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parietex progrip removal, an exercise in futility?
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parietex progrip removal, an exercise in futility?
Hi again Dr towfigh, your a very caring Dr to check in on my situation like this…
Unfortunately my systemic symptoms recently took a very drastic turn for the worse. About a week ago shooting pain in my left arm with alternating burning/numbness/pins & needles began which has now extended to other areas all over my body. It’s still mainly in my left arm but also now affects all other extremities as well, bad enough that my legs almost give out & I’m nearly too weak to walk at times when this hits me. It’s affecting me cognitively as well very strongly. I now realise I probably need all the mesh out in order to avert full blown autoimmune disease(theoretically proposed ofcourse) from completely destroying & ravaging my body at 31. And ofcourse I still look 3 months pregnant at times from umbilical area inflammation/swelling. (And here I was hoping to be married before I got pregnant, even if its with mesh (: if its a boy or a girl mesh I still don’t know though. Lol)I have met with both Rosey & Rammy at this point… Both were great & extremely competent when it comes to mesh removal. With Ramshaw being my most viable option at this point & having the most experience I believe.
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parietex progrip removal, an exercise in futility?
Hi there
Any update as to how you’re doing?
Did you seek consultation with any of the surgeons? -
parietex progrip removal, an exercise in futility?
I do not believe Dr. Meyers does any laparoscopic surgery for hernia repair or mesh removal. Michael Rosen is also on Cleveland. Dr. Ramshaw is now at the Univ of TN in Knoxville. I’d be happy to see you in MA, then we can talk about your chemistry project as well! I’m sure Dr. Towfigh would see you in CA anytime.
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parietex progrip removal, an exercise in futility?
Thankyou beenthere for your input, Who did you end up having the removal with of those 3 surgeons you mentioned? I don’t think there is a PM on here but I would still very much like to get in touch with you by email or otherwise to share info since I am very close to this tough decision. Was your mesh put in lap or open? Sounds like you had a good outcome?
I was also wondering what the consensus is on Dr William Meyers in Philadelphia for lap inguinal mesh removal of my kind..? I ask because I am looking for removal w/o any more mesh being put back in.
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parietex progrip removal, an exercise in futility?
Not sure where you are located but I had major problems with my hernia surgery.
I see you were recommended 2 surgeons in WI. I have met with one of them and would say his experience is very limited in post hernia pain and surgeries performed. The other I know the name but did not see him but met with one of his peers I think Dr. Wallace. I also met with Ramshaw, Goodyear and Yunis and spoke with Dr. G in Cleveland. I had surgery with one of them but all seemed very impressive and excellent at communications.
Good luck. Not sure if this forum has PM but you are more than welcome to contact me if it does.
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parietex progrip removal, an exercise in futility?
The goal is to remove whatever mesh is bothering you. I try to remove all the mesh but if it’s stuck to important areas and too risky it may be left behind. Depends on the reason for the mesh removal.
Consider driving to Cleveland? See Dr Yuri Novitsky in Case Western
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parietex progrip removal, an exercise in futility?
Marcello71
I had my Laparoscopically implanted mesh removed. There are no guarantees that every bit of the mesh can be removed. There is no guarantees that a nerve or another part of your anatomy will not get damaged. You need to see the most experienced and reputable surgeon possible to remove your mesh. Often times mesh removal alone will not work and triple a neurectomy with mesh removal is more likely to yield better results. Either way it is a chance you have to take verses the pain your in now. I would wait as long as possible. Often times pain subsides or becomes manageable even resolves with time.
Good Luck JG
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parietex progrip removal, an exercise in futility?
Thankyou for the help and guidance Dr Towfigh & Dr Earle, this website is truly a godsend to lost patients. In regard to the 2 surgeons mentioned, I have met with Dr goldblatt and he is a great, truly understanding & very competent surgeon however he’s never performed a laparoscopic mesh removal before unless for infection. I don’t believe Dr greenberg has either, unless infected ofcourse which is totally different. I am willing to have to drive atleast a few states distance for this, I just don’t know if flying across the country is an option for me at this point. I guess I really just need a surgeon who’s done atleast 10 of these & is located atleast in the Midwest hopefully(>14 hrs driving distance). What I’m wondering is, can any surgeon get all of the mesh out? It seems most just leave pieces behind where they’re hardest to get at but where they’re also causing most symptoms for the patient. So then would leaving pieces over the triangle of doom while removing mesh from all areas around it even help anything? They might as well call it the Bermuda Triangle of Doom for how few surgeons are willing to venture there…
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parietex progrip removal, an exercise in futility?
Here are some suggestions provided by a HerniaTalk member:
Dr Matthew Goldblatt and Dr Jake Greenberg are both located in Madison
I personally know both surgeons and vouch for their expertise and quality of care.
Let me know if this is helpful.
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parietex progrip removal, an exercise in futility?
