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Please second opinion with mesh removal
Hello everyone or Dr. Towfigh
Please
I’m dealing with chronic pain and immunological disorders after a recent hernioplasty.
Before surgery I had very localized right groin and testicle pain and discomfort. They found a minimal fat tissue direct protrusion in the right groin.
My surgery was performed 5 months ago with Rutkow-Robbins technique, using a plug and a mesh via open repair with General Anesthesia (I’m also a CSF leak sufferer from 3 years so I’m avoided to receive epidural anesthesia).After visiting another surgeon specialized in hernias with expertise in mesh excision and anatomical reconstruction, told me that pain and mesh reaction after three months is far to be normal and he recommends mesh removal, triple neurectomy and Shouldice or Bassini reconstruction.
My concerns are the common outcome of such complex and large procedure:
* Mesh removal:
– It’s possible after 5 months? The plug could be removed NON laparoscopically?
– My mesh is apparently normal on Sonography and no recurrence, but I have general and possibly immune disorders, and central neurologic pain sensitization (burning/cold legs, feet, arms and pelvis).* Triple Neurectomy:
– Is worth? Should I preserve those nerves?
– What about “NEUROMA” formation?
– Is needed a nerve ligation after cut?
– What are the feelings after that (numbness, muscular atrophy…)?
– Can the Cremasteric reflex be maintained?* Anatomical reconstruction (Shouldice, Bassini…):
– What is recurrence rate? – My original hernia was direct small fatty tissue.
I have friends who had surgery before de advent of meshes (90’s) and they are pretty well now.
– Could be done right after mesh removal?* Surgery time
– The surgeon can’t give me an approximation (hours). But how much it take in rough numbers?* Recovery time
A lot of thanks
Paco
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2 Replies
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Happy to help if you wish to see me.
Briefly:
– open mesh plug repairs are best removed via open technique.
– you have to double check to make sure your pain is from the plug itself and/or mesh and/or nerve. Once the diagnosis of the cause of your pain is pinned down, then the appropriate approach and options can be discussed. -
You might try contacting Dr. Towfigh’s office directly. She has recently removed a plug and patch, and also showed a neuroma on her Twitter page. She also talked about how the decision to perform a neurectomy depends on the individual situation.
Twitter is hard to pull information from, but it’s the world we live in. Her first tweet shows how to contact her office for consultation.
https://twitter.com/Herniadoc/status/1021561699290116097
What do you see?
This is a medium size Perfix #plug #mesh that has balled up, aka #meshoma . It was causing chronic groin & nerve #pain due to erosion into the spermatic cord, so I excised it. He is now #pain free!🙏🏻#meshcomplication #hernia #chronicpain #itsnotjustahernia pic.twitter.com/EgnLh0ULXR
— Dr. Shirin Towfigh (@Herniadoc) July 24, 2018
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