One month since mesh removal

Hernia Discussion Forums Hernia Discussion One month since mesh removal

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    • #28743

      Hi all,

      Many of you already know my story – essentially mild to moderate discomfort for 3 years after right-sided robotic mesh inguinal hernia repair for an indirect hernia, using progrip mesh. On and off soreness/stiffness/tightness, with a variety of other issues here and there that caused discomfort. I have wanted mesh removal for a long time but was tortured because I couldn’t decide what to do given that I wasn’t terribly disabled or in severe pain.

      I finally had the mesh removed robotically by Dr. Belyanksy on 2/15. I finally realized I wasn’t going to be happy until I did this because I wasn’t happy with the outcome from the initial hernia surgery. While I wasn’t in dire straits, I was uncomfortable most of the time.

      The surgery went well. He removed 100% of the mesh. There was no hernia present upon removal, and I received no other repair. He said there was a slight fold in the middle of the mesh that may have created some of my issues. He didn’t see anything else particularly interesting otherwise, except that the mesh was ‘riding up’ a little higher than normal in one area. But this ended up being a good thing as it meant the mesh was a little further from one of the critical nerves. No nerves had to be cut, either, during the surgery.

      Things have been going pretty well. The first week was rough as I just felt very swollen and uncomfortable after another robotic abdominal surgery. Shockingly little groin pain if any at all at first. I actually had, and still have, some mild to moderate nerve pain in my abdomen in the fatty area in the center of my stomach from the skin surface down to the muscle. He thinks over time this will fade. Related, I also have a tight feeling in the same area and the umbilical area in particular, and I think it’s related to the overly sensitive nerves. If water runs down my stomach in the shower, for example, it seems to trigger that tight feeling and skin sensitivity.

      I was originally very worried about an incisional hernia in the umbilical area and where the trocar incisions were, particularly on the right side where the opening had to be more dilated to get the mesh out. He had to use in internal dissolvable stitch to close it (typical), and with every slight movement I felt a strong pulling sensation. Fortunately, that’s mostly all gone now, and I can even sleep on both my sides and my stomach now fairly comfortably. I had a follow-up just last week with the surgeon, and he said there didn’t appear to be any recurrence or any issues around the trocar sites, and that it will just take some time for things to settle down.

      I still have some vague soreness and occasional tightness in the groin and lower abdominal area like before, but it’s a little different now. It doesn’t seem quite as stiff when I get up from a sitting position. I am hoping that over time it gets better. But I also know that I had a similar soreness before the original hernia surgery as well. I understand there’s a chance that will always be with me now. And I don’t know that my right side will ever be quite the same after two big abdominal surgeries. I think my body is just super sensitive and I tend to feel every little thing, particularly when I focus attention on it. Perhaps after another year or two or three I will mostly stop thinking about it. It’s only a month now, and my surgeon suggested it will take time, and to give it several months and see how things go. It will be interesting to see how things heal up in the absence of the mesh, and if scar tissue remodels over time and becomes more and more ‘normal’ feeling.

      I am very happy that I don’t currently have any major pain. I was terrified that I might be worse off somehow immediately after surgery. No bathroom or sexual issues, though I do feel a little like my BMs aren’t as loose as before. I’ve continued to take stool softeners and prune juice because I am scared of pushing too hard now that I don’t have mesh. And I am relieved, psychologically, that the mesh is out, and that any future pains and issues I have can’t be attributed directly to the mesh.

      I am hoping in several months that the tightness and nerve issues will settle and my abdomen will feel a bit more normal. While the swelling seems to have gotten better, it still feels a little puffy. I believe now that some of my issues, particularly those higher up on my right side, were probably directly related to the robotic abdominal surgery itself, which I think is quite a bit more traumatic than advertised. This opinion may change as time goes on depending upon how I heal up.

