Mesh Removal

[Good intentions]

G’s comment to me in Dc’s post got me to looking for when I joined the forum. It looks like it was a few months before I had mesh removal, in 2017. This might contain my first post, I’m not sure.

My comments, above, in this thread show that I was pretty disappointed in what I had learned since having problems with the mesh implantations and the fight to get the problems solved. Not much has changed since then. Mesh removal is much easier to find on the internet now, it was very difficult even just six years ago. I found Dr. Billing’s name on a forum for runners and a couple of other sites and had to use that sparse information to make a decision. I don’t think that there were any mesh removal videos on YouTube at all. It wasn’t discussed in open like it is today. I guess that’s an improvement.

[ajm222]

this is old but a thread i re-read constantly as i prepare to potentially have my removed soon.

maybe @drtowfigh can comment, but i was told that i’d likely no longer have a hernia even after removal because the robotically-placed mesh would normally create a ‘scar plate’ that would remain after removal and hold things in. sounds like @vtjbrent had a tissue repair after his was removed, suggesting maybe that wasn’t the case here. just curious as to why. not sure how his original mesh was placed but have to assume it was laparoscopic.

by the way, my current reasons for having my mesh removed are primarily foreign body sensation. also get the ‘pulling/tugging’ described above. not having pain much anymore. still weighing the risks/benefits give those facts.

thanks

[Cortz]

Hi DianeW

i know it’s been awhile but just wondering how you went finding someone in Australia?

Thank you

[Jnomesh]

There are a number surgeons listed in this site that specialize in mesh removal. Dr. Bruce Ramshaw, TN, dr. Igor Belyanski (Maryland-and who removed my mesh), dr. Sherwin Towfigh CA.
there are others but those are the tips in my opinion.

[thomson033]

I had emergency hernia surgery in Mexico and am dealing with chronic pain now. I only just received the surgical report and discovered they used a mesh to repair the hernia. My Dr has recommended I have the mesh removed so now I am looking for a Dr who is experienced in removing it and then repairing the hernia properly without the mesh. Does anyone know of any surgeons in Ontario Canada who is experienced in this. From what I understand a lot of Dr’s do not like doing this. Any help would be really appreciated. I am in the Canadian Military so if need be I could probably travel to get this done but I would like to keep it local.

[drtowfigh]

[USER=”2384″]jerseattlewa[/USER] : In Washington state, my colleagues who may be willing to remove mesh include: Andrew Wright, Peter Billings, Rebecca Petersen.

Why are you on Cipro? Are they treating a real infection? Epididymitis (if you are male)?

Dr. Raz is a urologist specializing in female surgery. The mesh issues and techniques to evaluate the vaginal wall (e.g., ultrasound) are different than inguinal hernia-related mesh issues and techniques for evaluation.

[drtowfigh]

[USER=”2345″]DianeW[/USER] : Some surgeon colleagues of mine in Australia that may be helpful to you. Not sure if they remove mesh: Keith Towsey, George Petrou, Rod Jacobs, Phil Lockie, Peter Bovey, David Wardill, Darrin Goodadll-Wilson, Mohammed Ballal.

[Good intentions]

quote Jhf1210:

I am now 16 months past my open ilingual surgery with as
much if not more residual pain post surgery. I’ve been able to participate in some strenuous activities without being incapacitated by the pain but wake up every day with some level of discomfort and outright pain. I’ve been through acupuncture, massage and rest with varying degrees of relief. I’ve even been to another University of Washington surgeon for a second opinion and been told that the history shows that the surgeon did what he would have done and that neither of them have had this experienced before. He indicated that mesh removal is painful 2 plus month recovery and likelihood of recurrence, pushing me toward not pursuing removal.

It’s very difficult for healthy people with no pain to understand what it’s like to live with constant pain. The typical surgeon is healthy with no chronic pain. The word “pain” implies something sharp and intense but it’s really the knowledge and feeling that the pain, even if it’s at a very low level, never goes away, that you’ll never be healthy again that drives the patient to having mesh removed. The doctors tend to think mechanically, about where the parts are and if they are functioning correctly. So, really, the typical doctor’s opinion about what you should do about your pain is almost meaningless. He or she can only really offer good advice if they have a history of patients who they have “fixed”. Then they’ll have a base of opinions from their patients that they can pass on to you, and they’ll have a better idea of who they can help. In short, find a doctor who has “fixed” people with mesh problems. The ones who haven’t can only do what yours did and say that they don’t know. They don’t have anything to refer to.

