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Re-absorbable meshes and chronic pain
I was wondering, are re-absorbable meshes less likely to cause chronic pain/discomfort etc? I seemt o remember having read something in this line but I am not sure…
I am aware that some believe they are more likely to cause a recurrence, but as it was mentioned by many I think that risk is more acceptable than the chronic pain one.
I was also wondering, can these meshes be placed laparoscopically/robotically? or are they only manageable via open repair somehow?last but not least, I also seem to remember having read that while plastic meshes induce a body reaction that creates scar tissue around the mesh, these “biological” ones are “integrated in the body, without the formation of scar tissue? I ask this as I am wondering if scar tissue itself could be a potential source of chronic pain, all things equal..
Thanks again for your insight (and patience with me 🙂
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7 Replies
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As with any permanent implant unless they can provide sound long term numbers and address the significance of chronic pain or disfunction it is difficult to say anything…I would assume naively that those implants that get reabsorbed at least are less likely to cause problems years down the road….also people claim they cause less short term pain
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Ovitex is only a few years old, with a very limited number of patients. The reported data is shockingly sparse.
Don’t overlook that TelaBio is a new company, one of those high tech “startups”, that just went public. They need to get more people to use their product quickly. It’s just the way things are today. This is not a new product from a big company. TelaBio’s survival depends on getting market share. They have to sell.
TelaBio was founded in 2012. Look through their new web page. Be careful.
https://www.bloomberg.com/profile/company/0747851D:US
https://www.telabio.com/ovitex.html
https://www.telabio.com/assets/download/OviTex%20Published%20Clinical%20Data.pdf
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Thank you to Dr Szotek for the info!
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And thank you to Dr Szotek for the contribution and useful information!
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The informative tele-health appointment sounds like a good idea, it can’t hurt! Get as much information as possible before making a decision on surgery and mesh v non-mesh. Your quality of life may depend on it. Best wishes!
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Alephy, I have to say, Dr. Szotek took me through this a couple of weeks ago and it was awesome to learn about the Ovitex mesh and see the pictures. I would highly recommend reaching out and making an appointment. Was the most informative hernia appointment, by far, that I have had with a surgeon.
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Thanks for your question. We use a significant amount of reinforced biologic mesh in the groin since I give patients a choice for this type of repair. The experience is somewhat limited but I likely have one of the largest, if not the largest series of prospectively collected data in the use of reinforced biologics for robotic inguinal repair. We have performed >160 of these repairs in the last 2+ years with zero chronic groin pain and 1.8% recurrence. I think however when looking at chronic groin pain related to hernia mesh you should realize that it is often the person placing the mesh that plays a pivotal roll in the resultant chronic groin pain as we have not seen it with our series of ProGrip synthetic mesh either. Technique is of utmost importance.
In our experience there seems to be less pain initially with the reinforced biologics and long term they seem to be about the same though.
I do not see a true indication that the recurrence rate will be higher with the reinforced biologics.
The concept behind Ovitex is that like Concrete scar tissue maximally compressed and then expands/stretches. If you place the biologic with reinforcement it is remodeled into your own tissue (a component of which will be scar) and when the tissue starts to stretch it has reinforcement like rebar in concrete.
Hope that helps a bit.
If you would like to discuss in detail and see images of the repairs, etc feel free to schedule a telehealth appointment and I will go through with you.
Dr. Paul Szotek
Indiana Hernia Center
http://www.indianahernia.com
317-868-1305
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