News Feed Discussions lingua hernia laproscopic mesh

  • lingua hernia laproscopic mesh

    Posted by tenreasy on August 19, 2018 at 12:27 pm

    I have lingua hernia on the left side. Noticed it about a 4 months ago as a bulge. My general doctor said I have a hernia and recommended that I do nothing. I am 6’1″, 57 yr old, 165 lbs. No other health issues. Good health. Recently it is bothering me if I walk for a long time. Gets bigger and some discomfort. Frequent gurgling sounds. Saw Dr. Mark Toyama in Chicago and he would do a laproscopic mesh repair using polypropelene material. I am freaked out by reading the horror stories of mesh complications. But it seems like all of the surgeons use mesh. Is it because of the new power of social media that the horror stories are distorting the actual success rate of mesh? I am confused. My other option seems like to see Dr. Tomas in Florida to do the Desarda technique.

    joep replied 5 years, 4 months ago 11 Members · 22 Replies
  • 22 Replies
  • joep

    Member
    October 15, 2018 at 7:16 am

    Thanks [USER=”2019″]drkang[/USER]. The problem is surgeons who practice non-mesh surgeries are very few now, and this skill is largely lost from most surgeons. Most patients cannot afford to travel to these specialist clinics (who practice non-mesh surgery). Hernia repair is one of the most common surgeries performed in world, so unless non-mesh repair is more practiced around world, there is not much patients can do about it.

  • UhOh!

    Member
    October 15, 2018 at 3:15 am
    quote drkang:

    Hi Jnomesh,

    I feel strong companionship with some people on this forum. It is the job of doctors like me who know the seriousness of mesh to pose issues concerning mesh. But you all on this forum are taking the trouble to do so. As a doctor, I am regretful of this.
    I am actually more fundamental than you think. Through the 15,000 inguinal hernia surgeries that I have performed, I have gained firm conviction that mesh is not required for successful inguinal hernia repairs. By successful, I mean minimizing recurrence and complication.
    Doctors that support mesh hernia repair always reiterate “evidence-based medicine’. But why is it that only a portion of published studies can be called “evidence”? Not only are there many “evidence” on this forum, mesh pain stories frequently appear in actual clinical fields. I do not understand why these cannot be called “evidence”.
    Some emphasize that there are people who get good results through mesh repair. This is true. 80-90% of patients that underwent mesh inguinal hernia repair are satisfied with successful results. However, this also means that 10-20% of patients awaiting mesh repair will encounter issues post-surgery. This is not a risk that can be overlooked.

    The most effective way to make doctors realize the seriousness of mesh complication is to have them personally remove the problematic mesh that they have implanted. Once this is done, no doctor will be able to disregard the gravity of mesh complication. The problem is, many doctors avoid personally removing the mesh that they have implanted. Their reason is that they are not capable of performing such removal surgery. This is merely an excuse. Doctors who perform mesh removal were not born with the skills to do so. Also, this surgery is not something that can be learned from someone else. It is a surgical process that has to be carried out personally and requires familiarizing and mastering of the process. So, doctors that claim they do not know how to remove mesh implants and direct patients to another doctor are really saying that they do not want to perform such a laborious surgery. Therefore, patients suffering from mesh pain have to persistently request for the doctor that implanted the mesh to remove it personally.

    I have conducted mesh removal on more than 50 patients and for every one of them, one thing always came to my mind. It is that the doctor that implanted the mesh would be able to remove it the most safely. This is because each doctor has a distinct method of mesh repair and thus naturally, would know the inserted state better than anyone else. Therefore, if suffering from mesh complications, patients should continuously complain to the doctor that performed the hernia repair and if mesh removal is decided, patients should persistently demand that doctor to personally remove it. If many patients do this, the number of doctors performing mesh repair will rapidly decrease.

    It will be interesting to see how the push here in the States towards Value Based Care (where insurance reimburses physicians based on the outcome), vs. Fee For Service, will impact hernia surgeries. It will undoubtedly depend on how those insurers define “success” when it comes to outcomes; if chronic pain is considered a “failure” then there will be a bigger push towards improving techniques and materials. However, if recurrence is the only basis for judging success or failure, then I think we will find surgeons even more reluctant to return to non-mesh methods, since it is somewhat of an unknown for them, when their mesh repairs yield virtually no recurrence.