This is a repost to my original discussion, I’m sorry I must have deleted my first 2 posts somehow instead of editing them…
I had bi-lateral inguinal + umbilical hernia surgery with 3 pieces of mesh(2 pieces of parietex progrip in groin & 1 piece of symbotex composite in umbilical) implanted in Feb 2015. It all began from me lifting things for my mother in Oct 2014 when I became over exerted feeling like things had sunk downward a bit in my stomache which followed with over a week of constipation. After an N.P. examined me saying I had no hernias she then suggested imaging at the hospital if things didn’t improve. After a ct scan at the ER showed only 1 very small umbilical defect containing fat, the ER doc came in saying “they only see one in there but I felt an inguinal hernia too, its there trust me” so I was sent to a surgeon. The first I went to said, “you don’t have any hernias, come back if something pops out”. So I went for a second opinion with that surgeon saying, “you have four hernias and I can fix them for you”. I said “but the first surgeon said I had no hernias” so he printed out 4 slides of my ct scan where he circled the 4 hernias to convince me of his diagnosis. So being frightened of them worsening or popping out into my scrotum I agreed to him fixing them but since my mother has a vasculitis autoimmune disease(I vehemently denied allowing an implant for fear of rejection), I said “only use mesh if its absolutely necessary to fix the hernias, otherwise sew them up or do nothing if they’re small enough” to which he nodded ok. Anyway I had the surgery which he did lap tapp with me saying after, “so you used 3 pieces of mesh, those hernias were bad huh? I mean it was necessary then huh?” to which he replied “well it would of been necessary in the next 3-5 yrs probably, it was a preventative procedure” I was kinda shocked, having been led to believe there were definitely 4 hernias that needed fixing prior to the surgery. Since the operation I have had all sorts of complications from allergic/autoimmune(bloating, swelling, inflammation, etc.) to groin/testicular pain(between 2-8 out of 10 at times) as well as vascular issues with my genitals turning purple at times of pain & activity. This prompted me to get other opinions with numerous surgeons since the surgery saying, “I don’t see why he did the surgery in the first place, you had no real hernias”. Hearing this made me wonder if removal would be easier or more possible if there’s no hernias being held in by the mesh currently. So finally I am here to ask what the optimal timeframe is to attempt to remove this parietex progrip & is it even possible without me losing a testicle? Because of the Polylactic acid microgrips that take 18 months to dissolve, is it better to attempt removal sooner to prevent more tissue in-growth or later once the microgrips have dissolved? I also believe I may have a solution or idea to dissolving them quicker or de-laminating it easier so to speak from all the vital structures in the pre-peritoneal space(triangle of doom: epigastric/iliac vessels, triangle of pain: sperm cord/ilioinguinal & other nerves) and wish to have a surgeon confirm or deny its feasibility…
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parietex progrip removal, an exercise in futility?
The real reason I posted on here was to hopefully be referred to an experienced removal surgeon in my area of the country. I have 2 pieces(bi-lateral inguinal) of parietex progrip and 1 piece of symbotex composite umbilical mesh. Im experiencing trouble from all three pieces currently but only wish to have one side of the groin + umbilical piece removed for now. I’m in the Midwest in Wisconsin and I only know of Dr Jacobs(who sounds very competent & thorough but is in New York) and Dr Ramshaw(who is my first choice but is in transition currently). Is there anyone else who removes mesh laparoscopically(with atleast 30+ removals under their belt) that’s located in the Midwest or even in or near Wisconsin?
I also have another more realistic & innovative idea for freeing up the mesh by dissolving the tissue ingrowth to it in the pre-peritoneal space… This one is too good to share over the internet though(it actually involves chemistry & biology n’ stuff (: ), it could prove to be very lucrative if it works. I just need help finding the right surgeon to remove this stuff, then the recipe is theirs, lol.
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parietex progrip removal, an exercise in futility?
Dear Marcello,
Regarding the nicotine: it prevents adequate collagen deposition and this is the reason why we feel it affects healing of incisions and increased hernia recurrence. I am not aware of vasodilation as the reason for the nicotine effect. At this point, we do not have the scientific evidence for any of this.
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parietex progrip removal, an exercise in futility?
Thankyou for the response Dr towfigh(I am hoping to consult with you on removal in the future if all else fails). My symptoms before the surgery that sent me to the ER were just constipation & resulting pressure that got better before the surgery which I told him about, I said: “ya know I’m not constipated anymore or in any pain at all…”, he then gave me a physical exam with his response being: “ok looks like its time to get you into surgery”. This led me to believe that he saw something warranting surgery that I didn’t understand which I trusted since he was the surgeon. I maybe had the 1 tiny asymptomatic hernia at most but then again I’m no surgeon(all the other doctors & radiologists I’ve seen say I only had 1 very small umbilical defect as well). To answer your question, I had no real symptoms at the time of surgery and I agreed to the surgery purely based on his diagnosis & a fear of them getting worse. The only difference I felt after the surgery was foreign material left inside me(I.e. I didn’t feel as if any hernias or bulges had been fixed inside or out, everything was the same as before). I’ve also had a scan since the surgery that, aside from areas of identifiable mesh, is identical to the prior scan from before surgery with the same radiological findings.