I know that’s what you’re asking for but I just wanted to reiterate the fact that talking to someone with experience in mesh removal is the key. Chaunce1234 supplied a list in Post #4 in this thread – https://www.herniatalk.com/6259-seek…emoval-surgeon

Do you have any more details about your procedure that you can supply? Type of hernia, type of mesh, brand of mesh…etc. Direct or indirect hernia, plug and patch, Bard/Ethicon/Covidien… Those are factors to consider. Your records should still be available from the facility where you had the surgery. Where the operating room is, not your surgeon’s office. They will have the records of materials used, plus your doctor’s notes.

One thing that might drive you to having it removed is when you realize that nothing has changed for many months. You’re not improving and you might even be getting worse.

Good luck.

[Jhf1210]

I am now 16 months past my open ilingual surgery with as
much if not more residual pain post surgery. I’ve been able to participate in some strenuous activities without being incapacitated by the pain but wake up every day with some level of discomfort and outright pain. I’ve been through acupuncture, massage and rest with varying degrees of relief. I’ve even been to another University of Washington surgeon for a second opinion and been told that the history shows that the surgeon did what he would have done and that neither of them have had this experienced before. He indicated that mesh removal is painful 2 plus month recovery and likelihood of recurrence, pushing me toward not pursuing removal. The more I read, however, the more I’m convinced that I need to pursue a different course and not just hope that it will get better after waiting 16 months. For those who have had the removal surgery I’d like to find out if you have used a surgeon in the Seattle area and whether there are particular questions or decision points that tipped you over to the removal decision thanks

[jerseattlewa]

SEEKING AN EXPERIENCE MESH REMOVAL SURGEON. Reply to your response. I’m aware of how mesh embeds itself. Point of clarification. My problem is minimal or moderate as to pain so long as I’m on antibiotics. Otherwise it escalates and I suffer red eyes, foggy brain, loss of libido, feel sick all over. I have found it to be a wild goose chase as to finding surgeons. At first I would call the front desk and most of the time it was negative, but some assured me the doctor was able and knowledgeable and experienced, but none were and only 1 had removed a hernia mesh and had a bad result. Then I started asking for, or selecting, (on phone calls) to talk with the doctor’s medical assistant or surgical nurse. Again, most were negative (the doctor had no experience) and a few assured me the doctor was experienced. The last two of these did not work out well at all. About 10 days ago, upon my second visit, the surgeon came out and said he had never actually removed a hernia mesh and suggested I “find” someone that actually had experience. I’ll leave it at that. It seems to me that in my past research I’ve checked out Billing, MD. But, I’d have to go back and look in my notes. I will check him out again. I do not beat around the bush with any of these people. For me, its not about groin pain. Its about infected mesh and if the doctor has ever removed it. I have little interest in discussing with a surgeon what other doctors know or do not know as that would tip them off. I prefer to ask direct questions and listen to whatever they have to say on their own as so I can figure out if they actually know anything about mesh and in my experience very few do and most of them have mistaken or incorrect knowledge. They have biologic mesh, but really I believe that most repairs can be done without any mesh. There are a dozen different non-mesh methods of repair and such non-mesh methods are combined by some surgeons. Thanks for the tip about starting a new thread. I’m new to this and it seems like a good idea to start one.

[Good intentions]

Dr. Peter Billing is in Shoreline WA. He removes mesh. He’s been doing it for eight years. No offense, but I’m not sure that he will be open to spending time on the thoughts about the mesh implantation field, and the doctors involved. I understand the frustration but he won’t be able to help with that. But he will know how to remove the mesh, with a good outcome likely. You’ll need to carefully explain to the front office people that you’re not a referral (most practices deal mainly with referrals from primary care physicians so will get perplexed when somebody calls out of the blue) and that you’re calling about groin or abdominal pain. Get an examination then let the doctor make the decision on the appropriate course of action.

https://www.evivamd.com/about-eviva/meet-our-physicians-providers/peter-s-billing

Full disclosure – I am not Dr. Billing

One problem with making progress on the chronic pain issue is that mesh works very well for many people. And not all mesh is the same. So, blanket statements about its suitability or non-suitability just don’t work. Real progress probably won’t be made until there is a suitable replacement for woven mesh, that gives better results. The investments in woven mesh have been made by the medical device makers, and they won’t give up the return on those investments until they have another revenue stream. The device makers are not composed of physicians, they are manufacturing companies, composed of engineers, and executives, and factory workers. They see numbers, not people.