    If chronic pain necessitating removal is considered a failure, and there is at least a partial clawback of compensation paid by the insurers to the surgeons, then that will certainly help push them in the direction of basing decisions solely on the likelihood of recurrence.

    Personally, I don’t consider life with a hernia that bad (granted, mine is confirmed by ultrasound to contain only fat), and if I were to have it repaired, I would gladly take an increased recurrence risk over the risk of new pain. Worst case scenario, I’m back where I started but with a new scar…

  • drkang

    Member
    October 15, 2018 at 12:08 am

    Hi Jnomesh,

    I feel strong companionship with some people on this forum. It is the job of doctors like me who know the seriousness of mesh to pose issues concerning mesh. But you all on this forum are taking the trouble to do so. As a doctor, I am regretful of this.
    I am actually more fundamental than you think. Through the 15,000 inguinal hernia surgeries that I have performed, I have gained firm conviction that mesh is not required for successful inguinal hernia repairs. By successful, I mean minimizing recurrence and complication.
    Doctors that support mesh hernia repair always reiterate “evidence-based medicine’. But why is it that only a portion of published studies can be called “evidence”? Not only are there many “evidence” on this forum, mesh pain stories frequently appear in actual clinical fields. I do not understand why these cannot be called “evidence”.
    Some emphasize that there are people who get good results through mesh repair. This is true. 80-90% of patients that underwent mesh inguinal hernia repair are satisfied with successful results. However, this also means that 10-20% of patients awaiting mesh repair will encounter issues post-surgery. This is not a risk that can be overlooked.

    The most effective way to make doctors realize the seriousness of mesh complication is to have them personally remove the problematic mesh that they have implanted. Once this is done, no doctor will be able to disregard the gravity of mesh complication. The problem is, many doctors avoid personally removing the mesh that they have implanted. Their reason is that they are not capable of performing such removal surgery. This is merely an excuse. Doctors who perform mesh removal were not born with the skills to do so. Also, this surgery is not something that can be learned from someone else. It is a surgical process that has to be carried out personally and requires familiarizing and mastering of the process. So, doctors that claim they do not know how to remove mesh implants and direct patients to another doctor are really saying that they do not want to perform such a laborious surgery. Therefore, patients suffering from mesh pain have to persistently request for the doctor that implanted the mesh to remove it personally.

    I have conducted mesh removal on more than 50 patients and for every one of them, one thing always came to my mind. It is that the doctor that implanted the mesh would be able to remove it the most safely. This is because each doctor has a distinct method of mesh repair and thus naturally, would know the inserted state better than anyone else. Therefore, if suffering from mesh complications, patients should continuously complain to the doctor that performed the hernia repair and if mesh removal is decided, patients should persistently demand that doctor to personally remove it. If many patients do this, the number of doctors performing mesh repair will rapidly decrease.

