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Mesh Removal Question
Hi all, really appreciate this forum there is so much good information on here.
My back story. Healthy at the time 24 year old scheduled for a Right inguinal hernia in 2012. Repaired Lap with mesh. Surgeon said operation went well
Started getting strange symptoms after surgery. Loud stomach noises, constipation, large amount of undigested food in stool, foul breath, nausea, early satiety, feverish. Went to ER. Ct scan showed nothing. Surgeon said probably just post surgical ileus. Has a groin mass shortly after surgery too in same spot as before. Surgeon said just seroma. Never went away. Scheduled an appointment at shouldice 6 months after initial operation because I suspected it wasn’t a seroma but a hernia recurrence. Turns out it was a hernia so they repaired it via shouldice method. I also ended up having a port site hernia from the trocar above my belly button that they fixed as well.
Fast forward to today and my symptoms have never really gotten better. I still experience sleep disturbances, fatigue, brain fog, achy joints. Never had that pre mesh. I’ve tried everything medically to manage the problem because I really don’t want surgery again. I’ve tried low fod map, high fiber, low fiber, hypnotherapy, probiotics, testing for sibo(was negative) had a colonoscopy and egd which were negative, tried going on pro kinetics, tried taking all kinds of supplements for gut health. Sometimes these things would work for a while but the symptoms always return. I’m now starting to get this tingling sensation in my fingertips and toes as well as random spots on my body where my skin feels like it is on fire, but then quickly goes away. I always used to get a lot of skin rashes but that has gotten better with probiotics. I exercise 5-6 days a week. My bmi is 25. All my lab work is normal. I eat a healthy diet. I’m at a loss of what else to do and feel my quality of life is being affected. My question is now 11 years after getting that mesh put it does anyone think it would be of benefit to get it removed?
My other question is it was put in lap and I know Dr. Towfigh said if it’s put in that way it should come out that way. Will taking the mesh out damage my shouldice repair if it is taken out lap or robotic? Is there anything I can do to minimize another port site hernia since I got one the first time? I’m located in michigan. Any good surgeons around here to do it? I’ve heard of Dr. Iacco at Beaumont on this thread and didn’t know if he comes recommended. Please advise.
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16 Replies
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Andy,
Just curious if you went ahead with the removal and if so which surgeon you used?
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Andy Elliot, you really should get your medical records. There are many different types of mesh and some of them might be made of a material that explains your symptoms. Progrip has polylactic acid, which is meant to degrade over time and be absorbed by the body. Atrium’s mesh had an Omega-3 fish oil coating on it, which has been shown to cause problems. Later they polymerized the fish oil and that also caused problems. There are materials with anti-bacterial metals in them. Some materials are prone to infection, like the biologics.
The more you know the better off you will be. Most surgeons never solve the problems that their own mesh implantation caused. They end up working on other surgeon’s problems. Often, problems like yours will just be classified as a “mesh reaction”. The body’s rejection reaction can be very strong.
Anyway, I’m not sure that many surgeons actually frequent this forum so you probably won’t get an answer. Here is a link that might help you find specific experiences like yours. Sometimes doctor will publish about the odd cases that they come across.
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What type of bowel symptoms did you have? I’m just trying to make an educated decision on if removal will benefit me. Every other test I have is coming back negative so I’m at a loss for what will help.
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Blood tests will typically be normal. That’s not a reason not to act. Symptoms and your history are the most important. Imaging can also help.
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For the record, I recently had robotic inguinal mesh removal by Dr Yunis which I consider a complete success. I had lived years with chronic groin pain and other unexplained urologic and bowel symptoms. About half a dozen doctors couldn’t (or wouldn’t) attribute my worsening health to my hernia mesh. Arguably, many things can contribute to abdominal discomfort, so I understand why doctors are reluctant to diagonse mesh as a cause. Statistically, a very small number of patients have actual mesh problems, but when someone does, it is an uphill climb to get it recognized and resolved. Mesh removal is a considerable risk, and proceeding with it might complicate things even more. In my particular case, my symptoms just kept getting worse so I took the leap of mesh removal by a highly qualified surgeon. Once my mesh was removed all my issues went away and it dramatically changed my life. I feel very fortunate. If I could go back in time to my original hernia consult, I would have done things very differently. Unlike the pamphlet implies, hernia surgery is actually a big deal. Get second or third opinions from different healthcare providers, find an experienced surgeon with a wide range of skill sets and a genuine interest in patient outcome. I couldn’t be happier with my mesh removal doctor, and I wonder how differently things would have gone had I consulted with him 6 years ago.
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I had my mesh removed by Dr.Peter Billings here in Kirkland,WA. I am actually here in a Hotel recovering before flying back home. Will be coming back in June to remove the right side since my situation is bilaterial inguinal. Apparently my left side mesh was very complicated to remove so doctor did not have enough time to do both sides on same day.