Good luck. Call Dr. Billing’s office. Start a new thread if you want to get more looks. You’ve tagged on to someone else’s story and it might not be fresh enough.

[jerseattlewa]

SEEKING AN EXPERIENCE MESH REMOVAL SURGEON. I am fairly well educated with a doctorate degree from a major university. So, I’ve really worked and studied and taken actions to get my mesh problem resolved with no luck so far. I had mesh implanted 16 years ago for a hernia. I was not told about it until after the surgery. It’s been a nightmare ever since which has only got worse over time. I started having pain shortly thereafter to which only antibiotics would abate the pain – specifically Cipro being the best. No doctor I’ve ever talked to knows that Cipro is a powerful anti-inflammatory according to NIH research. This is important as if I’m experiencing allergy an anti-inflammatory would work in abating symptoms and so its not clear if the Cipro is acting against infection or allergy. No doctor or surgeon that I’ve ever consulted with has any clue as to this including 3 different infectious disease M.D’s. I’m seeking a surgeon in Seattle or the State of Washington to remove it, or in some other state where the surgeon will accept my medical insurance. Does anyone know of one? I might be open to paying cash, but it will wipe me out financially. It’s near impossible to find doctors that know anything about mesh problems after its implanted or how to remove it. I’m seeking one that has actually done a removal and not just talked about it and one that is beyond the ignorant level as what I’m finding is that there is some back-woods rule that it’s not something to remove unless some kind of gross infection is present. There is also some back-woods rule among many I’ve talked with that its a 50 percent chance of loss of a testicle due to damage during surgery to the cord over which the mesh is usually laid – it’s said that its hard to know where the cord is at. Can you imagine if organ transplant surgery had a 50 percent chance of catastrophic injury to another organ? Well, with organ transplants that is not the case and they get it right. It’s just that the surgeons are not putting in the time and effort when it comes to hernia mesh removal. Surely, diagnostic modalities could be employed to avoid the loss of a testicle. Perhaps, real time imaging or reconstructed imaging. Another thought is to cut 1 to 2 cm around the cord and leave that 10 percent or whatever it is in. As an example, with Staph, to be infectious you need 10 to the 3rd power or 9th power, 1000 to 1 million organisms to get to an infectious dose of Staph. Reducing the load of whatever clinical or sub-clinical or semi-sub-clinical infection or allergy I have to the polypropylene on my body by 90 percent would be welcome. I believe most get to the 50 percent chance by operating “blind” by not having or knowing what diagnostic imaging to use. I’ve been to many doctors and specialists including infectious disease, general surgeons, radiologists and they are all lost. I need the real deal. And, one that is interactive and open to discussion and learning. Get a hernia and a million surgeons are lined up to fix you up with mesh. Now, go try to find one that is willing and highly experienced in mesh removal or in anything related and its extremely difficult. You have Dr. Raz, M.D. out of UCLA that at last report has done 900 mesh removals for females and by now its probably over 1000. You just can’t find surgeons with that much experience as to hernia mesh removal more than you can count on 1 finger. Further, Raz knows that 3D ultrasound is the best diagnostic modality. I can’t find any radiologists that have any clue on doing 3D ultrasound as for mesh. PS: Special note: regular 2D ultrasound will show mesh too so long as you have a stenographer that knows what they are doing. See Dr. Mueller on mesh on Youtube as well. Further, with Raz he’s not at the back-woods standard where he will only remove mesh if there is some gross infection. The truth is that no one knows what mesh of any material does over time within the human body. Its an experiment. Its not something that can be measured. Just as one example, there are over 1600 different enzymes within the human body. None of the mesh manufacturers have ever done any study as to how even one chemical in any mesh interacts with even one of these enzymes. And, its most likely something that can’t be done. The testing is crude, as an example – such as a study that might show that after 12 months the mesh has not failed and therefor the hernia has not reappeared. And, as most mesh is grandfathered in by the FDA under 510k they are not going to do the long term and short term testing as to how toxic or incompatible various mesh is with the human body. Not counting “voluntary withdrawal” the FDA has recalled 95 mesh devices since 2003. What the **** is going on! You can’t find staggering numbers like this in any other industry – not with airbags for vehicles – not with any other product. There are dozens of non-mesh means of repair of a hernia. Surgeons will tell you they will not last, but NIH and other studies show that (as just one example) the Shouldice method has a re-occurrence rate of single digits. Tell a surgeon that and it will shock them. Also, ask them why that would not be a logical option to risk or have another surgery down the road? That line of thinking will shock them as well. They are trained in the fast and dirty method of using mesh, but none were trained in its removal. You’re not going to find any surgeon or doctor willing to risk everything they own that mesh is a safe product. Keep in mind, mesh has no warranty offered. Even a small child knows that anything of value comes with a warranty. Demand a warranty from the surgeon and the manufacturer and none of them will give you one. My opinion is similar to that of Dr. Raz, never have mesh implanted. Find a surgeon willing to do a non-mesh hernia repair.