  • Jnomesh

    Member
    October 14, 2018 at 1:07 am

    I also think it is really inaccurate for studies to compare mesh vs non mesh repairs outside of recurrence. When you compare pain between the two t’s impossible to know what the source of one pains is with mesh is and the severity of causes , as mesh can harden, migrate, fold up, encase nerves, become infected, attached to one’s bladder, intestines and other things like autoimmune disorders which I think in time Will come to light as a possible side affect of mesh as well as one being allergic to mesh.
    It’s s fine to analyze different types of pure tissue repairs but analyzing “pain” from one method using one’s own tissue and some sutures and another method that uses large piece of plastic inserted into someone’s abdomen meant to be permanent just seems really not to smart.
    so i ask people this (and I’m directing this around I inguinal hernias ) if pain is relatively similar between mesh and non mesh repairs (which I personally don’t believe) and let’s even say recurrence rates are a tad lower with mesh (although a specialty hospital like the shouldice clinics data blow away mesh results in regards to both pain and recurrence) then why is it that mesh repairs are the gold standard and dominate the industry? Why is it that one has to search high and far to find a surgeon who has expertise in pure tissue repairs? Why arent peoe offered a choice? Why has one method so dominated the other? Anyone who says big pharma doesn’t heavily answer my question is just fooling themselves. Statistically speaking pure tissues repairs in this country are practically extinct-instead people are left with no choice but to be implanted with permanent mesh or travel to another country to get a non mesh one.
    On top of that mesh companies are frequently coming out with “new and better” meshes. Why?
    why are meshes recalled? Why is mesh in other countries for women with pelvic problems being banned? Why is there not even a registry for mesh that is used and patients complajts documented and tracked. Why is mesh pushed through a unregulated 510k process that does not require clinical trials. Why is there no protocol to deal with issues that maybe and are probably mesh related? Why are there practically no surgeons (except for a few compared to thousands who do the implanting surgery ) who are trained specialists on removing mesh? And dealing with long term pain issues from the surgery. Why is there no back up plan when things go bad with mesh?
    something is just very fishy.
    Hey I’m not saying mesh is evil and I’m not saying get rid of mesh but what I am asking for is a choice and not just a choice but a real choice as in surgeons being trained in both procedures equally-not 2 or 3 who specialize in non mesh orepairs in the United States. I’m asking for patients to be educated by surgeons they see regarding the draw backs and dangers of mesh even if the surgeon believes they are small or “never happens “ to their patients. Let people k ow that they are permanent and they can’t be removed. Surgeons let your patients know if something does go wrong with the mesh that you can’t remove it and let your patient k or they are screwed for life.
    its time for the plahjnf field to be evened out-I think rationale people can agree to this.
    It doesn’t really matter what the pain post mesh implantation percentages are, for the people who have them their lives they once knew are changed forever and they face a medical community all to willing to look them in the eye and say it has nothing to do with the mesh-I’ve lived through it and ultimately had to have it removed Bc guess what my mesh it turned out had rolled up into a rock hard ball and attached itself to many organs and structure that it shouldn’t have. But guess what from the outside it all looked fine and 6 months of being passed to surgeon to surgeon test to test doctor to doctor all said there is nothing wrong with me and the mesh looked fine and even if something was wrong it couldn’t be removed because it would kill me. Nothing worse to be in sickening pain and not to believed by the medical community. However this part of my journey/story is what every single person who has had mesh pain has gone through. How heartbreaking and how shameful that the medical community turns a blind eye when someone who didn’t have the pain before being implanted with mesh is dismissed and passed off.
    That being said many thanks to the few surgeons out there like dr. Towfigh, Belyanski, Ramshaw, Billings, Jacobs who at least can offer people some hope who have issues with mesh even though they all overwhelmingly support the use of mesh as the gold monopolistic standard for hernia repair.
    My hope is non mesh repairs can make their way back and surgeons can specialize in doing them tans doing them often-not to replace mesh not to be a suitable alternative. And simultaneously my hope that the guidelines for mesh become stricter-which included clinical trials in humans (sorry animals can’t tell you if they are in severe pain ) as well as a registry to track every implant and track patients complaints.

  • Good intentions

    Member
    October 12, 2018 at 6:49 pm
    quote drtowfigh:

    [USER=”2029″]
    The most recent study published this past year put mesh and non-mesh repairs head-to-head and showed the risk of chronic pain is similar. It’s important to not that historically, tissue repairs were very painful and patients had to miss work and some were maimed by the repair. That is why a tension-free mesh repair was developed. For the first time, an inguinal hernia repair could be done as an outpatient and didn’t require a 3-day hospital stay. People tend to forget these details.

    Thank you for the reply Dr. Towfigh. I think that you have conflated the short-term with the long-term, as is often done. Short-term is business, the 3-day hospital stay; long-term is Hippocratic, as in “do no harm”. I think that you are right though, in that people have forgotten what the purpose of the repair is – the quality of the rest of the patient’s life. Many years. Not the hospital stay. No offense intended but it’s right there, in your words.

