News Feed Discussions robotic mesh removal post op problems

  • robotic mesh removal post op problems

    Posted by NFG12 on March 23, 2017 at 10:35 pm

    Back in May 2015 I was talked into doing a bilateral hernia repair with 3d max mesh 6×4 on both sides, right femoral, left inguinal. I had no lumps or anything like that on either side nor any pain they were found on a CT scan. The left side was about a half inch and the right side was a little bit over a half inch, I know this now because of medical records. I got told mesh is the gold standard and I would be back on my feet in no time. I then get the surgery and it caused problems I never even had that with time just got worse and worse. They put the mesh in on both sides and fixated it with tacks. I gave myself a good year to get better but the pain was just getting worse and worse so then I knew I had to get checked out, the day after surgery I had numbness on my left side not the right so much but on the left from the crease of my thigh and going down it to. The surgeon said don’t worry about it it will go away in some weeks. Then like I said I gave this a good year to clear up but it never really did, the numbness somewhat went away a little bit but it was still very sore to the touch. So about a year later I get a CT scan to try to figure out what is causing me pain and it showed that the tacks were going into my pubis symphysis on both sides. So I now knew it was the mesh and the tacks doing this and causing me the pain. So I searched around for a surgeon that could help and it took a little while then they went over what could be done. I looked up stuff for awhile myself and never knew that so many people have problems with mesh. when I got the first surgery I was about 165 pounds and im 5’11 so im pretty thin. So then I found the new surgeon to help and I told them I just wanted the mesh removed and the tacks removed and no mesh put back in because I consulted with Dr. Ramshaws office and they explained how when mesh is put in and there for awhile that when they remove it the hernia is usually closed and also that I didn’t want any nerves cut and they said okay that sounds like a plan because I read about neurectomys and it seems people had nothing but problems with them. So they say okay we are going to do it robotically and they explain how it is more precise and better visualization and I agree and we set the date for removal. Then on the day of surgery I show up and he comes back to talk pre op and changes everything around and says im going take all the nerves and put more mesh in and I was like how are you changing all this right before surgery that’s not right, it gives me no time to think about the options when I said over and over I just agreed to have the mesh and takes removed with no cut nerves. He then states well once I go in and take the mesh and tacks out if you are still in pain I cannot go back in and get them which now I don’t think is true so I didn’t know what to do I was sick of being in chronic pain. So this kind of scared me and I opted for just the illioguinal nerve on the left to be litigated and nothing on the right because my left side is the side that hurted badly. Then I get taken back for surgery which lasted about 3 hours or so. I then wake up and I cannot feel neither one of my feet, they felt numb and asleep, I then tell the nurse and she says it is most likely from the positioning from the robot for a long period of time. Then once I grab my medical records a month later it states that the genital branch was cut on both sides. He stated at first that he cut the illioguinal and genital branch on the left and just the genital branch on the right side but when I asked him why isn’t that on the report he took it back saying that no I just cut the gential branch on both sides which I do not believe because its been a different story everytime, plus my left side is so much more numb than the right and its a big difference, I can barely tell any numbness on the right side but the left side I can tell really bad. So it is now 3 months after this surgery and I pretty much feel worse then before. I feel so much weaker in my legs, I have burning sensations in my groin now from the nerves being cut, they think I could have some nerve damage from the postioning because my feet are still numb with a pins and needles feeling. Ive developed pain in the spermatic cord my doctor said there is some sort of cyst type thing now on the left side and my testicle has been very sore. Dr. Towfigh if you can give me any feedback that would be great this has been a long road that I thought would end after having this done. Have you ever seen nerve damage from the robotic surgery? They took the mesh out in one piece does that sound right? First on the right side then we he came to the tacks he left them for the time being then started taking out the left side then he removed it with the tacks and took it out in 1 piece. How long do you think it takes to recover from Bilaterally mesh removal? What does the genital branch nerves do and supply, I never asked for these nerves to be cut. Do you think my feet will get better over time from this from the positioning/have you ever seen this happen? Will the nerves that were cut start to settle over time/I wish I would have not agreed to that. Can cutting those nerves cause the numbness in the legs and the feet or do you think that is from the robotic positioning?Is it possible to that the nerve overlapped another one and it was cut through also, that’s why it feels way number on the left side then right side? Also what can cause the spermatic cord to develop a cyst type thing after mesh removal and how does it go with healing with the spermatic cord does scar tissue grow back over it?Can that cause discomfort and problems or not usually? Sorry I wrote so much, Any insight will be greatly appreciated everyone.

