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New Here : Seeking Advice Regarding Recurrent Hernia(s) After Component Separation
Hello!
I am beyond thankful to have found this forum and website. I am going to attempt to explain my issue/question in a succinct way in order to get some advice.
I am a 31 year old female, non-smoker, not overweight, very athletic and otherwise healthy.
Following the birth of my first child in 2006, I developed a paraumbilical hernia. That hernia was repaired with mesh, with the laparoscopic technique. That hernia recurred just prior to my pregnancy with my second child 5 years later. I, of course, left it untreated during that pregnancy. It was again repaired in a similar fashion with mesh when my child was approx. 10 months old. The surgeon found the original hernia to have recurred, along with the development of an additional ventral hernia just above the mesh from the first repair. Mesh was again placed. A few years later, I could tell the hernia(s) had again recurred. However, we desired to have another child and I elected to delay repair. Following the birth of our third child (all vaginal uncomplicated deliveries of 7-ish pound babies), I developed a ventral hernia from below my navel area all the way to almost the top of my rectus muscles. This was repaired with a robotic technique by a general surgeon, who repaired the herniated diastasis, used mesh, as well as a small incisional hernia that was not directly in the midline area. That repair was performed in September of 2017, and by February of 2018, I could tell I had a major issue. CT scan showed that the entire hernia had recurred, and was even larger. The hernia sac came over the top of the mesh that had been attached. I was referred to a plastic surgeon. In June of 2018, the plastic surgeon together with my general surgeon performed an open component separation procedure using NO mesh. Recovery was uneventful and normal. In January of 2019, I had a recurrence near the top of the midline incision. This was repaired without mesh. I now currently have yet another recurrence near where my bellybutton used to be (casualty of component sep surgery). The surgical plan now is to place a piece of mesh over the entire midline incision, with enough coverage to hopefully reduce tension and prevent recurrence.
I truly respect & fully trust my surgeon. He answers his phone when I have post-op questions, saw me every single day when I have been hospitalized following surgeries, etc. I consider my relationship with him a true privilege.
Questions :
Am I off base wondering WHY this continues to happen? I follow all post op rules.Would a consult with a surgeon who specializes in hernias be beneficial to me? My surgeon says that hernia surgeons all over the world have a small percentage of patients like me, where recurrence can be difficult to stop.
If mesh had been used in my component separation procedure, would that have helped this at all? Is there a way to “go back” and place mesh the way it could have been done during that procedure?
I apologize for the length of this post, but this is such a difficult issue to navigate. Thank you in advance for any responses! – Laura
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9 Replies
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[USER=”2029″]Good intentions[/USER] Yes! When my surgeons here in Virginia recommended him to me, I immediately started reading everything I could about him. Needless to say, I was very impressed. Some of the presentations he has done in the recent past directly address the issues I’m having – multiple recurrence after CS. As a patient, it makes me feel hopeful.
Dr. Heniford is also a proponent of “pre-hab” prior to hernia surgery. That speaks volumes to me, as I can tell that my level of physical strength/fitness has helped me through these many surgeries. I am really looking forward to seeing Dr. Heniford, and I really appreciate your reply.
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Dr. Heniford is one of the few surgeons that vocally questions what is happening in the hernia repair industry. He has asked “who are we protecting” about what is happening. I think that he sees that the device makers have too much influence.
He used to be part of the Carolinas group but has apparently moved to a different practice. Good luck. [USER=”2845″]lkdivers[/USER]
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Just looked him up and his clinic. Seems like a great place to start. Keep us updated on what they find to be the issue!
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[USER=”2854″]localCivilian[/USER] – I agree. “Rollercoaster” is an excellent description. From what I have read, Dr. Heniford (Carolinas Hernia Center) is a hernia specialist. I will also definitely be looking into the online consult with Dr. Towfigh! Thanks!
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Wow. What a rollercoaster you’ve been on.
At this point and after this many recurrences, I would for sure go out of my way to find a true hernia specialist. Dr. Towfigh would be the best option for you. You can even schedule an online consultation with her if you can’t make it out to LA. At least just to get a solution as to what’s going on with you and recurrences. She’s also an expert when it comes to hernias in women so that’s also a big bonus. She may be able to use some of her evidence and findings to help you out with your case.
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Thank you all for your helpful responses! My plastic surgeon did a tissue repair of the second recurrence in May. I now have yet another (rather large) recurrence at a different location. My surgeons have referred me to Dr. Heniford in Charlotte, NC. I am waiting to see how long it will take to get an appointment with him.
[USER=”935″]drtowfigh[/USER] – both my general and plastic surgeons believe that I may have some type of sensitivity to the sutures used (#1 ethibond) because the sutures simply “come out” of the main midline repair area. My plastic surgeon said they are still knotted, not broken, and the muscle seems to heal back and not be “frayed”. They just come out and create an area for a hernia to form. Have you seen anything similar? Thanks a bunch! This is such uncharted territory for me. I’m ready to get my life back.
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I think it is always wise to get a second opinion and with a hernia specialist would be best.
Sometimes this means traveling and or going out if your network. Some who are not in the same state as yours may be able to review your documents, scans etc and offer advice.
There is dr. Towfigh on the west coas and also Dr. Igor Belyanski on the east coast in Annapolis MD.
You maybwsnt to research these two surgeons or see if they know of or can rx someone in your state/city who can offer a second opinion. -
Thanks for your post. And welcome to our forum.
When hernias keep recurring, we have to forensically analyze the cause(s): was it a technique issue, too little mesh, wrong suture, etc? Is there a risk factor for recurrence that we are not addressing (eg, straining, coughing, obesity, nicotine use, connective tissue disorder)?
Recurrences can occur. I think it’s time now to figure out why and a hernia specialist that loves the analysis part of their job is the best next step.
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I am not an expert but recall a couple of people who are dealing with problems similar to yours. It might help, or might not, to know the type of mesh that was used in your previous surgeries. It is unclear if mesh material and/or knit pattern and other details matter or not. Many surgeons think that all meshes are essentially the same, while others choose based on device properties. Many surgeons have no choice of the device they use, their purchasing department chooses for them, based on contractual negotiations. Anyway, the small details might offer a clue for you.
This forum uses the @ function to notify people if you want them to know you’ve posted. Type the @ symbol then the first few letters of their screen name and a small menu should pop up to choose from.
Here is a thread with comments from both of the people I mentioned above. Good luck. [USER=”1593″]mamadunlop[/USER] [USER=”1176″]Momof4[/USER] [USER=”935″]drtowfigh[/USER]
https://www.herniatalk.com/5297-what-is-the-long-term-outcome-will-it-ever-stop
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