Mesh removal and neurectomy
06/20/2020 at 7:58 am #26806aldpeevParticipant
Is it necessary to have a neurectomy (or maybe triple neurectomy) when removing mesh that is open inserted. Why some say neurectomy affects motor functions and it’s not only sensory and others say that it is only sensory. Which one is the truth ?
06/20/2020 at 8:58 am #26807AlephyParticipant
I think it may vary from person to person. BTW I found this article about a professional tennis player having had some nerve burned after an hernia surgery
He is still playing, but it depends on which nerves and what “burned” means exactly…
06/20/2020 at 9:08 am #26809Momof4Participant
I know that a triple neurectomy causes laxity in abdominal wall. I was told no side effects besides sensory before I had it but told otherwise from Dr. Towfigh after the fact. I have bulging in the area.
06/20/2020 at 10:22 am #26811aldpeevParticipant
They have installed me ProGrip mesh and that i found is they dont use tacks to fix it. So if they don’t use tacks it can’t affect ilioingluinal and iliohypogasric nerves (source: https://www.youtube.com/watch?v=YcMflnDNNNM ). Then triple neurectomy is not necessary. Is that source reliable and do I understand it correctly is the question. Is the mesh installed via open method located in the preperitoneal space ? From what I understand, yes. I’m not native English speaker.
06/20/2020 at 10:59 am #26816Good intentionsParticipant
It’s not fixation, tacks, that cause problems with the nerves. It’s the tissue growth in to and around the mesh fibers, and the shrinkage that follows that is the problem. The nerves become trapped along with the mesh in a bundle of scar tissue.
The surgeon removing the mesh has to decide how much time to spend trying to peel the nerves free, or if they even have the steadiness of hand to get it done.
“They have installed me ProGrip mesh and that i found is they dont use tacks to fix it. So if they don’t use tacks it can’t affect ilioingluinal and iliohypogasric nerves”
06/25/2020 at 8:14 am #26843DrBrownParticipant
Whether or not there is muscle weakness after neurectomy depends on where the nerves are cut. The ilioinguinal and the iliohypogastric nerves are both motor and sensory initially but become purely sensory at about the level of the internal ring.
Before mesh is removed, it is important to determine whether or not the nerves are a component of the pain. Physical examination and nerve blocks can help make that determination.
I agree with Good Intentions. A patient can often have nerve pain without staples.
Bill Brown MD
07/01/2020 at 9:25 pm #26916JeromeParticipant
Gasquet had his surgery in Munich and highly likely had the minimal repair technique performed by dr Muschaweck like many European footballers.
Since he mentions nerves being burned, he likely had a neurolysis and neurectomy of the genital branch of the genitofemoral (gfn) and or ilioinguinal nerve. This can be up to 15% if there is any sort of sign of compression or damage to the gfn during the minimal repair technique.
Neurolysis and neurectomy (while still really sucks) during an original repair is not as severe as a neurectomy or neurectomies during mesh removal.
If there is a neurectomy it’s about 2-5mm vs 1 inch or more in a mesh removal.
Whether or not the nerves are at the level of internal ring or not, these are important nerves that indirectly supports male genitalia and our ability to be intimate comfortably.
To say they are just sensory, which I disagree and imply they don’t serve a a specific purpose is insensitive.
07/01/2020 at 10:24 pm #26918AlephyParticipant
Was he operated by Dr.Muschaweck? How did you find out? Couldn’t find this info on the Internet ☺ I wish she operated also in Switzerland 😣
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