    NFG12 replied 6 years, 10 months ago 4 Members · 8 Replies
  • 8 Replies
  • NFG12

    April 9, 2017 at 8:12 pm

    Do you see that sometimes when you remove mesh that men have some testicular pain afterwards for awhile? Is it just from trauma? The Op report says there was some ongoing bleeding in the epigastric area but it was controlled. It also says that the Vas and testicular blood supply was preserved. Does your spermatic cord go through some trauma with mesh removal that heals with time, is that why it can be sore for awhile? It also stated there was more scar tissue on my left side than the right side, can that explain why the left is still sorer than the right side?

    And it states that neurolysis was performed but also neurectomy of a small piece of the Genital branch on the right where my susposed femoral hernia was and the Genital branch on the left side also where my inguinal one was. If the neurolysis was possible couldn’t I have just got that done and not the neurectomy then, I didn’t really want any nerves cut I told him.

    Also is the genital branch neurectomy more of a mild neurectomy, I don’t feel much numbness on the right side but in my left side it feels way more numb like at were my scrotum starts at the top and the base of the penis and the crease of my inner thigh I thought that was more of the illioguinal nerve in that area but he said he didn’t take that nerve but nerves can overlap and distribute to different areas because I thought he cut more nerves on the left because it feels way number than the right side. Could he have cut the whole Genitofemoral nerve all together on the left that’s why I have more numbness on that side?

    Also how long do you think it takes for recovery from mesh removal? I’ve heard a good 6 months to a year which sounds pretty right. I am only 3 months out at this point from mesh removal. Also do the nerves that were cut kind of settle down after awhile I am not really liking the feeling of that so far at all, that’s why I told him I did not want any nerves cut and only the mesh and tacks to be removed.

    I developed a big hematoma, my scrotum was huge but they said that was normal with mesh removal then I asked if we should drain it they said no it will heal with time and that’s when my left testicle started to hurt so I got an ultrasound about 2 months after the mesh removal and it showed that I developed Microlithiasis of my left testicle that I never had before. They said because the hematoma was not treated that it can build up calcifications. Do you think that’s possible? Have you ever seen it happen?

  • drtowfigh

    April 8, 2017 at 5:13 am

    Excellent discussion about a very difficult problem.

    Some comments:

    If you have testicular pain since the mesh removal, you may wish to see how you do with spermatic cord blocks. Sometimes the mesh invades the little nerve plexus around the vas and removing the mesh leaves behind the damaged microscopic nerves. There is a treatment for it. It starts with a diagnostic cord block.

    Any pain that radiates below the knee can be related to your spine. Get that worked up. You may have had an underlying disc or something to start with, and the positioning from the robot made it worse. That should also be treatable.

    The cyst you are reporting over the testicle may be a fluid collection or hydrocele. I need more information to help you figure out that one.

  • marcello71

    March 25, 2017 at 11:17 pm

    I feel so sorry for all of us going through this endless & completely unnecessary nightmare. It’s simply a medical profession valuing plastic over biology/life & profit over people.

    What other questions do you wish you had asked prior to removal NFG12?

    Also how are your symptoms lately Momof4 have you made any more progress or decisions?

    BTW I private messaged both of you Momof4 & NFG12 because I had some more private/personal medical questions for you both & info to share if that’s ok. You have to sign in & look in your inbox under notifications to see PM’s I believe…

  • NFG12

    March 25, 2017 at 6:04 pm

    Thanks momof4 for the kind words I appreciate it. Marcello71 the mesh was in for about 19 months, I never even had pain before I got the first surgery and after I got the surgery the pain just got worse and worse it never subsided. I am 27 years old, I just remember life before these surgeries and I wish I never went through with the first one. I didn’t lose a testicle but the one on my left has been hurting since I got the mesh removed, I developed some little sort of cyst or something on my spermatic cord after removal on the left side. I don’t think he clipped any epigastric vessels. I looked in to University of Michigan but its hard to get in there, I was looking at 3 months just for a consult. I should have traveled to do it, you really have to find someone that knows what there doing. My first choice was Dr. Ramshaw but then I found these hernia specialists in Michigan here that are susposed to be the best in the state but im not so sure about that now. And yes the nerve stuff is weird and im not liking the feeling of that. How long has your mesh been in for the longer the more scar tissue, mine was like I said about 19 months so that’s why I wanted to get it done because I figured the less time less scar tissue it will be easier to get out. Ive heard so much bad stuff about mesh period and I studied quite a bit but that #d max mesh is causing a lot of problems for man guys. That mesh on one side has some bioabsorbable acid to make more of an inlamed respose withing your body. The mesh stuff is a joke to me honestly especially if your not a heavy person. If you did a shouldice repair it most likely will heal good and hold up and if it does come back then you just have to fix it again, if you use mesh and it doesn’t hold or just causes problems then you have to go through the whole mesh of taking it out and all that. And those nerves do serve motor functions like to the cremaster muscle and stuff. My pain before mesh removal could be bad sometimes where it would keep me up at night and it was horrible so sometimes a 9 or 10. As of the mesh removal so far theres somewhat of a difference but not so much as of yet it will probably take some time but I hope I improve with time, it is a relief to know that it is out though. I just want to tell you Marcello71 and Momof4 to ask a lot of questions. With the mesh removal heres how it goes, Some surgeons wont even do it unless they do neurectomy to, they will say the neurectomy with it is the only real way we know that you will not wake up in pain, or they will say we could not free the nerves without damaging them, or if they even think the nerve has been irritated and it could be causing pain they don’t want to take that chance so they cut it, or they say well even if we leave the nerves there after removing the mesh scar tissue will just grow back over them and cause them to get irritated anyways. Dr. Towfigh wrote on here somewhere that even under a microscope they cannot tell if the nerve is damaged so there they don’t take that chance and they cut it. All I can tell you Marcello71 and Mmof4 is to ASK ALOT OF QUESTIONS AND DO SOME STUDYING ON THIS YOURSELF TO! THATS THE MOST IMPORTANT PART!

