Mesh removal and neurectomy

Hernia Discussion Forums Hernia Discussion Mesh removal and neurectomy

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    • #26806
      aldpeev
      Participant

      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 ?

    • #26807
      Alephy
      Participant

      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

      RIchard Gasquet: “I Spent the First 15 Days in Bed”

      He is still playing, but it depends on which nerves and what “burned” means exactly…

    • #26809
      Momof4
      Participant

      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.

    • #26811
      aldpeev
      Participant

      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. 

    • #26816
      Good intentions
      Participant

      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”

    • #26843
      DrBrown
      Participant

      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.
      Regards.
      Bill Brown MD

    • #26916
      Jerome
      Participant

      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.

    • #26918
      Alephy
      Participant

      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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