My bilateral hernia surgery with mesh

[David M]

This sounds good, Spinotza. I’ll add that in this time of proliferating sock puppets, you sound real to me. Can you give us more detail about how big your hernias had progressed and whether they were direct or indirect?

[Good intentions]

Good luck.

Was it a Lichtenstein repair? Do you know the type of mesh used?

[spinotza]

Dconfused77, pain on exertion for Lichestein on average is 10%, right? This is for all doctors regardless if they are experienced or trainees. The likelihood of suffering from pain will be lower if you are operated by a specialised doctor.

I don’t think mesh related issues are exaggerated but we need to understand the statistics. 10% people suffering from pain is too much for such a common operation and the field’s understanding of mesh needs to evolve. However 90% of people who have this surgery will go on with their lives and never join this forum.

This is what happens for many many support groups, for every single type of surgery. You can find these groups on facebook where those with a bad outcome will complain and those with a good outcome just go on with their lives so it’s very lopsided on the Internet.

As you said mesh lowers the chance of recurrence and I’m only 34 and incredibly active – swimming, calisthenics, cycling, running, tennis are all things that I enjoy and perhaps a pure tissue repair was not the best option for me if I wanted to get back to some of these activities. But for someone who just likes walking and relaxing then the option changes drastically, no?
Dr Towfigh has created a wonderful place for us to discuss about our problems with hernia surgery and she made a recent video where she argues that surgeon is more important than technique and having someone who listens to you and what you want from the surgery is key: https://www.youtube.com/watch?v=x7x_RfsT43s

One of my favourite positions is sitting cross legged and no I don’t feel the mesh at all. I hope you make the right decision for yourself but you need to detach yourself a bit from this forum because you already know enough to make a choice and more anecdotal evidence (n=1) is not going to help.

• This reply was modified 8 months, 3 weeks ago by  spinotza.

[spinotza]

So you’ve made some good points that I am glad to answer.
It’s pretty simple: pain was getting worse, not enough money for abroad no-mesh and was heading towards emergency NHS surgery with no choice over the procedure, possibility of a trainee operating on me.
OTOH I had private insurance, could choose an experience doctor that performs these operations on a daily basis which I think is one of the most important factors in outcome.

So I did and was convinced when the doctor suggested open instead of laparoscopic which is the trendy option these days but not at all what I wanted. Open with local anaeshtesia to me was ideal, even if it was with mesh. I also liked the fact the my doctor is an academic as well teaching at Imperial.
British Hernia Centre website is exaggerated they should stick to the numbers and references to peer review papers which they have in fact published over the years. The centre is a jewel however located in St Mary Hospital with excellent facilities.

So I’m recovering well, I don’t need any painkillers, I feel better than before the surgery and I couldn’t feel happier. I am more worried of recurrence then anything else because the little pain that I have every now and then it’s entirely manageable and will probably disappear soon since it hasn’t even been 2 weeks.

As for everything that has been said on this forum about mesh problems + all the studies, I acknowledge the very real possibility of things going wrong and I accepted it as risk that I was willing to take rather than a certainty.

• This reply was modified 8 months, 3 weeks ago by  spinotza.

[spinotza]

I remember the beginning when the cuts started and the last 10 minutes when I woke up. I believe I was administered midazolam. I didn’t choose it was recommended. We were perfectly aligned from the start because I didn’t want general anesthesia.

Let me tell you something: I am so glad sedation exists. I was kinda getting pannicky when I realised this is about to go down but this anesthesologist was sooo cool and he asked me if I want a sneak peak of the sedation drug and as soon as he gave me a little bit I felt like I flew to ceiling and I could take anything and started smiling. Then they started injecting me with the local anesthetic and I felt it a little and then after a couple of minutes he injected more sedative and I think I fell asleep. But towards the end I started asking how’s it going is the first one finished? And he said actually we’re about to finish the second one. And I asked if I should be speaking and he said better not so I remained quiet and waited. It was very nice.

What are the downsides to sedative? From what I understand from reading I was perhaps fully conscious the entire time but I just don’t remember the majority of it. But doing it with no sedation requires self-discipline of steel imo.

• This reply was modified 9 months ago by  spinotza.

[spinotza]

Duhh. You are right! I should have mentioned I took Movicol laxative and docusate stool softner which made it possible.

[spinotza]

Yes it was open with mesh at the British Hernia Clinic In London. They have a pretty archaic website in which they talk a lot about how their method is so special, but it’s actually a Lichtenstein open surgery with mesh which a lot of places offer. They do have decades of experience though and specialised doctors.
I made the mistake of not starting laxatives from Day 1 and I think that’s why it took so long. OTOH the pain in the first two days was too much to sit on the toilet.

[spinotza]

Thank you for the kind words, you encapsulate well how I feel right now.

I will return to update this thread when I find out some useful information like what mesh I used or whether the hernia was indirect or direct but the latest is the following:

Slept poorly because the official recommendation is to sleep on the side which hasn’t been operated on which is difficult when you have bilateral hernia.

The smaller barely visible hernia incision hurts the worst, because of course it does while the one which was the size of a tennis ball is giving me almost no pain.

Finally, walking has been difficult. Had to use a heatpad to numb the pain and a walking stick to lean on but eventually I managed to do it. That’s it, things are getting better so I’ll rest and see where I am in a couple of days 🙂

[spinotza]

At the check up the doctor said he won’t know if the hernias are direct or indirect until the surgery. I will ask him at the follow up as well as the name of the mesh.

[spinotza]

Hi David. The right side was very large from the beginning and the left side was invisible to me except for when I would push hard I would see the movement of the hernia.

I’ve been wearing hernia boxer shorts for the past 5 years which had pads and added compression. Wit the boxer shorts I could even run for a bit, I could go to the gym and I became very strong and athletic right before the surgery. I would say that the right side was almost tennis ball sized and maybe it got a little bit larger over 5 years but maybe it didn’t I couldn’t tell much of a difference.

But the pain changed. Even with the boxer shorts I would feel more and more sore at the end of the day and I was getting diminishing returns from not opting for surgery.

My own conclusion was that I need to get the most experienced doctor that performs daily such surgeries, get an open surgery with local anesthetic and be in great physical shape: swimming, no smoking, calisthenics.
I’m 34. Initially I wanted a mesh free repair, perhaps the Kang one but I couldn’t afford to travel to South Korea and the private insurance meant I had a lot leeway choosing a doctor in the UK.

[spinotza]

Thank you. I’ve read so much about this I know the hardest days are the seocnd and the third if everything goes well so I’m garing up.

It was Lichenstein. I will come back with the name of the mesh, unfortunately I forgot although I did ask.