Mesh in Elective Hernia Repair: 10-Year Experience with over 6,000 Patients

Hernia Discussion Forums Hernia Discussion Mesh in Elective Hernia Repair: 10-Year Experience with over 6,000 Patients

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    • #29464
      Good intentions
      Participant

      Here is the abstract of a newly published paper, reviewing ten years of hernia repairs using synthetic mesh.

      4.4% of the patients reported severe or disabling symptoms at 5 years.

      No percentage is given for patients who reported “excellent long-term quality of life” (long-term being up to ten years only, actually, by the bounds of the study). Instead of a precise number the old fall-back of “a majority of patients” is used. 51% is a majority.

      In the one graphic that is legible you can see that they minimize complications down to “bothersome mesh sensations”. No percentage is shown in the abstract for those being bothered. Instead they center and highlight mesh infection and show the low percentage.

      https://ars.els-cdn.com/content/image/1-s2.0-S1072751521001848-fx1_lrg.jpg

      I wish that I was not so cynical but the verbiage and presentation is disingenuous. Just report the numbers and let the reader decide. It might be in the full text but it is a pay-per-view document. Three of the authors are paid consultants of big mesh makers.

      The efforts continue to find a reason to continue to use mesh. Most seem fruitless, but at least this group published the results. Unlike the “International Hernia Mesh Registry” that Johnson & Johnson keeps delaying.

      https://www.sciencedirect.com/science/article/abs/pii/S1072751521001848

      Excerpt:

      “Conclusions
      Rates of mesh-related complications vary by hernia type. A majority of patients report excellent long-term quality of life, although a relatively large percentage of patients experience severe or disabling symptoms at long-term follow-up.”

    • #29465
      Good intentions
      Participant

      I just found a video presentation about the study. Posting before I watch it.

    • #29466
      Good intentions
      Participant

      The video is worth watching. It is surprising, or not, that this large group of authors, some of them representing several of the big mesh makers, combined all types of mesh materials and forms, in to “mesh”. And they did not define the method of implantation. Apparently they just see it all as essentially the same. All mesh is the same and it doesn’t matter how it is implanted.

      Overall, frankly, it seems like a project simplified down to “mesh is okay”. It is very thin on useful information.

      And, again, if you add up everything greater than and including “bothersome” you get about 15%. 16% to be exact.

      In the end, just another report that everything is fine with mesh implantation, except watch out if you’re a young woman and avoid Surgeon A.

    • #29467
      Good intentions
      Participant

      The primary author is from a large laparoscopic mesh implantation center.

      https://www.northshore.org/gi-and-general-surgery/general-surgery-programs/comprehensive-hernia-surgery/

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