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Robotic Inguinal Hernia Mesh Explantation (removal): …
I kind of feel like I’m piling on here but I just came across this video by Dr. Brian Jacobs, a well-known name in the field of hernia repair. He presents often at the various hernia repair conferences.
He is an interesting guy and the video is interesting because even though this woman apparently has no physical/medical reason to have the mesh removed, ten years after a lap TEP implantation, he still does not acknowledge that mesh can be a problem. He mentions that she has chronic pain but says that is it not because of the mesh or scar tissue. But offers no rational reason for the pain. He also makes a comment that he uses the same type of mesh for hernia repairs and that the “overwhelming majority” (imprecise, he doesn’t have a number) of his mesh implant patients are very happy with their implants. It’s not clear that he actually believes what he is saying, it seems like he is just saying the correct words for liability purposes. Put it in one patient , remove it from another, how do you justify it? At least he does removals and seems good at it.
It’s from 5 months ago. It seems to be a sort of advertisement for mesh removal, it’s from his personal/professional YouTube account.
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Here is another really interesting video from Dr. Jacobs. Biologic meshes have been a hot topic off and on over the years. The premise has been that the collagen of the biologic mesh gets slowly replaced by the human body’s collagen until, eventually, the two are indistinguishable. It is a nice dream and worth attempting. But this video by Dr. Jacobs shows a biologic mesh that was explanted after 1 1/2 years and shows no sign of absorption or even of tissue infiltration/incorporation. It peels off just like it probably looked when it was implanted. If you look back through the literature you’ll find that this is actually not uncommon with biologics. The new biologics were supposed to fix this problem.
Something to be aware of if a surgeon wants to use the latest biologic mesh for your hernia repair. It might actually be a good thing, the ability to just peel the mesh out if there are problems. In the first video in the post above you can see that the main problem is getting the veins and nerves peeled off of the mesh without damaging them.
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