Odd paper from New Zealand

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    • #31764
      Good intentions
      Participant

      Here is an abstract of a new publication from some surgeons in New Zealand. They state they performed this study due to “negative publicity surrounding surgical mesh in the media”. They report a “no pain” rate of 92%, which, of course, can be converted to a “pain” rate of 8%. 7% of respondents could feel the mesh, apparently. No explantations were reported but they did not ask if explantation was desired or requested. The recurrence rate was very low. The study covered six years, but it’s not clear when the respondents were surveyed. Could be at the two week checkup or it could be years after surgery.

      The study was focused on Progrip (trademark) and seems to be an effort to push back against negative publicity. Apparently, an 8% pain rate is okay with them.

      At the end they recognized the need for a national registry.

      It is strange that they published in a for-profit journal. If they want to “get the word out” they should publish in a free journal.

      https://onlinelibrary.wiley.com/doi/abs/10.1111/ans.17860

      Excerpt –

      “Conclusion
      In this cohort, laparoscopic inguinal hernia repair with ProgripTM has shown a low recurrence rate and excellent post-operative QoL. The QoL data shows that the public perception of mesh based on media reports of complications may not be relevant for this operation. The knowledge gained from this study reinforces the potential value of a national mesh registry such as those seen overseas.”

    • #31765
      Watchful
      Participant

      For me, the surprising thing there was that “no participants reported severe or disabling symptoms”, although it’s hard to know how to interpret that without a definition of “severe or disabling”.

      I think 8% with pain, 7% with mesh sensation, and 2% with movement limitation is pretty bad for those who fall into those groups, and those are not very small percentages.

    • #31766
      Watchful
      Participant

      One thing I always wonder about with these studies is what about anesthesia complications? This procedure is under general anesthesia. 0% issues? My mom had complications from general anesthesia: delirium, a jump in cognitive decline. I know this is not specific to this surgery, but still should be mentioned if there were relevant complications.

    • #31780
      Johnso
      Participant

      Watchful:

      I know 2 people who experienced a rapid decline in their cognitive ability after surgery requiring general anesthetic. Another friend of mine after 3 surgeries requiring general anesthetic said he does not feel as sharp as he was prior to surgery. I can only hope the medical community develops a general anesthetic that is gentler on the mind.

      During Dr. Towfigh’s Hernia Talk Live #98 “Watchful Waiting for Hernias” with Dr. Fitzgibbons, Dr. Fitzgibbons said for uncomplicated unilateral hernias a lot of his patients especially doctors prefer an open repair so they can avoid general anesthetic (30 minute mark approx).

      • This reply was modified 2 months, 3 weeks ago by Johnso.
    • #31786
      Watchful
      Participant

      Right, some doctors are indeed aware of the cognitive impact of general anesthesia, but many are not. In general, this is not widely known.

      I had no idea about it until it happened to my Mom. It happened to her twice – she had two surgeries with general anesthesia, with a serious cognitive impact after each surgery. When that happened, I did some reading about it, and found out that this is a known problem, just not talked about much for some reason. I read that doctors started noticing this happening to their parents – it has the most noticeable impact in older people who have less cognitive reserve. Supposedly, some general anesthetics are known to cause less cognitive damage than others, but I don’t know all the pros and cons. It’s best to avoid general anesthesia if at all possible.

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