    I would have taken a one month hospital stay if it meant I could have avoided the last four years of dealing with this mesh-caused mess in my abdomen. I would have taken two good years and a recurrence. I would have taken living with the hernia. If somebody had told me the true risk of having mesh implanted I would have avoided it. Instead it was sold as easy, low risk, walk-in-walk-out, you’ll be back to work in a few days, you’ll be back to full performance as an athlete, you’ll be normal again, surgery. I was sold a false story. Lied to, to be blunt.

    Do you have a reference for that most recent head-to-head comparison paper? I have not seen a well-done long-term study. Most use short-term results, and many seem biased toward showing that mesh is “okay”, or that it’s no different than a tissue repair. Many are funded by the device makers, indirectly. The medical field, and society in general, needs some good honest hard-working researchers, unbiased by device maker support, to do real research, exposing the truth. In the long term, everyone will benefit. In the meantime, lack of knowledge and business reasons will be used to keep the mesh industry growing.

    Sorry to be so blunt. I have worked for several very large organizations and have seen how these situations develop. Once the commitment is made and the money and effort is spent to build the program it’s very difficult to get people to see the truth, if the program was built on faulty reasoning. Lives and careers are built around the sales and implantation of surgical mesh, right or wrong.

  • saro

    Member
    October 12, 2018 at 5:46 pm
    quote drtowfigh:

    [USER=”2029″]Good intentions[/USER] this is an important discussion to have.

    Chronic pain comes in various flavors. There is mesh-related chronic pain, but there is also non-mesh related chronic pain.

    We know that there is risk fo chronic pain with any operation, regardless of technique. We also know that each patient will have their own risk of chronic pain, different than their neighbor. We haven’t figured out why that is. It’s the billion dollar question no one has been able to figure out yet.

    The most recent study published this past year put mesh and non-mesh repairs head-to-head and showed the risk of chronic pain is similar. It’s important to not that historically, tissue repairs were very painful and patients had to miss work and some were maimed by the repair. That is why a tension-free mesh repair was developed. For the first time, an inguinal hernia repair could be done as an outpatient and didn’t require a 3-day hospital stay. People tend to forget these details.

    The reality is there is no one ideal repair. Some will do best with non-mesh repair. Others with mesh repair.

    My doctor, congratulations on the excellent work done to guide people to the best solution. We know a lot from your words. You have argued, unfortunately, that chronic pain remains an unknown quantity and does not depend on the type of intervention, mesh or non-mesh. You have also argued that laparoscopic surgery has a lower incidence of chronic pain, yet it seems to me to apply only synthetic networks, not biological, so it may feel in some subjects also the presence of the network, I suppose. However, from what is evident, the idea of making me fall asleep and inflate a gas …. I can not ask you to go beyond your already clear exposure. But, as I said, every word of yours adds knowledge to our experience and helps us

  • dog

    Member
    September 16, 2018 at 5:16 am
    quote tenreasy:

    I’ll let one the doctors chime in, but urinary retention after surgery is a risk which is caused by the general anesthesia. Could happen in any surgery where you receive general anesthesia. Plus the fact that I am 57 yr old male with not the greatest prostate. It is a risk you will have to consider.

    One thing I will say is that I am glad I had the procedure done locally so that my wife could help. Travelling by myself from Chicago to somewhere like Florida really did not sound appealing. If everything goes ok then fine; but still the thought of outpatient surgery and then going to a hotel to recuperate by myself did not seem attractive. Just my 2 cents.

    Well, sometimes you can do it under local sedation.. .or prostate must be advised by doctor to be treated before surgery or used different type of general anesthesia or if doctor see that can happen with you ! ..Sorry it is not about you..It is about our medical system that is totally out of any common sense and control >>> Doctors use general methods like robots themselves … Philosophy is clear “ONE tool fits al” l without considering our special circumstances and after they get way with everything ..They are Breaking main low ..”.Don t harm!!!

    If i conduct my business that way i would be out of business ..like a lot of You! ! . People come to me with problem pets from all over USA.. .Yes ! CANT fix every case…some of it driven by genetics or just too far gone :{ i am not Jesus or God .but i can make it better all the time …just the question is…to what degree ? That depends not just of me ..SO.. i let people straight FORWARDLY know about risk and limits, even if some CLIENTS have a hard time to hear it.. ..That is my principles!

