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My size what mesh for small bilateral hernia
I clearly have a small right rt hernia but surgeon says he tells weakness on the left as well.. no bulge… that being said I am 5’7. Weigh 145lbs male… I keep hearing about thin people and mesh… what would be good for me I have long legs but short torso……would love to know what docs would think and if lightweight which lightweight… surgeon wants to do bilateral parietex
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13 Replies
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No still scared to death
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Did you do the bilateral surgery?
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Most drugs in the US have a standard adult dosage. I’m not aware of weight-based drugs for the majority of oral medications given to adults.
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Dr. Towfigh, wow, surprising to hear that. Do body types get different amount of pain killers? I heard of Americans unhappy in Japan unable to get the same dosage of their regularly used medicine in the States (due to regulations placed on physicians). Americans, tending to be heavier than Asians, might need heavier dosages. Correct?
Would success of surgery have any relation to patient body weight? Thin, medium, heavy have different advantages?
Thank you for your kind attention! -
Yes, thin patients are easier to operate on than obese. That’s not why thin patients have more pain.
We don’t know enough about ethnicities and their different reactions to an operation. As far as I know, there is no difference.
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@Dr Towfigh
Given what you and Good Intentions point out about lightweight, would East Asians necessarily have higher rates of complications than Westerners given their slighter builds? Studies might not be found for that. In your own experience, might this difference happen?Also would thin patients be easier to operate on than obese ones? A surgeon recently gave me that idea. If so, I wonder if matters of pain and complications follow suit.
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Thank you so much Dr Towfigh for chiming in… such a sensible voice and practitioner is a blessing for the general public… God bless
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At what BMI do you start to see increased risk for mesh-related reaction?
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The reality is we don’t know the real truth about anything. We know what’s been reported in peer reviewed literature from various population studies. Their results may or may not apply to an individual patient.
Most of us believe that lightweight mesh has less overall foreign body, and therefore less inflammation, and so it should result in less mesh-related pain. One major study disproved that. In fact there was more pain with lightweight mesh. Not sure why.
The (Parietex) ProGrip anatomical mesh is an excellent choice and in our experience has had the least amount of mesh-related complications.
Similarly: thin patients. I feel that thin patients, especially women, do worse than normal weight or obese patients. Your BMI is 23. That’s normal and not really ”thin.” So I would not necessarily be that worried about you falling into the category at risk for mesh-related reaction.
Again, we are dealing with likelihood’s and odds. We cannot predict the situation for each individual patient. Yet
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I forgot to say that I had Bard’s lightweight mesh implanted, Bard Soft Mesh, and after just a few months it had stiffened. It felt like a plastic picnic plate in my abdomen. The mesh is only soft when it’s outside the body, and for a short while after implantation. Once it gets “incorporated”, filled with collagen, it shrinks and stiffens. I’m sure it looks like a good idea when the surgeon is holding it in their hands.
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And here are the two studies I mentioned.
http://file.scirp.org/pdf/IJCM_2014072117033945.pdf
Watch Brent Matthews in this video and read the questions on the screen. It’s from 2018.
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Here are the Parietex products. Many different ways to knit a polyester fiber.
https://www.medtronic.com/covidien/en-us/products/hernia-repair/mesh-products.html
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There are studies that indicate that the “light weight” concept doesn’t actually work and may actually cause more chronic pain. See Dr. Bendavid’s work about nerve damage in small pores. Also Dr. Brent Matthews of the Carolina Group recently presented work that showed that “light weight” mesh seemed to have no benefit over “regular” mesh. He also showed that mosquito netting used in more primitive areas of the world worked as well as the medical device makers’ expensive products. Light weight mesh is an idea that has not really been proven for long-term results. But it sounds promising as a solution for chronic pain so it made it to market.
Parietex is a brand name that covers many different forms of device. I’ll try to post a link to the numerous products that use the name “Parietex”. Search it on the web if I get blocked. Get more details about their plans and how they will make decisions. Don’t be afraid to say no if they can’t give you proof that their patients have actually done well with their method and materials. Don’t let the device makers’ own internal studies be used as proof. Your doctor should know through correspondence with his/her own patients.
As far as being thin, it might be that thin people are generally active people. I am thin and active and it was the activity that caused the pain. Not being thin. From an anatomical perspective I think that the “thin” thing is just a simplistic way to place blame for a failed repair method.
Many many surgeons are on the laparoscopic large mesh implantation train. There is security in numbers, for them, but not us. Get details. It’s the rest of your life. Good luck.
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