  • Momof4

    March 24, 2017 at 8:51 pm

    NFG12, sorry to hear about your problems. I hope you continue to improve. I know Dr. Towfigh and other doctors that I have seen say that you can continue to heal for a year. Maybe that gives you some hope. Marcello71, you stated that you are going to undergo robotic mesh removal. Would you mind telling us who is going to do the surgery and where? I am still trying to make a decision and of course want it to be the most informed decision possible.

  • marcello71

    March 24, 2017 at 7:27 pm

    Oh ok, that makes more sense. So how long was the mesh in for & how old are you if you don’t mind me asking?

    If he didn’t put anymore mesh in & he got all of the old mesh out, that’s pretty good as far as these scenarios turn out usually. I hate to say it but if you also didn’t lose a testicle or need epigastric vessels to be clipped off or didn’t develop a serious infection; then it sounds like a success. You won’t know for sure until atleast 6 months to a year have passed btw. Of course you are right about the nerve stuff that’s very scary & serious, plus I think those nerves serve more functions then they say(might not only be sensory nerves).
    I am about to undergo the same procedure & I am fully aware that I could be in worse pain after removal. If I am in worse pain after removal that persists past 6 months however, then I can go for neurectomies at that point.

    Just curious, was your removal performed at University of Michigan, another teaching university or by a private practice surgeon?

    Also final question, how bad was your pain/symptoms before removal & how are they now on a 1-10 scale?

  • NFG12

    March 24, 2017 at 5:36 pm

    Thank you for your kind words Marcello71. I agree that mesh is no good, it seems to cause way more bad than good. No Dr. Ramshaw did not do the surgery I just consulted with them about having it done and he just does it laproscopic, he was my first choice but im in Michigan and I searched around here and found someone but ive been regretting it so far. And the surgeon yes changed everything on me at the last second when he came in pre op. He said if I remove the mesh and tacks and that doesn’t work and your still in pain I cannot go back in for the nerves then, which now I don’t really believe that and I wish I hadn’t let him do that. After the surgery I woke up and could not feel my feet at all, it slowly has went away but not all the way and im 3 months out, I feel kind of worse than before so far to be honest, I feel so much weaker, especially from my calfs down which is most likely from nerves being compressed for so long in the position they put you in for the robot your like tilted back so I think that was compressing my nerves and I was like that for about 3 hours. He said he got all the mesh out and that is the only positive thing I can take away from this so far. But that’s what I was saying about Ramshaw is that they said usually about 85% of the time they remove mesh the hernia is not there because of the tissues there closing it and I told the surgeon I did not want more mesh in me and the op report states there were no obvious hernias on either side.

  • marcello71

    March 24, 2017 at 4:50 pm

    First of all I’m very sry to hear your story, the exact same thing happened with me being talked into mesh that I definitely didn’t want or need except I was implanted with 3 pieces at once.

    Second, did you say that dr Ramshaw performed robotic mesh removal for you???

    If so I was not aware he does it that way(it’s hard to teach an old dog new tricks was the metaphor used I believe, lol). Though they were very nice, honest & pleasant people to me, it’s disheartening to hear that any dr would change everything at the last minute on you like that. Are you sure it wasn’t a mix up or oversight by an intake nurse or hospital staff instead?

    Did he atleast get all of the mesh out(if so then I’d say there’s your silver lining) & how long did you have it all in for?

    Finally, did they have to put more mesh in after removal?

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