cancer, although this might be a silly thought, and also all the infestation it can cause, an alien body in mine…), and kind of tend to prefer Desarda, however I am not sure whether with my DFSP, this is an appropriate method. Whether that tissue they need there needs to be supported by fat (which I do not have in that area anymore) or it does not need any of these? Does anyone know anything about this – i.e. which method to choose if you had DFSP on the same area?
Many thanks! -
1 Reply
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I don’t know much at all about how constant inflammation might affect cancer-prone tissue. I don’t think that any of the possible repair mehtods need fat for support. Fat or omentum or intestine are all potential recurrence sources. Anything slippery AND MOBILEthat can ooze under the mesh is bad.
One thing that might more important is the type of hernia, direct or indirect, and its location. If you read Dr. Kang’s posts in the thread linked below you’ll see how they can be treated differently. Today’s laparoscopic mesh procedures tend to be a one-size-fits-all method, with large area coverage. If your hernias are indirect then a simple tightening of the deep ring would seem like the simplest most appropriate repair method. No need for mesh. If I understand things right, I’m still learning.
Even a direct hernia can be repaired using a minimal amount of mesh, if a tissue repair method is not appropriate for you. I would imagine that a doctor could think that they are doing you a favor by covering all of your abdomen with mesh. So be prepared to hear that. The “state-of-the-art” still assumes that “mesh”, of any kind, is an inert object in the body. It’s what is being taught at the big training clinics, and on the web sites of the medical device makers.
Good luck.
Here is that link – https://www.herniatalk.com/7478-marcy-repair-in-adults-with-inguinal-hernia
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