[Roger2346]

quote drtowfigh:

Good Intentions:

That was a fascinating response. Rings very true. It is an uphill battle for us surgeons to treat our patients and have the insurance companies agree there is a problem that needs treatment.

Dr Towfigh – firstly thank you for helping so many recover from awful complications and also for setting up this comminity where people can share stories and gain access to useful information. I’m sure you have helped many without evening knowing.

i am lucky in that i have not had a hernia and had to make the choice between mesh and non mesh repair. I have however undertaken an embolisation for a varicocele for fertility reasons. I was pushed down this route by my urologists and told that no one performs microsurgery any more. I was also convinced that that inserting objects had no effect on the body, is done all the time etc etc

whilst my complications i would say are light as what i could imagine mesh repair complications would be with fascia and tissue encouraged to grow through the mesh, they are still present. I’ve gone from being a perfectly healthy young male to a chronic pain patient and have now developed anxiety as a result. The whole experience is one i would not wish on anyone.

the surgical community should be made aware of the potential complications of inserting foreign objects into people. There is often an immune response that cannot be anticipated and it can literally ruin people’s quality of life.

Despite what i imagine to be a complex surgery i am now looking into having my coils removed as cannot stand the thought of living out my many remaining years in my current state. I’ve read of people undertaking similar surgery though understand it is an incredibly rare thing to do.

thank you again for setting up the community. Communication with others really helps to make sense of a nonsensicle situation

[neumannb]

Is the person responding as Dr. Towfigh this doctor that performed the removal on the OP? I’m very interested in learning more about removal but I’m also very confused about this string of posts.

[Unknown Member]

Hi Jnomesh,

Thanks for your feedback. I’ve only just found this forum and it’s good to hear from other hernia/mesh sufferers, although not because we’re suffering of course.

Yes, I am also alarmed at how much knowledge and experience has been lost since surgeons embraced mesh, as finding an experienced and reputable native tissue surgeon is difficult. Thank you also for Dr Garvey’s name, he is the only surgeon who has been recommended to me by a woman whose husband had a terrible response to mesh when used for his hernia repair. I have been in touch with Dr Garvey’s Secretary and expect to see him in 2018 once my body has healed from surgery last month to remove another medical device.

I just get seriously annoyed when members of the medical fraternity misrepresent the truth or are ill informed themselves, or just lie and another person is mesh injured.

Wishing you a wonderful New Year J.

Di

[Jnomesh]

Well said. Especially the part about the patient not at the very least being offered an alternative/a choice between mesh repair and pure tissue repair. The fact that mesh is the “gold standard” and very few surgeon are even adequately trained to do a pure tissue repair is very alarming.
im sure you’ve heard this name pop up before on some of your forums but there is a dr. Steve Garvey in Australia that removed mesh and specializes in a pure tissue repair. Best of luck on this unfortunate journey some of us are on.

[Unknown Member]

Hi drtowfigh,

I had a umbilical hernia repair late 2012 and am now looking for a surgeon in Aus who can successfully remove the mesh without causing nerve damage. I didn’t know that I could have had a native tissue repair. Mesh was the only option I was told about by my public hospital surgeon.

I am also a member on 4 closed online mesh support groups around the world and have learned alot from reading other people’s experiences as well as reading external reference materials from sites including the Therapeutic Goods Administration.

I have read there is an economic advantage to using mesh for hernia repair over native tissue repair in Australia, under Medicare, as surgeons are paid the same amount for a mesh repair which takes up to an hour versus 3-4 hours for a native tissue repair. Of course surgeons will choose mesh if they can operate on 3-4 people in the same time as 1 native tissue repair. They can earn 3-4 times more by using mesh, and that’s where surgeons can be accused of putting profit before patient safety.

Added to that, no where near enough research was done on any of the mesh products before putting them into the human body – worldwide! Using polypropylene, a petrochemical product, to repair prolapses inside the body just doesn’t seem like a smart choice. Mesh has been used in different forms for over 20 years so why are failures still not tracked, and current practices modified accordingly.

