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Mesh
Is it possible to openly remove mesh from an umbilical hernia that was put in laparoscopically?
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10 Replies
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Highly variable. Lap has Better outcomes in terms of recurrence rates. In some patients it may be overkill as it involves 3 scars.
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[USER=”935″]drtowfigh[/USER] would you usually do open surgery and not inside abdominal cavity?? i had mine put in ipom and am really worried about bowel obstruction and other problems
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Umbilical Hernias 1.5cm and higher are best repaired with mesh.
your BMI is low, so I prefer to use the lightest weight mesh infection I do choose to use mesh.
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[USER=”935″]drtowfigh[/USER] size of the hole was a little under two cm. not sure on mesh I just know it was circular and about 5×5. as far factors I am 5’9 and have a bmi of 19-20. only physical activity I do is running and yoga. don’t smoke either.
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Depends on the size of the defect and mesh and your risk factors for recurrence. Short answer is yes. Longer answer is depends.
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[USER=”2029″]Good intentions[/USER] or really any tissue repair would be fine as long as it’s done by someone who has done a lot and has good experience. i’m thin and had a small hernia so that’s why I think sutures would have been fine. problems are lack of healing it seems like. its been three months since I had the surgery and the site is still really swollen and super firm it’s almost like my umbilical area doesn’t even move freely anymore as far as the insides. also experiencing significant fatigue and the mesh is making me psychologically distressed knowing it’s in there… not saying removal is needed right now but I guess just in case. if I could I would have it removed and have a tissue repair instead
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That is a difficult question since most laparoscopic methods start at the navel, as I understand things. It seems like TAPP should be possible but a lap surgeon would know for sure.
Shouldice and Desarda are inguinal hernia repair methods. Umbilical hernias are a different problem. They might be one of the areas where mesh is actually better than sutures.
Are you having specific problems that you can share? Somebody might have a recommendation. Good luck.
[USER=”935″]drtowfigh[/USER]
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[USER=”2580″]DrBrown[/USER] Thank you for the reply and information Dr. Brown.
I also should have added that IF removal is done, I would like a pure tissue repair, but a good tissue repair. But since the mesh was implanted laparoscopically I know that it will be difficult to remove the mesh using open surgery method and possibly making the defect even larger. I had a small defect by the way. Is there any possible way I can get the mesh removed laparoscopically or robotically assisted so the defect won’t get larger, then followed by a repair such a Shouldice repair or Desarda repair? The question is for anyone to answer
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Dear Runner.
It is possible to remove Umbilical Hernia mesh. There are often adhesions between the mesh and the intestines, so the removal needs to been done very carefully.
So I would advise trying non operative methods to control your symptoms before proceeding with surgery.
Regards
Bill Brown MD -
Forgot to add, along with doing a pure tissue repair.
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