      He basically said he wouldn’t put any restrictions on me now, and I can start exercising again when I feel like it. I may actually go for a very short jog today to see how that feels. But he did say that running is rough on the body and I may want to consider something else like biking, swimming, etc, going forward. He even suggested some of my issues might have started after I took up running, which I did shortly before all this happened. I am of course still super nervous about getting another hernia now that I don’t have the mesh, but he suggested that a smaller indirect hernia tends to close up pretty well with the scar tissue the mesh creates, and even after removal could hold well. If I do get another hernia, I can get an open tissue repair on that side. The other side still remains hernia-free.

      I’ll keep you all posted as time goes by. I know that new issues can occasionally crop up months after this kind of surgery, but that things can continue to also improve for a very long-time as well.

      By the way, Dr. Belyansky is no longer really doing mesh removals. He’s trying to refocus his time on his primary passion – complex abdominal wall repair. I don’t believe he’s taking new patients any longer for this type of surgery.

      Feel free to ask any questions you might have.


    • #28756

      Glad you did well but I wish he had stopped doing mesh removals before he did mine.

    • #28757

      Congrats! So, are you happy with the outcome? Timeline seems long. The doctor I saw says that I would instantly feel much better?

    • #28758

      Yes, at the moment I’m happy I had it done. We’ll see long term how it plays out. I think if you go in with terrible nerve pain and major issues, you can notice big improvement immediately, assuming nothing from the surgery makes anything worse, which is possible. But total recovery from this surgery takes a long time. I do think I had immediate improvement in some respects. But healing the whole area will take a while. I know Dr. Brown has said many times that healing from this is a long process. And I’ve spoken with several removal patients that have seen improvement continue for many months or even years. Really depends on what your issues are.

    • #28759

      My issue is that while you had a good outcome my experience was negative and injurious.

    • #28761

      Yes, as mentioned, being worse off is always possible and a serious concern for anyone undergoing mesh removal. The statistics favor improvement, but the details are all very important and each case is unique, and there are no guarantees regardless.

    • #28762

      Best wishes on your recovery. I’m glad things are looking up for you. Among all you wrote, which was quite interesting, I was taken by this:
      I may actually go for a very short jog today to see how that feels.
      But he did say that running is rough on the body and I may want to
      consider something else like biking, swimming, etc, going forward.
      He even suggested some of my issues might have started
      after I took up running,
      which I did shortly before all
      this happened.
      Remarkable. Multiple doctors, directly and indirectly, have indicated to me and others that running is fine. When I hear that I think of jogging not the 100yd dash. Did he mean jogging as well? And does that match up with what you had heard about it before?

    • #28764

      So I believe what he meant was not that running caused the hernia itself, but perhaps theoretically could have caused some of the groin pain and discomfort I was feeling. I think he was just trying to consider possibilities for the discomfort in my unique case where it was more mild to moderate and was never super obvious that it was 100% the mesh causing 100% of the issues I was having. And I absolutely have had pain and discomfort in the groin from running, similar to the issues I’d had as a soccer player as well. I think he was just saying, after I brought up exercise and I asked what was ok to do now, that as we get older even jogging becomes harder and harder on the body, and that something a little easier on the muscles and joints like biking or swimming or walking would potentially be better. So he didn’t say I couldn’t run, and he wasn’t suggesting the running was the reason for my hernia. Just that it might have caused some of the groin discomfort (for example with sports hernia, which isn’t actually a hernia) and could be harder on the body as we age and there were better alternatives, particularly if you’ve had issues and recently gone through surgery.

    • #28768

      AJM, glad you are initially happy with the procedure. I had been tracking your case and was wondering if you went through with it back in Feb. All the best to you in your recovery.

    • #28770

      thanks, mitch. will be sure to keep you posted on my progress. hope you continue to feel good as well. will be interested to see over time if your issues continue to improve. i believe mine did to some degree over the years. but after three years i was worried they would never fully resolve. some folks would probably not have been much bothered with my particular set of symptoms, but i was. finally decided i had to take the chance to see if there would be improvement with removal. and i had grown somewhat worried about having the mesh long-term regardless (though much of this could have simply been reading too many bad stories on the internet admittedly). still not out of the woods and won’t really know for sure where I land for many months i think. but i do believe some of the symptoms were definitely the mesh, while others might have been caused by other things. the latter will be clearer with time.