I agree with each of the posts here from people who have had mesh hernia repairs. A) no way to “see” mesh in the body so finding it, identifying what the problem is before surgery is nearly impossible; B) Mesh is not meant to be removed, so no contingency there for when the mesh fails and/or the Surgeon hasn’t placed it correctly and it needs removing; C) Surgeons are not skilled enough to be able to successfully remove the mesh intact and not cause severe nerve damage; D) When the body has an immune response to the polypropylene and starts attacking the mesh, the surface of the mesh corrodes and the toxic materials are released into the body causing a myriad of Autoimmune responses. Where are the medical protocols for successfully managing these health problems.

When this happens patients are treated like lepers by the majority of the medical fraternity.

I realize it’s easy to just blame the surgeons as we see them and not the medical companies making the medical implants, but surgeons are not helping their image by being so closed minded about mesh failure and the truly terrible outcomes so many people are suffering from. People are dying from biofilm – infections that are antibiotic resistent.

This has to change, and it begins with surgeons not being so afraid they won’t even acknowledge there is a number of problems.

[drtowfigh]

Good Intentions:

That was a fascinating response. Rings very true. It is an uphill battle for us surgeons to treat our patients and have the insurance companies agree there is a problem that needs treatment.

[Good intentions]

quote Jnomesh:

Unfortunately there aren’t many choices out there as mesh has become the gold standard. Whether you argue for or against mesh the real take away is when it goes bad it really goes bad. 99% of the implanting surgeons do not k is how to remove the mesh and to me this is a fundamental problem in using mesh. 99% of surgeons and radiologist do not know how to read an MRI or CT scan to identify mesh issues-and that is a problem! So you get passed on from test to test to doctor to doctor and they all say everything is fine with the mesh. It’s a long and brutal journey, not to mention you will have to most likely travel to another state to find a removal surgeon.
i don’t think the surgeons understand this point.
The physical, emotional and psychological effect this has on someone.
there has to be a better way-then sticking something in someone that statistically speaking can’t come out of you and almost a zero chance to see something is wrong on tests-unless you find the 4 or 5 surgeons in the United States out of thousands who can help you.
this is the fundamental problem with mesh.
sorry for the rant-it’s been a long journey for me.

Good luck, and thanks for posting. And thanks for another name to add to the surgeons who will remove mesh.

Your summary matches the conclusions I’ve come to almost exactly. Especially the part about “really bad”. The surgeons who implant the mesh have no recourse if it doesn’t work. They don’t know what to look for, And they don’t know how to respond. In addition, there is no specific “code” for mesh removal, in the insurance industry, so it’s not tracked, directly anyway.. Most doctors today are part of the standardized health care industry. It’s very bureaucratic. I’ve developed much appreciation,and sympathy, for my surgeon, after seeing how his actions are all second-guessed and graded, for proper fit to the system. As far as the insurance companies are concerned, mesh problems don’t exist as a thing. Which makes it very difficult for the surgeons who implant mesh, to keep up with problems.

I think that if a person went to a doctor with just the symptoms, and didn’t mention the mesh, they might get farther along to a solution.

Again, good luck. And keep posting. I’ve learned most of what I know from forums like this one.

[Jnomesh]

I would like to echo everything vtjbrent said in his post. I recently had my mesh removed. It had folded and curled into a ball and was rock hard.
i too had it removed robotic assisted laparoscopically by dr. Igor Belyanski who saw in a CT scan what so many others had missed that the mesh had folded. It was much worse when he actually got inside there. I am about 4 weeks out.
i am encouraged to see you are doing so well 6 weeks out.
And yes if I could do all over again I would of researched the best way and place to get a pure tissue repair. Unfortunately there aren’t many choices out there as mesh has become the gold standard. Whether you argue for or against mesh the real take away is when it goes bad it really goes bad. 99% of the implanting surgeons do not k is how to remove the mesh and to me this is a fundamental problem in using mesh. 99% of surgeons and radiologist do not know how to read an MRI or CT scan to identify mesh issues-and that is a problem! So you get passed on from test to test to doctor to doctor and they all say everything is fine with the mesh. It’s a long and brutal journey, not to mention you will have to most likely travel to another state to find a removal surgeon.
i don’t think the surgeons understand this point.
The physical, emotional and psychological effect this has on someone.
there has to be a better way-then sticking something in someone that statistically speaking can’t come out of you and almost a zero chance to see something is wrong on tests-unless you find the 4 or 5 surgeons in the United States out of thousands who can help you.
this is the fundamental problem with mesh.
sorry for the rant-it’s been a long journey for me.