    I tell them what i can do for min result .. and ask if it is OK ? .and trying for max of course.

    By contrast i remember when i meet doctor here in Newport beach ca ..He was telling me how mesh surgery is simple and easy..and side effect less then 1 PERCENT ..just was POLITE AND SMILING { Southerner California style;:}}} whole time….

    After that HE TOLD ME THAT that pain possible can happen..HE HAS NO control ..no one know why pain CAN HAPPEN million reasons for that ….so he was preparing me ..so i will possibly have bad reaction or something unknown
    Well I believe that the only one thing doctors must blame their own negligence and poor training.

  • dog

    Member
    September 16, 2018 at 3:22 am
    quote Good intentions:

    I hope you won’t be offended Dr. Towfigh, but your comment really affected me when I saw it. So I wrote this…

    Hello Dr. Towfigh. I’m sure that you agree, as a doctor and a scientist, that the issue of chronic pain is not one of whether or not laparoscopic techniques are “better” than open techniques, but one of whether pure tissue repairs are better than the new mesh repairs, and/or whether there are certain mesh materials and methods that are the cause of the high levels of chronic pain.

    As you know, to do good scientific work, and to make good decisions, good meaningful numbers are needed. Is a 10% chronic pain rate really better than a 15% chronic pain, for example, if a method exists that gives a 2% chronic pain rate? It seems that the commitment and investment in laparoscopic training, and/or open repair with mesh, is dominating the market and the discussion, leading people to compare which of two “bad” methods are best, instead of perfecting these new methods so that true claims of superiority can be made..

    Defining things in terms of better or worse is just not going to produce true progress in stopping the growth of the chronic pain problem.

    As someone who has been harmed by today’s “best” method of TEP implantation of lightweight mesh by a highly trained, experienced surgeon, and whose problems were found to derive solely from the mesh, no errors in technique, I feel obligated to make this point. No effort has been made by anyone involved in my situation, a perfectly healthy male in excellent shape, a perfect “candidate” for TEP mesh repair, to understand why this optimum method did not work. Chronic pain is, today, accepted as normal, with pain medication used as the solution to the problem.

    If prospective patients keep getting assurances that these undefined materials and methods are “better” than others but without knowing the true risk, in usable numbers, then it will be impossible to improve the situation. People need to be aware that there is still significant risk of very debilitating chronic pain. Lucky46 is an example of how bad things can get.

    Sorry to be so blunt but comforting words aren’t going to help anybody. They just perpetuate a bad situation.

    Good luck tenreasy. I hope that your recovery goes well and that your long-term outcome is one of the good ones. I assume that my words in my previous post, #3, just sounded like the rant of a weak-willed person and you decided to go with what the surgeon told you would work? Can you give more details on the materials used and how it was placed? The possible combinations of materials and methods, using mesh, is really incredible, and adds to the lack of focus and progress. The situation cannot reasonably be described in simple terms of mesh, laparsoscopic or open, I think.

    Good intentions

    The problem is ..that no one cares about your pain.. Private medical system driven just by One think by Profit. …. they will convince us about everything and of course that risk of chronic pain is reality with any operation, regardless of technique…{.well to me it is hard to believe} … if person had no pain before and has pain after ..it means doctors didn’t do meticulous work { plan and execute} with greatest detail how headlining tissues and nerves and pick most safest techniques ..possibly not most profitable.. .. Everyone can have PAIN …..it is really sorry statement almost kind of excusing mistakes doctors makes that they will never admit,,,, of course :}

  • tenreasy

    Member
    September 16, 2018 at 12:42 am

    [USER=”2029″]Good intentions[/USER] I hope you feel better and get any hernia issues resolved. Well let’s not scare the heck out of me. Hoping my recovery goes well with no chronic pain issues! Northwestern is a great hospital by the way. Very pleased with the care. Only need to take Tylenol a couple times a day. Quickly gaining my strength for longer walks.

  • drtowfigh

    Moderator
    September 16, 2018 at 12:07 am

    [USER=”2029″]Good intentions[/USER] this is an important discussion to have.