    • #28774

      How long was the procedure?

    • #28776

      Hour and a half I think?

    • #28782

      Thanks for sharing your recovery experience, @ajm222. Dr Belyansky is a skilled surgeon. Your experience is what most patients should be experiencing from lap/robotic mesh removal: surgical pain that improves over time, yet resolution of preoperative symptoms.

      Just know that though you had built scar tissue from the repair, and that is likely why Your surgeon did not see any hernia after the mesh was removed and thus a re-repair was not necessary. However, this scar tissue may not be adequate for longterm prevention of another hernia. If you have new groin symptoms in the future, you should be evaluated for a hernia recurrence.

    • #28792

      Thank you, Dr. I’ll certainly be keeping an eye on it. I know Dr. Belyansky suggested hernias that were originally indirect seem less likely to reherniate after removal, at least for the 3-5 years he’s been kind of tracking this. I did assume there was a decent chance someday I’d get another hernia there. Would be nice just to have at least a few years where I don’t have to think about all this. Then I can consider an open tissue repair if needed.

    • #28793
      Eva Tulip

      Hi! Happy to hear some positive stories on the topic. May I ask a general question about mesh removal – of a mesh was placed to fix hernia (e.g. big one), after it is removed how come the person lives without it? i mean what supports the hernia? How is it better than before the mesh was put on the first place?

      • #29648

        That question comes back all the time after mesh removal, why the mesh is no longer needed? Maybe the mesh removal includes some tissue repair also?

    • #28797

      Hello ajm222

      I am having the same exact issues as you although I also had vertical cut above the belly over old incision which was causing pain. Although my mesh was put in both openly, the doctor who removed it said he felt comfortable removing it robotically. From the open above incision he saw a small hernia that he sutures with dissolvable sutures but I continue to have these sharp soreness along the left lines of the incision. I don’t know if this is nerves from the new scar tissue? Old? If it’s going to get better or not because work was done at the belly and nerves are all connected? I just don’t want to continue having the same soreness because that was the major reason I had mesh removed. This seems like a never ending nightmare. I also don’t know why the doctor didn’t close the hernia robotically when he was in there? I am so confused what he did exactly robotically vs what he did openly and why he is telling me he couldn’t see anything? He also mentions in the op report that he removed the meshes from the incision he made. So now I am not sure if he just made 4 trocar sites and just did the removal but pulled the meshes out from the open incision only? I asked if the extra incision served a purpose and he said yes because he was able to see the small hernia. But then I am like hmm 🤔 why weren’t you able to see the hernia robotically from the inside? He is a very skilled surgeon who came highly recommended so I am confused 🤷‍♂️

      • #29649

        When doing robotic removal, there is typically enough scar tissue left behind to cover the original hernia defect. This may or may not hold long-term, but I don’t think a further tissue repair can usually be done at this time, beyond a stitch or two to reinforce things. Typically a tissue repair, if needed, would have to be done at a later date in another surgery. If the mesh is removed openly, a tissue repair could be done at that time. And of course there are cases where mesh is removed and replaced by new mesh during the same removal surgery.

    • #28801

      Hey JR – sounds like Dr. Towfigh is answering some of your questions on the other thread. Who did your surgery by the way? Feel free to private message me if you’d rather. My mesh was inguinal and I think the situations are too different for me to be able to speak with any intelligence on what’s going on. I’m actually surprised in my case I have any of these abdominal/umbilical issues while the groin area is mostly fine. But mine seems to be getting a tad better each week with time. And my surgeon did say it could take a while for things to settle down. Most of the swelling has subsided but the abdomen still feels a bit bigger than before, and there is still some internal tightness and sensitivity. But as I said, it seems to be improving very slowly. I think you have to give things a few months, particularly where nerve pain of any kind is involved, to see where you land. In fact, that sort of pain can take even longer (years in some cases) to fully improve. But if after a couple months you’re still suffering in the same way, some sort of medication or injections should probably be considered. If the mesh was in fact the direct cause of those symptoms, they should improve.

