News Feed Discussions Hernia Discussion Hernia repair pain – 5.5 weeks post – doc said location is unusual

  • Hernia repair pain – 5.5 weeks post – doc said location is unusual

    Posted by enoughsaid22221 on January 20, 2025 at 5:10 pm

    I am 5.5 weeks post op from right inguinal hernia repair via robot with mesh . I am having significant point tenderness slightly below and slightly to the right of my belly button if I push down on the area. Started two weeks post op. Appears to be over the abdominal muscles. Also have pain in the area when sitting, almost a burning sensation in the belly button area, some numbness. It is not near any of the incisions. It has not improved since it’s started. I saw the doctor for followup, he said he has never had a patient with pain in this location this before from an inguinal hernia repair. He told me to give it more time … Has anyone experienced this kind of pain in this area before from an inguinal hernia repair ? Did it get better? From reading , nerve pain in this area is not very common at all. I felt the recovery has been great otherwise which is why this is so frustrating and discouraging. I’m worried this is a forever pain. Feeling very discouraged.

    drtowfigh replied 2 weeks, 1 day ago 3 Members · 10 Replies
  • 10 Replies
  • drtowfigh

    Moderator
    January 27, 2025 at 1:03 am

    Sounds like the area is too high to be related to the mesh and too low to be related to the robotic incisions.

    I would recommend a nerve block, in the same plane as one would do for an ACNES injection

  • Good intentions

    Member
    January 21, 2025 at 12:46 pm

    Where is the pain in relation to the entry ports? Robotic surgery requires opening the peritoneum from inside, if TAPP is performed, or via splitting the peritoneum away from the wall through the navel if TEP is used. With TAPP the space created needs to be big enough to place the mesh between the peritoneum and the abdominal wall, then it is sewed or stapled shut. Adhesions can occur at the suture line if the sutures are loose.

    With the TEP approach sometimes the peritoneum is accidentally torn during blunt dissection (peeling) and needs to be repaired. There might be a suture in the peritoneum at that point.

    Your surgery notes will tell you more about what actually happened during your procedure and how big the piece of mesh used was. Some doctors use the biggest piece that they can under the assumption that it will help avoid recurrence after shrinkage. Recurrence is still the greatest fear for the hernia repair surgeon. Pain is somebody else’s problem. Did your surgeon suggest a referral to a different doctor?

    Regardless, once the mesh is fully entangled with new tissue there’s not much to be done except hope. 5 1/2 weeks is still early for healing, the body is still encapsulating the fibers of the mesh, but late as far as entanglement and shrinkage. You probably noticed a flattening and tightness of the mesh area after 2-3 weeks. That’s the new tissue grabbing on to the mesh and pulling it inward.

    Keep moving, I found that there seemed to be painful areas that were helped by more vigorous movement. I assume that the disruption of fluid supply after surgery and healing caused a poor environment for the nerves in the area. Dr. Bendavid has published about this as a possibility for chronic pain.

    Your surgeon is just tossing out ideas, be careful. It’s very simplistic to suggest nerve blocks when pain is involved. Nerve blocks and neurectomy have their own side effects. If nerve blocks work but the pain comes back the next suggestion would be cutting of the nerves, neurectomy.

    Good luck. Get your surgery notes.

    • enoughsaid22221

      Member
      January 21, 2025 at 12:57 pm

      It was a TAPP, my doc said the pain was a little high from where the sutures and mesh are. The incisions are there above the belly button medial and lateral. This is my second repair but on the other side, I did not have these issues then. I guess I am looking for reassurance that is there still hope things can improve ? What type of doc would you referral be recommended for ?

      • Good intentions

        Member
        January 21, 2025 at 1:42 pm

        Some place like the Cleveland Clinic Chronic Groin Pain Clinic, with Dr. Krpata. He might know enough to head off a problem while it is still small. Link below.

        I would still get the surgery notes, even if just for your records. I got mine and sometimes I still wonder if the surgeon who said he did my surgery is actually the one that did it. For his status in the Clinic his notes were surprsingly poor.

        5 1/2 weeks is still early. Try to make it work.

        https://my.clevelandclinic.org/podcasts/butts-and-guts/chronic-groin-pain-clinic

  • enoughsaid22221

    Member
    January 21, 2025 at 12:02 am

    Error

  • drtowfigh

    Moderator
    January 20, 2025 at 11:44 pm

    Could this be from a belly button hernia? Or ACNES.

    • enoughsaid22221

      Member
      January 23, 2025 at 8:52 pm

      Dr Towfigh, Have you seen an umbilical hernia develop and become symptomatic so quickly after inguinal hernia repairs (ie in 1-2 months) ?

      Would you recommend imaging at this point ? I feel like the belly button area is a bit too high for pains related to the mesh for an inguinal hernia repair. I have found very little documentation of nerve damage or pain in this area from an inguinal hernia repair.

      • drtowfigh

        Moderator
        January 27, 2025 at 1:05 am

        Sounds unrelated to your surgery.

        Belly button hernias can cause pain to the left or right of them. But you’re explaining something lower. That would not typically be related to a hernia

    • enoughsaid22221

      Member
      January 21, 2025 at 12:14 am

      I do not feel a bulge that I can appreciate in the area , the surgeon did not either . Although I did not have a palpable bulge with my inguinal hernia either. Would it be worth asking for imaging like an ultrasound ?

      Does the mesh typically go that far superior on an inguinal hernia repair to cause nerve pain in that area ?

      The doctor did recommend a nerve block if it did not get better …

      • Good intentions

        Member
        January 21, 2025 at 2:18 pm

        Sorry for the odd order of replies. It’s a glitch of the forum software.

        One thing that might help you is to wear clothes that do not put pressure on the painful spot, or cause it to move when you’re walking or sitting. It seems obvious but I have found that the irritation from pressure on my own painful spot would not manifest as pain until afterward. Most pant waistbands cross right over the painful areas created by hernias and hernia surgeries.

        I’ve also found that keeping track of activities can help identify correlations. Basically, you have to become hyper-aware of the spot and take care of it, allowing it to heal. It might take months before you get back to your normal routines.

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