    Chronic pain comes in various flavors. There is mesh-related chronic pain, but there is also non-mesh related chronic pain.

    We know that there is risk fo chronic pain with any operation, regardless of technique. We also know that each patient will have their own risk of chronic pain, different than their neighbor. We haven’t figured out why that is. It’s the billion dollar question no one has been able to figure out yet.

    The most recent study published this past year put mesh and non-mesh repairs head-to-head and showed the risk of chronic pain is similar. It’s important to not that historically, tissue repairs were very painful and patients had to miss work and some were maimed by the repair. That is why a tension-free mesh repair was developed. For the first time, an inguinal hernia repair could be done as an outpatient and didn’t require a 3-day hospital stay. People tend to forget these details.

    The reality is there is no one ideal repair. Some will do best with non-mesh repair. Others with mesh repair.

  • Jnomesh

    Member
    September 15, 2018 at 11:07 pm

    I think that was a very thorough and well thought out response Good intentions. I also think one of the issues is the reporting of chronic pain.
    In the real world outside of these studies people who have chronic pain and go back to their implanting surgeon in most cases are eventually dismissed by there surgeon as there is nothing else they can do for them and it’s off to pain management. I seriously doubt that any of these chronic pain cases are being reported by the actual implanting surgeons and on top of that manny people are being told by their surgeons and other professionals that the pain they are experiencing int due to to the surgery so people leave and go off on other ventures, their back, hip, GI etc. it’s really a shame-there absolutely needs to be a registry and Surgeons by law need to document pain issues so we can get true numbers
    reagsrdi pain with mesh-especiallgy when you take into consideration mesh is meant to be a permanent implant. The fact that there isn’t even a protocol to make sure someone isn’t allergic to plastic is rediculous even it is most likely a small amount of people-we are taking about a permanent piece of plastic.
    i also believe for some people the mesh causes or exasperated autoimmune issues. I’m not drawing straws out of thin air-I talk to many people these days who are having autoimmune issues after being implanted with mesh. Some cases are immediate some show up years later.
    when these issues arise the mesh is never suspected instead they go down the typical route of being passed off to the GI specialist etc.
    bottom line is there needs to be new protocols when it comes to mesh. Mesh should at this point not be the gold standard it should be a option, and a option that most patients should have the choice about and also be able to choose a pure tissue repair. And as a result we need Surgeons to be trained on becoming experts at pure tissues repairs otherwise what’s the point. Every surgeon need to be trained on meeh removal and how to spot mesh issues. People can’t be used as guinea pigs.
    im currently speaking to someone whose husband had laparoscopic mesh inserted for a inguinal hernia and the husband is in pain lots of burning and inflammation and it’s beem almost 5 months post impantation. He is a formal shell of his self before surgery. Sorry but this isn’t normal. He has tried nerve blocks and been put on gabapentin which have not helped The surgeon had passed him off to a surgeon who deals with mesh issues-not a name on the list on some of these posts.
    this new surgeon has rx ibuprofen for 2 months and to come back in 2 months.
    If I were a betting man you can see where this is going. The pain will continue-maybe it will be numbed by the Ibuprofen but once that is discontinued it will still be there at which time in 2 months and then the surgeon will say he still doesn’t think it’s the mesh etc.
    really a sad state of affairs.
    one of the most common things I see when I speak to people who have severe pain/issues after hernia repair with mesh is that they get passed off from the implanting surgeon as the mesh surgery isn’t the cause. However it’s real simple if the pain wasn’t present before the surgery then it is due to the surgery!!!!
    if mesh is going to be used then at the very least we need a responsible system to help people and to recognized the it’s either due to the mesh itself or caused by the mesh secondarily ie nerves trapped by mesh etc.
    mesh has now been discontinued:banned in some countries (australia and Scotland) used for pelvic problems in women. These women lives have been ruined and revision surgery for many has not worked-if they can even find a surgeon willing to remove the mesh and believe the pain is caused by the mesh-sound familiar.-they are still left in debilitating pain Bc iof the widespread damage mesh can do. It’s only a matter of time before the attention turns to mesh for hernia repairs. Human lives have to be put ahead of big pharma profits.