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So I guess I don’t know if it has me covered. I was hoping one of the docs who has expertise in this area could weigh in. Anatomically I’m not sure if it would damage the shouldice. Also has anyone see cases where the symptoms are brain fog, digestive bloating, bad breath, pins and needles in extremities all immediately present after surgery but not before? i don’t have pain per say though. I just don’t know if mesh removal would benefit me. I don’t want to pursue a path where I’m gonna do more harm than good.
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Hello Matt. Good to hear that you’re doing well after mesh removal. I looked up your last post on the forum and linked it below.
Can you tell who removed the mesh? People often query the forum looking for good options. Also, any details you could offer of your story, from implantation to explanation, would help others looking for solutions and things to avoid.
Good luck.
https://herniatalk.com/forums/topic/can-mesh-be-removed-from-laparoscopic-inguinal-hernia-repair/
Can mesh be removed from laparoscopic inguinal hernia repair?
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After 5 years with mesh, I had my laparoscopically placed mesh robotically removed 2 months ago. I haven’t felt better in years. Surgery and recovery were far from fun but we’ll worth it in my case. I have been lucky enough to not have any hernia recurrence so far. If you think your shoudice repair has you covered, and provided you can find s qualified surgeon, mesh removal is worth considering in my opinion.
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@drtowfigh do you think I should consider mesh removal given my scenario and would I damage my shouldice repair if removed Lap/robotically?
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I don’t know much about him. His education and publications suggest that he is at the forefront of hernia repair technology.
Today’s hernia repair centers are starting to include mesh removal as a normal part of their repertoire. They will put it in and they will take it out.
If you do get deeper in to consulting with a surgeon about your problems be aware that there will probably be a long path ahead before any surgeon will agree to remove the mesh, unless they have seen similar problems themselves and resolved them with removal. Your complete medical records from start to finish might be enough for a surgeon to make the decision though.
Unfortunately, today’s medical practitioners are pretty well siloed. Each doctor is very narrowly focused. For example, several forum members have had urological problems that resolved with mesh removal but hernia repair surgeons generally refuse to consider ufology and urologists claim ignorance about mesh complications. It can be very frustrating.
I wish that I could be more positive. But it is a lot of work to find solutions after a mesh-based hernia repair. You have to find the right surgeon.
Dr. Belyansky is another possibility. He is also at the forefront of technology, and speaks at the big conferences.
https://www.luminishealth.org/en/find-a-provider/igor-belyansky?language_content_entity=en
Dr. Jacob also.
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So I can request them, but I do know I had a TAPP repair. My understanding of that technique though is the peritoneum is sutured to cover the mesh once it is sutured in place. Have you heard good things about Dr. Iacco?
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I don’t think that laparoscopic removal of mesh should damage a Shouldice repair. The laparoscopic procedures would be on the other side of the abdominal wall, the inside. The peritoneum would be pulled back and the mesh peeled off of the abdominal wall and critical vessels and nerves. The Shouldice repair should be untouched.
You really should try to get your medical records. There is a wide variety of laparoscopic repair methods. For example, one advantage of TAPP over TEP is that TEP avoids contact with the intestines, and also minimizes the chance of adhesions. If you had a TAPP repair it might help explain why you’re having problems. “Lap with mesh” really means very little.
Also, “robotic” is still laparoscopic. The instruments are just mechanized. But they move in the same spaces and do the same things. There is a powerful effort to promote robotic methods, around the world. It’s the latest new “tech”. But there is little evidence that robotics are better than a skilled surgeon using hand tools. You can find many publications on the subject.
Dr. Iacco did a residency at Beaumont but is now in Michigan.
https://michiganherniasurgery.com/about-us/our-team/anthony-iacco/
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Thank you for the reply. That is very useful information. I’ve tried to ask a few general surgeons about whether removing the mesh robotically would damage the shouldice repair. They didn’t seem to know the specifics of the shouldice, but thought that it would potentially be ok? I just don’t want to create a worse situation.
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Another surgeon with much experience in gut problems is Dr. Peter Billing of Transform Weight Loss. He has heard many stories and removes mesh. But he also uses (or at least used to use) mesh for laparoscopic hernia repair. So he has a certain type of objectivity. He will talk to you over the phone, somebody on the forum is scheduled for surgery with him this month.
It seems like, at the least, an open-minded surgeon would want to perform exploratory surgeon to look for physical problems and/or inflammation.
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Do you have your surgery records? It might help to know exactly what material was used and how.
Dr. Krpata at the Cleveland Clinic is leading an effort to understand chronic pain. While you might not define what you’re feeling as pain his center will still have the collected cases of many people with mesh problems.
Search “krpata” on the internet or use the link below (it is specific to krpata on herniatalk). I have also included a link to Google Scholar if you want to focus your research on professional research.
I mention often the cognitive bias that revolves around mesh. The investment in its use is enormous. Good luck.
https://www.google.com/search?q=site%3Aherniatalk.com+krpata
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