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Need mesh removal + no-mesh repair. Options?
Title pretty much says it. I have a hernia on my left side that has progressed to the point that is is no longer possible to ignore in terms of pain (though, I believe it is still quite small). I had a hernia on my right side repaired with polyester progrip mesh 7 months ago and that made the pain much worse.
My understanding is that, as the progrip mesh went in laparoscopically, it should also be removed laparoscopically. But, there does not seem to be an option for a laproscopic no-mesh repair (for the other side).
Is there any way to kill two birds with one stone and get both operations done at once? Or, am I definitely looking at two surgeries?
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12 Replies
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Re mesh removal:
– if preperitoneal mesh (eg laparoscopic it open Kugel patch and some plugs), then Removal is best done laparoscopically.
– if anterior mesh (eg open) then mesh removal can only be done open.Re tissue repairs:
– I do perform robotic tissue based inguinal hernia repair. It is best for those with small indirect hernias. I do combine it in patients who get laparoscopic mesh removal and still need a repair.Re Progrip
– though polyester mesh has been known to cause more inflammation than polypropylene because it’s braided, we do not see more complications or chronic pain with Progrip mesh. -
If the mesh is removed laparoscopically and there is a hernia, can it be fixed via open method tissue repair in the same surgery or is that too much for the body to take. Otherwise I guess you would have to walk around with a hernia while waiting to heal up enough for your second surgery
Also since a Kugel patch goes in via open method but is placed preperitoneally or inside of the abdominal wall, Is it better to be removed open or laparoscopically. -
I would love to hear about at least one mesh which turned out to be at least okish, or not too bad…all this mess will result in people completely distrusting both the doctors and the medical industry!
Can at least a doctor tell me on what basis they decide to adopt a mesh at the beginning?? based on the manufacturer’s promises? …I find really disturbing that the “trials” on chronic pain/inflammation/complications with this or that mesh are done by single surgeons who compare the outcome on their patients…
As many have said I do not understand the difference between a drug acceptance process and a mesh (I mean, it should be a similar one)…and to think that doctors also get angry when one asks “too many questions”:) (or 🙁 -
i had also seen studies and anecdotal evidence suggesting progrip actually, generally-speaking, had better outcomes than other types of mesh. and perhaps that’s on average true. but maybe it just has more potential to cause problems in those whose bodies tend to overreact to an implant.
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it’s fascinating (and scary) that i learn something new every day. hadn’t really considered the fact the progrip would be the source of more pain given all the little velcro-like prongs used to keep it in place, but it makes sense. with the advice of my surgeon we chose that type specifically because tacks wouldn’t need to be used, and i had read so many horror stories about different types of permanent fixation causing nerve pain.
i also wonder if perhaps that’s why my pain is less now after 22 months or so. the PLA prongs supposedly dissolve after about a year. i imagine in some cases it can take quite a bit longer. i did continue to have pain up until about 18 months or so. but not nearly as much now. but it feels like there’s a lot of scar tissue present which along with the mesh itself may be the reason for so much foreign body sensation and tugging/pulling.
hoping that if i do get this surgery they can remove some of this scar tissue (which i think they do a little bit of just in the process of removing the mesh).
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I just spoke with a surgeon in Germany that said exactly what you have heard: “progrip polyester mesh causes more inflammation and thus more pain than the other types of mesh materials.”
Based on my n=1 data, I would agree! I have had nothing but pain since the mesh was put in me. I just hope that getting rid of the mesh will get me back to normal — or at least something like normal. The past 6 months have been a nightmare.
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Your mesh can be removed by the laproscopic method or the open method. That said, I’ve heard since the mesh was placed laproscopically, it’s best to remove it that way.
The hernia on the other side – if it were me I’d go to Shouldice clinic to get it fixed.
I’ve also heard progrip polyester mesh causes more inflammation and thus more pain than the other types of mesh materials. Mine is a progrip polyester self fixating mesh and I am strongly considering removal. -
dr. towfigh has responded to a similar thread saying she’s really one of the only people who does lap or robotic pure tissue repair i believe. she said dr. belyanksy and dr. jacob and maybe another are interested in learning this from her. otherwise, i think most tissue repairs need to be done via open method. so if you have lap or robotic removal, you’d probably need a separate surgery for repair (if needed) unless you went to her.
there may be some situations where perhaps a weakness or very small hernia or defect might be able to be touched up somehow robotically if the surgeon was in there doing a removal. but i’m just speculating.
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The mesh I have in me is supposedly light weight. I feel it and it causes pain. I wouldn’t put mesh in my body ever again. The fact is, nobody know how his/her body will respond to mesh once it’s in there.
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I am in the same boat but my right side was put in open and is a preperitoneal patch so I think it is best to be removed laparoscopically. I have seen a few doctors recommended by this forum. They would remove the right and replace with a newer lighter weight mesh as well as fix the left side with mesh. All in one operation and doctors seem very good. It is tempting but I am still paranoid about mesh after my previous problems with the kugel patch. Alternative is to have open removal and tissue repair but that can be a tough surgery from what I read. I have also read that many people who have their mesh removed laparoscopically don’t have any hernias present. The scar tissue has covered them up. Not sure if you would be in this group or how to tell beforehand. The doctors I talked to seem to think I would need mesh. This may be because mine was put in open and not laparoscopically?
I guess the question is can you remove mesh laparoscopically and if there is a hernia present, can you get a tissue repair? if yes, does it happen right then or do you wait to recover and the go in from the other side. Seems like no solution is easy! -
To deeoeraclea,
From what I have gathered from speaking with my doctor and other specialists non-mesh repair has to be done non-lapro, and even with removal that is generally how it appears to be done.
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” – if anterior mesh (eg open) then mesh removal can only be done open. ”
So a mesh from a previous OPEN surgery wouldn’t be eligible to be removed laparoscopically?
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