  • Good intentions

    Member
    September 15, 2018 at 5:38 pm
    quote drtowfigh:

    [USER=”2686″]tenreasy[/USER]
    Also, though I agree with what has been written about national chronic pain rates, those studies were for open repair with mesh. Those risks have been shown to be significantly lower with laparoscopic repair.

    I hope you won’t be offended Dr. Towfigh, but your comment really affected me when I saw it. So I wrote this…

    Hello Dr. Towfigh. I’m sure that you agree, as a doctor and a scientist, that the issue of chronic pain is not one of whether or not laparoscopic techniques are “better” than open techniques, but one of whether pure tissue repairs are better than the new mesh repairs, and/or whether there are certain mesh materials and methods that are the cause of the high levels of chronic pain.

    As you know, to do good scientific work, and to make good decisions, good meaningful numbers are needed. Is a 10% chronic pain rate really better than a 15% chronic pain, for example, if a method exists that gives a 2% chronic pain rate? It seems that the commitment and investment in laparoscopic training, and/or open repair with mesh, is dominating the market and the discussion, leading people to compare which of two “bad” methods are best, instead of perfecting these new methods so that true claims of superiority can be made..

    Defining things in terms of better or worse is just not going to produce true progress in stopping the growth of the chronic pain problem.

    As someone who has been harmed by today’s “best” method of TEP implantation of lightweight mesh by a highly trained, experienced surgeon, and whose problems were found to derive solely from the mesh, no errors in technique, I feel obligated to make this point. No effort has been made by anyone involved in my situation, a perfectly healthy male in excellent shape, a perfect “candidate” for TEP mesh repair, to understand why this optimum method did not work. Chronic pain is, today, accepted as normal, with pain medication used as the solution to the problem.

    If prospective patients keep getting assurances that these undefined materials and methods are “better” than others but without knowing the true risk, in usable numbers, then it will be impossible to improve the situation. People need to be aware that there is still significant risk of very debilitating chronic pain. Lucky46 is an example of how bad things can get.

    Sorry to be so blunt but comforting words aren’t going to help anybody. They just perpetuate a bad situation.

    Good luck tenreasy. I hope that your recovery goes well and that your long-term outcome is one of the good ones. I assume that my words in my previous post, #3, just sounded like the rant of a weak-willed person and you decided to go with what the surgeon told you would work? Can you give more details on the materials used and how it was placed? The possible combinations of materials and methods, using mesh, is really incredible, and adds to the lack of focus and progress. The situation cannot reasonably be described in simple terms of mesh, laparsoscopic or open, I think.

  • drtowfigh

    Moderator
    September 15, 2018 at 3:44 pm

    [USER=”2686″]tenreasy[/USER] Dr Toyama is an excellent surgeon.

    Also, though I agree with what has been written about national chronic pain rates, those studies were for open repair with mesh. Those risks have been shown to be significantly lower with laparoscopic repair.

    Finally, the risk of urinary retention is a combination of anesthesia and enlarged prostate. It is at higher risk with most pelvic surgery, which includes all inguinal hernias.

  • tenreasy

    Member
    September 15, 2018 at 2:26 pm

    I’ll let one the doctors chime in, but urinary retention after surgery is a risk which is caused by the general anesthesia. Could happen in any surgery where you receive general anesthesia. Plus the fact that I am 57 yr old male with not the greatest prostate. It is a risk you will have to consider.

    One thing I will say is that I am glad I had the procedure done locally so that my wife could help. Travelling by myself from Chicago to somewhere like Florida really did not sound appealing. If everything goes ok then fine; but still the thought of outpatient surgery and then going to a hotel to recuperate by myself did not seem attractive. Just my 2 cents.

