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HerniaTalk **LIVE** Q&A: Let’s Talk about Mesh11/09/2021
HerniaTalk LIVE is a weekly Q&A hosted by Dr Shirin Towfigh, hernia surgeon expert, with invited special Guests to answer your hernia-related questions.
This week, our Guest Panelist is Dr Charlotte Horne, hernia surgeon at Penn State in Hershey, Pennsylvania
Topic: Let’s Talk About Mesh
Join us this Tuesday 11/09/21 at 4:30pm Pacific time (GMT -7) as a Facebook Live. You can also register to join via Zoom here: https://us02web.zoom.us/webinar/register/WN_eYxgWk8CT-mxCTmQ0WERCg
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7 Replies
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You can look back over the years and see that blaming technique is the tool that the mesh-makers and users have used to deflect attention from the mesh. Blame the technique, but don’t name a specific technique. Claim that there is no evidence of problems inherent to mesh alone but provide no evidence, and ignore the fact that there is no evidence that mesh is not the problem either. It’s just a coincidence that mesh is there, and that the pain disappears when the mesh is removed..
Simple logic can be used to draw a solid correlation between mesh implantation and chronic pain, if enough data is collected. Laparoscopic procedures that involve peeling the peritoneum from the abdominal wall but with no mesh implantation, for example. Explaining why removing mesh removes the pain. That one seems very clear. I had mesh with pain, the mesh was removed and the pain was removed. How can the cause of the pain not be considered an intrinsic property of the mesh? There was no neurectomy done during the mesh removal.
I think that the word game here is the same word game used to make jokes, or to retain something that makes money, or continues something that a person has invested time and money in to. It’s not the fall, it’s the sudden stop at the end that injures people. Guns don’t kill people, people do. It’s not the mesh causing the pain, it’s the shrinking and buildup of tissue around the mesh that causes the pain.
In the big picture, the mesh-makers plan has worked. They have delayed and deflected and convinced for many many years and today’s surgeons have their whole careers invested in supporting mesh-based hernia repair, and, therefore, they have to support mesh. They have investments and bills and don’t know any other way. Pure tissue repair is not taught in the major medical schools. Everywhere you look, behind the scenes, you will find mesh-maker support, for the conferences, paying the huge exhibitor fees to the various surgery or hernia societies (75,000 – 100,000 for a booth in an exhibit hall), at the universities with their on-campus robotic surgery training centers, consultancies, and complimenting the surgeons who say good things about mesh.
Dr. Towfigh, can you give a few examples of the “problem in surgical technique” that you have seen? And explain how it was the cause of the pain, and not the mesh? It shouldn’t take long. A presentation on the topic at one of the big meetings would surely be well-received, even applauded, if you could show your colleagues what mistakes to avoid. Much more impactful to patients and colleagues than busting myths. Busting myths helps the mesh-makers but does not help your colleagues and their patients. Think of all of the patients you could help by speaking up. I think that it would be much more personally satisfying and fulfilling also, than just defending the use of “mesh” in all of its forms.
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If that is so would it not be an idea to find out who did the ineffective surgery and stop them performing more, at the very least.
Seems to strengthen the argument that it isn’t a surgery that should be allowed to be performed by non specialising surgeons as it is in UK if I understand correctly.
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There is a lot of truth to that statement. The complications I see from hernia repair often stem from a problem in surgical technique and not intrinsically to the mesh product itself.
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“it isn’t the mesh causing the problem but the way it’s put in”
Was the comment from Dr. Horne? I have not watched the video. That is in the same vein as blaming mesh problems on fixation. Without the details of what is the right way to “put it in” or the wrong way, it is a useless comment meant to divert attention from the problems with mesh. It’s just one more surgeon “protecting” the mesh industry.
Any surgeon who makes a comment protecting mesh should have information about how to make things better. Otherwise they are just acting as tools for the mesh makers. If they truly believe in what they are doing then they should be actively working to remove the “evil-doers” that are destroying their reputations.
Start removing the bad and all that’s left will be good. The mesh-makers might lose some business but without surgeons promoting the right way to do things, they’re all contaminated. Silence just lets the bad continue.
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Also if there are few or no long term studies of “bioabsorbables”, isnt it premature to regard such as safe?
Mind you, same could be said for covid 19 vaccinations – and I’ve had 3 so far!
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Thanks for this… Re the “it isn’t the mesh causing the problem but the way it’s put in” comments, shouldn’t that mean mesh placement is restricted to suitably experienced surgeons only?
It may be different in the USA but in the UK, and I’m talking NHS / national state provided health, as far as I understand it, most general surgeons can do this and even trainees.
If placement is vital, and I can appreciate it is, then who performs it is critical also I would think.
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Dr. Horne was a wealth of information. I so much agree with her thoughtful analysis.
If you missed this session about mesh, you can VIEW and SHARE from here: https://youtu.be/0B3F3Q0TJJg
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