    • #29645

      ajm…..thanks for sharing your story….I’ve posted mine elsewhere but I want to share this with you and ask for your opinion/advice on my situation if you have some time.

      what did you do and didn’t do 4 weeks post removal, 8 weeks, 12 weeks…..I should be able to grok the remaining increments.

      I’m 2 weeks and 3 days out from bilateral bard 3d max mesh removal via robotic 4 port surgery, peritoneum “quilted” back together. abdominal swelling has been reduced 60% or so from ASIS to ASIS, with reduced swelling also around where new, smaller, Progrip was placed, just on right side this time, to cover the previous inguinal and femoral hernias.

      scrotum swelling is down also but testicles pretty tender, right more than left.

      I’ve very cautious about getting in/out of bed, etc, but I making a point to walk for :15 twice a day, whether outside or in the house (due to air quality lately here in oregon).

      if my bladder gets full, which it does since I’m drinking loads of water, hardly a beer, then pressure on top of pubic bone is pretty tough until I expel.

      so I’m wondering what the do’s and don’t are from your perspective given the timeframes I posited at the beginning. any info would be appreciated.

    • #29647

      hey there paul –

      i really should have journaled my recovery, but didn’t. but i do remember that the first week was rough – not because of removal pain but just swelling and feeling like my whole abdomen was huge and tight. i also had some discomfort at the trocar sites, particularly a lot of pulling and tugging on the side where the mesh was removed. it was more dilated and my surgeon said to expect it to feel more uncomfortable for a while. he had to put a stitch there as well.

      after that it was just a lot of ups and downs. some pain and soreness and feeling like the area was kind of weak, plus some tightness and pulling at various spots. over time all of that has steadily improved. at 6 months i am still dealing with some of that but at a level that doesn’t bother me very much.

      i will say that at 2 months i completely dismantled a huge playset in our backyard and hauled it all to the local trash dump over a period of several hours. and i have probably done more in the last few months in terms of yardwork (to include tons of heavy lifting) than i had done in the previous several years. and i am now starting to run again almost daily, whereas i had only been running every other day at most while i had the mesh in.

      so in general i would say all of the various symptoms slowly got better over time, very slowly. and i am hoping that continues over the next 6 months, one year, two years, etc. the tightness, pulling, soreness and weakness have all improved.

      also, i did have sensitivity and pain in my testicle on the right side. that also has improved quite a bit in just six months. again, very incrementally but without question it has improved. in fact, it’s mostly gone i guess. but it took a while. i definitely continued to notice it for several months, and it’s maybe still vaguely there. but the trajectory is positive.

      i think you have to just be patient and listen to your body and stay as active as you can (but don’t go too crazy, at least for the first month or so) and plan to re-evaluate after 3 and 6 months. no specific dos and dont’s really. the surgeons never have any good advice. it’s always just listen to your body. everyone’s experience is different and i think you just need to figure that out for yourself. but again, i think at least for a month or so be active but don’t go crazy. then slowly start pushing yourself a bit more and more.

      hope that helps

    • #29650

      thanks so much for ‘splaining a bit more. I agree with all you suggest, even more so since I had mesh removed from both sides. dr chen sent me a slew of images of the removal and the subsequent repair as well as a pretty horrid image of the bilateral mesh itself….no wonder I was dying’….23 centimeters across/length, about 12cm wide/high. my main issue is patience, which my wife reminds me of often as not being one of my many virtues, so all things bendy and jostly and twisty are going to have to wait. thanks again for your help!!!

    • #29651

      yeah, you’ll be feeling all kinds of stuff for a while – some painful and some just weird. but as long as things are improving a bit month over month, I think you’re good. but it can take a while and there are definitely ups and downs, so you just have to extend the timeline. i can certainly understand the impatience. i always freak out with every little twinge and worry about everything, so that was also really hard for me. still is.

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