  • dog

    Member
    September 15, 2018 at 5:17 am
    quote tenreasy:

    I have lingua hernia on the left side. Noticed it about a 4 months ago as a bulge. My general doctor said I have a hernia and recommended that I do nothing. I am 6’1″, 57 yr old, 165 lbs. No other health issues. Good health. Recently it is bothering me if I walk for a long time. Gets bigger and some discomfort. Frequent gurgling sounds. Saw Dr. Mark Toyama in Chicago and he would do a laproscopic mesh repair using polypropelene material. I am freaked out by reading the horror stories of mesh complications. But it seems like all of the surgeons use mesh. Is it because of the new power of social media that the horror stories are distorting the actual success rate of mesh? I am confused. My other option seems like to see Dr. Tomas in Florida to do the Desarda technique.

    I would Run to him or to one more great doctor i like a lot in Florida ..- Dr Jonathan Yunis in Sarasota, FL :}

  • dog

    Member
    September 15, 2018 at 5:10 am
    quote tenreasy:

    Except for the minor problem where I could not urinate after the surgery (it resolved the following day) everything went fine. . So far so good.

    WOW!!!! How Humble we are to accept such treatment..where cure is worse the disease..NOT acceptable side effect ..i would not call it minor..it gives these doctors incentives to those doctors make excuses for everything.. Dr drkang Could that happend with you ..if you would do this surgery….Why this could happend .i would made the fur fly…!

  • tenreasy

    Member
    September 14, 2018 at 8:57 pm
    quote Chaunce1234:

    Good luck and keep us updated on your case and decision making.

    The hernia was getting larger and bothering more. Low level pain discomfort. I had surgery 4 days ago – robotic laparoscopic with mesh done in Chicago. Except for the minor problem where I could not urinate after the surgery (it resolved the following day) everything went fine. Minimal pain; only need to take Tylenol as needed. Walking helps a lot. Limited to lift nothing over 15 lbs for 6 weeks. Doing light housework and driving ok. So far so good.

  • tenreasy

    Member
    September 14, 2018 at 8:31 pm

    The hernia started to really bother me while I was on vacation. Maybe longer walks aggravated it. Mild pain but the hernia was getting larger. Had surgery 4 days ago in Chicago. Everything went well except I could not urinate after the surgery but that resolved the next day. Minimal pain, only need to take Tylenol once in awhile. Getting my strength back quickly. Limited to lifting less than 15 lbs for 6 weeks.

  • dog

    Member
    August 25, 2018 at 5:03 am

    Dr Jonathan Yunis in Sarasota, FL is exceptional expert !

  • Chaunce1234

    Member
    August 20, 2018 at 6:41 pm
    quote tenreasy:

    I have lingua hernia on the left side. Noticed it about a 4 months ago as a bulge. My general doctor said I have a hernia and recommended that I do nothing. I am 6’1″, 57 yr old, 165 lbs. No other health issues. Good health. Recently it is bothering me if I walk for a long time. Gets bigger and some discomfort. Frequent gurgling sounds. Saw Dr. Mark Toyama in Chicago and he would do a laproscopic mesh repair using polypropelene material. I am freaked out by reading the horror stories of mesh complications. But it seems like all of the surgeons use mesh. Is it because of the new power of social media that the horror stories are distorting the actual success rate of mesh? I am confused. My other option seems like to see Dr. Tomas in Florida to do the Desarda technique.

    Statistically, chronic pain is the biggest risk of inguinal hernia surgery, and you can find many large scale studies that support that as the risk to be concerned about. [USER=”2029″]Good intentions[/USER] makes excellent points that are worth considering.

    In the middle of the USA you can also consider reaching out to the following surgeons who are able to perform both mesh and no-mesh repair methods for hernias:

    – Dr David Grischkan in Cleveland, Ohio

    – Dr Paul Szotek in Indianapolis, IN

    – Dr Bruce Ramshaw in Knoxville, TN

    – Dr Jonathan Yunis in Sarasota, FL

    – Dr Robert Tomas in Fort Meyers, FL

    – Shouldice Hospital in Toronto Canada

    There are other options elsewhere in the country/world too, but you are correct that most surgeons use mesh.

    My personal opinion is to find a surgeon who does a lot of hernia surgeries with successful patient outcomes. If you want a mesh repair, find someone who does a lot of mesh repairs. If you want a no-mesh repair, find someone who does a lot of no-mesh repairs. Practice makes perfect, one would assume.

    Good luck and keep us updated on your case and decision making.

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