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Professional societies still advocating for mesh, with vague unsupported claims
I just came across this leaflet produced by the British Hernia Society and am shocked at how vague and “tone-deaf” it is. No actual numbers are used, just undefined words like most, and gold standard, and vast majority. “Periodic reviews by authorities”. Even claiming that most surgeons use mesh to repair their hernias, implying that, therefore, mesh is “okay” and the preferred method.
Very disappointing that a professional society like this still seems to be working for the device makers. Even using Bard’s “gold standard” phrasing. Very hard to understand how a doctor can support this lack of rigorous examination of these products that are being identified on a regular basis as the cause of people’s ruined lives. Unconscionable. Unbelievable. Like they live in a separate, sheltered world.
Here is the link, and the copied text.
From the British Hernia Society:
Mesh and your Hernia Repair “helping you to make an informed choice”
Introduction In addition to discussions with your surgeon, this brief information sheet has been prepared to help you make the right choices for you.
What are my options? Not all hernias require an operation, but the majority will at some point, as they do generally get bigger and may cause more symptoms.
Non-surgical options “Watchful waiting” is an option for patients with a hernia with only minimal symptoms. The presence of a hernia in itself, should not limit your abilities to carry out all your usual activities including exercise.
Surgical options The repair of a hernia involves an operation. Two main techniques exist:
Non-mesh repair: this involves closing the abdominal wall defect (hole) with stitches that does create a degree of tension.
Mesh repair: the use of mesh to augment the repair and act as further reinforcement.
Repairs can be performed by open or laparoscopic (‘key-hole’) surgery and the technique most suitable will be discussed.
Surgical mesh, regulations and safety The use of mesh to repair the majority of hernias has been the preferred method in the UK and worldwide for over 25 years. There is a large volume of data on the outcome of various hernia operations and different meshes. Indeed when surgeons themselves have hernias they opt for mesh repairs. Meshes used in surgery are tightly regulated and require a CE-mark to be used in patients in the European Union. Patient safety is a critical component of this regulation and regulatory compliance is subject to periodic reviews by authorities in the EU.
Is a repair with mesh a ‘gold standard?’ Many patients who develop a hernia, have a ‘tissue weakness’ which doesn’t hold stitches well. This explains why repairs with stitches have a higher failure rate than those with additional mesh. For the vast majority of patients, mesh poses little if any additional risk, and coupled with a lower recurrence rate, has resulted in the use of mesh becoming the gold standard in hernia repairs.
Are there disadvantages to a mesh repair? Mesh is foreign material, like any synthetic implant (dentures, crowns, heart valves etc). It can become infected but this is a rare event. Some patients can develop chronic pain after surgery. There is no firm relationship with the use of mesh and chronic pain, and non-mesh repairs can equally result in this problem.
Summary For most patients mesh is a safe and reliable way to repair a hernia. Millions of hernia repairs have been successfully performed with mesh. Alternatives are available and will be discussed to help you make an informed decision. Further information is available at http://www.britishherniasociety.org
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3 Replies
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People who advocate mesh surgeries never had them done on themselves
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People resist behavior change (it’s hard)
People hate admitting they were wrong (it’s embarrassing)
People can have multiple definitions of “gold standard” (depending on how they define successful outcomes) -
It is the official guidance of the British Hernia Society as of November 14, 2018. The momentum behind the use of “mesh” is huge. People are putting on blinders and hiding from the truth, I think.
https://twitter.com/BritishHernia/status/1062723661801705473
We have produced a Mesh safety leaflet for patients - https://t.co/a70Q7Go29i
— British Hernia (@BritishHernia) November 14, 2018
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