>>All that being said, I don’t want to sound like I have a negative attitude or any bitterness at all. I don’t hold any grudge or anger towards my implanting surgeon, especially since I can’t say for sure what his intentions were or not. He still to his day tries to assure me that I did infact have 4 hernias. Maybe your right Dr towfigh maybe he meant prophylactically, but he used the words, “you have 4 hernias and I can fix them for you” so I don’t know how one could fix something prophylactically. However I also can’t diagnose myself and am not a doctor(no matter how often I pretend to be one & even ask my friends or family to call me doctor lol). And as far as I have heard mesh works just fine for many people that have hernias & that never experience any problems with it. At this point I am only interested in recovering my health & moving on with my life once it is removed.
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parietex progrip removal, an exercise in futility?
Fascinating discussion
I agree with Dr Earle. I would have to see your imaging to confirm if you indeed had hernias. I wonder if you had small hernias that were treated and your surgeon’s comment about “prophylactically” repairing them intended to imply that you had not yet incarcerated or strangulated your (small) hernias and he was protecting you from this possibly occurring in “3-5 years.”
I don’t know. Just trying to make more logical sense of the situation.
Question:
– did the symptoms for which you presented to the ER resolve after the hernia repair? That is what is important. Just because your hernias were small does not mean they were not causing your symptoms. Symptoms are a more important reason to operate than size.As for mesh removal: it’s almost always feasible. It has risks. Injury to your spermatic cord or to nerves in the area are definitely risks with this operation and so I would not take recommend that procedure lightly. The question is why do you have your symptoms and direct the treatment toward that end.
If you are fit and you had three pieces of mesh, a tightness or stiffness of your abdomen and pelvis may be the cause. Also, the type of fixation you had may be the cause. Inflammation due to mesh should resolve Formosa Patients after the first couple of months. Thin patients and women are more likely to have this problem, as are those with fibromyalgia and inflammatory disorders. Dr Earle’s recommendations are right on for that problem.
If your mesh is too tight, Botox injections have been shown to help out with that problem. It’s a unique thought. It relaxes the muscles and therefore the repair. It is a temporary effect but many people have a long lasting result.
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parietex progrip removal, an exercise in futility?
I love the analytical thinking! Unfortunately, it wouldn’t work. The reason is that the tissue actually grows through the pores of the mesh, and that tissue is not dissolvable (at least no way that we know). If it’s infected, that tissue ingrowth doesn;t happen. As for removal for pain, it’s legit, but sketchy, and shouldn’t be done without a very thorough evaluation, particularly looking for other causes of pain. You may want to try the medrol dosepak though – way stronger than aleve. Just don’t take NSAIDs at the same time.
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parietex progrip removal, an exercise in futility?
Thank you for your speedy reply, this website truly is incredible & very valuable to ailing patients. I have tried numerous NSAIDs and am currently on aleve(naproxen) daily as well as tramadol for pain but as I am only 30, I do not see leaving the mesh in working out for me in the long run. I do not blame the mesh at all for my situation as it does work great for so many, however I just completely didn’t need(or want) it to begin with. My focus now isent to blame anyone but just to try to regain my health & move on. My idea for easier removal(this hopefully will be seen by Dr towfigh as well for her input) came about when any surgeon I saw said that the only situation warranting removal is infection of the mesh because in that case(I’ve been told) bacteria & inflammatory fluid or pus collects around the mesh making it as easy as “slipping a tissue out of a Kleenex box”. So then couldn’t this be simulated with a non-infectious sanitizing liquid like a biological or antibiotic type fluid possibly? It may sound silly but I saw one of these videos where the pre-peritoneal space was swollen & blown up like a water balloon full of infectious fluid, so the surgeon slightly incised near the top so as not to let too much infectious fluid out, then he pulled the balled up mesh out drenched but completely de-laminated and free-floating. The surgeon then used a clear antibiotic type fluid to irrigate the space, filling it up just like the fluid before it had… What makes me feel its even more feasible is that polyester is hydrophillic & polylactic acid is metabolised by hydrolysis. So maybe even filling the pre-peritoneal space with a high water content sanitizing liquid then leaving it to soak with the patient anesthetised for 30 minutes could facilitate it being slipped out like a Kleenex just as easily. Completely theoretical & quite comical to a surgeon I bet, but I just thought what if?
Btw I see your a fellow U of A alum, go wildcats! -
parietex progrip removal, an exercise in futility?
marcello71 – I’m sorry to hear your having problems. It sounds like your initial symptoms were not due to hernias. Having said that, without an exam, it’s very hard to know if there were hernias, weaknesses, or nothing. It’s also difficult to know if the mesh is causing the current symptoms or not. In the event there is an ongoing inflammatory component to your symptoms, would consider a month long course of anti-inflammatory treatment. This includes a medrol dosepak, followed by 3 weeks of naproxyn. Myoflex cream or aspercreme topically, and ice/heat used on a schedule based on trial and error as to what seems to help best for you. I have seen this work many times, but not every time. This is easy, and low risk, and if you have any side effects from the meds, simply stop them. These should be prescribed by a doctor who should go over all the risks/benefits so you can decide. I am interested as to what your idea is about separating the mesh from the surrounding tissue. There is no “right” answer to mesh removal timing, but usually, the longer the better, unless it’s within a week or so. Hope this helps!
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