HerniaTalk **LIVE** with Q&A: What’s New from Hernia Conferences 9/7/21

[Alephy]

I can understand that, but I still think the “risk” of unexpected problems after a mesh repair should be factored in together with the recurrence rate….

Having said that, < 13% seems low enough to me, considering that it is similar to the mesh figures anyway: or am I missing something basic here?

[drtowfigh]

As a surgeon, it is not considered appropriate to offer an elective operation that has a 30% recurrence rate, even though to a patient that may imply 70% success rate and they are acceptable of that. We understand the implications of recurrence: more pain, more disability, larger hernia, more difficult operation the second time, more likely to recur the second time. It’s a domino effect we don’t like.

[drtowfigh]

Cost is highly variable depending on the contracts. Phasix is signficantly more expensive in general than Tigr Matrix.

[Pizamka]

Hello, I wanted to ask about cost comparison Phasix vs Tigr Matrix. Would anyone here be able to help? Many thanks!

[Alephy]

@drtowfigh Thanks for the video, it was really interesting!

Did I understand correctly that when the absorbable mesh is placed below the muscle the recurrence rate is around 12%? It was also mentioned that depending on the technique the recurrence rate with absorbable meshes can vary dramatically, which prompts my question:
I have often heard doctors say that biological meshes don’t work, but I have failed to see articles detailing clear numbers to this conclusion; in the video the recurrence rate (depending on the technique) is said to vary between 12% and 30%. So has something changed in the technique or mesh quality to account for this discrepancy?
On the one hand it is said that the absorbable meshes just don’t work, and on the other a recurrence rate of 12% to 30% is mentioned: is the 30% upper limit the complete failure argument? (I got the one behind the 80% recurrent rate in case of an incisional hernia, if I remember correctly)

The lower limit, 12%, seems close the synthetic mesh performance to me, which would warrant (costs aside) the use of these meshes.

In answer to the patient’s poll I can say this:

I would be ok with a risk of recurrence up to 30%, as I am inclined to the idea that a hernia surgery might have to be done again in the future. The caveat here is when i.e. if a new surgery will be required down the road in say 10 years or more, it would be still acceptable to me, considering also the possible advancements in technique, materials etc. Should a surgery be required few years after the first one, I would still consider it as a risk worth taking, re-assessing though my options for the second surgery…

My answer is based on my age, lifestyle and expectations for the years to come: I am not in my 20s, and I am not looking at professional competition in a particular sports (the poll should include the age and lifestyle factor in my opinion).

I really liked the idea of an absorbable mesh combined with a tissue only repair, however I have only heard about this possibility in this forum and in the video, which makes me think that this would be difficult to get from an average surgeon (at least in Europe).

Last but not least, offering any alternative to the synthetic mesh (whatever that is) in case of urticaria, allergies etc sounds like a must to me, as a risk prevention measure…

Thanks again for all the info!