Thin people and mesh

[miner]

quote Good intentions:

I don’t think that this is true. I’ve thought of the difference between professionals and athletic people and the effort expended by each can be similar. The skill levels are different but the work on the body is about the same. The damage that the mesh does is not just pain, that can be disappeared with drugs. It’s real damage, with swelling, and inflammation, followed by healing efforts. There are also real effects on physical function in that area. Constant inflammation causes other problems. You would expect professional athletes to be even more sensitive to the physical damage that the mesh causes.

When the meshes are removed they are always smaller than when they were put in. They’re not flexible anymore, not soft, not pliable. Often the tissue around the mesh is inflamed.

Unfortunately there is not evidence either way. You certainly can find some well known athletes who have had tissue repair a quick search shows several famous soccer players who have had tissue repairs. I suspect there are many more lesser known athletes who opted for the quickest repair they could get to get back on the field. When your career only goes a couple years you cant take the summer off to heal. Back surgeries are a prime example look at all the fusions and disc repairs they mention when you watch a football game. There was no waiting to see if it would get better. They cant wait they lose there job.

[Good intentions]

quote SighFigh:

Good Intentions,

Would you mind telling me what surgeon you used for the last repair? You can send it me by private message if you don’t mind.

thanks in advance!

There was not actually a repair, just removal of the mesh. The tissue around the mesh has become stiff and leathery, so the hernia is gone. In the big picture, I traded one type of damage for another. And paid for it with three years of life quality and a lot of money.

Sorry. It looks like you’re seeking a solution to a hernia problem. I think that the surgeon who removed my mesh also uses mesh for repair. We did not talk much about his hernia repairs, only my mesh removal.

I still recommend trying to find a surgeon who knows of at least a few of his or her patients that have returned to their former activity levels, and can describe them to you. And make sure that they are using the same method that worked for those patients. Many surgeons are getting drawn in to changing to laparscopic large area implantation, covering all of the lower abdomen with mesh, for the speed of surgery and the prophylactic aspect of covering a large area. They’re changing from what used to work, but with a low level of recurrence, to untested methods that cause new unexpected problems.

[Good intentions]

quote miner:

Keep in mind most professional athletes have whatever surgery gets them back on the field fastest not what might cause chronic pain. As they can play through chronic pain with medication.

I don’t think that this is true. I’ve thought of the difference between professionals and athletic people and the effort expended by each can be similar. The skill levels are different but the work on the body is about the same. The damage that the mesh does is not just pain, that can be disappeared with drugs. It’s real damage, with swelling, and inflammation, followed by healing efforts. There are also real effects on physical function in that area. Constant inflammation causes other problems. You would expect professional athletes to be even more sensitive to the physical damage that the mesh causes.

When the meshes are removed they are always smaller than when they were put in. They’re not flexible anymore, not soft, not pliable. Often the tissue around the mesh is inflamed.

Once a procedure has been shown to actually delay getting back to performance levels for pro athletes, it is avoided. The managers, agents, and support people behind the athletes know what will work long-term. I doubt that the athletes themselves have much to say about the procedure used. It’s a financial decision. You can find old literature where they tried to use mesh to repair athletic pubalgia, aka sports hernias. They don’t do that anymore, it didn’t work.

I didn’t mean to write so much, rejecting your idea. Sorry. The short answer is, actually, that laparoscopic mesh implantation is a one hour outpatient procedure. And because the incisions are smaller, the healing is faster. Rapid return to work is one of the main selling points for laparoscopic mesh implantation. It should be the fastest way for a pro to get back on the field, and they don’t use it.

You’ve actually helped form another argument against mesh implantation. If it really was what they say it is, professional athletes would be using it.

[miner]

quote Chaunce1234:

I believe that Dr Towfigh offers tissue repair to thin patients.

For what it’s worth, Shouldice Clinic in Canada has weight requirements on their repairs, which suggests that a tissue repair works best on people who are not obese. They routinely prescribe diets to people if they come in and don’t fit into their BMI criteria, telling them to come back after they have lost weight.

Seconding that comment by “Good Intentions”, those three doctors routinely work on professional athletes and thin patients, and my understanding is that whenever possible they default to using tissue repair.

Keep in mind most professional athletes have whatever surgery gets them back on the field fastest not what might cause chronic pain. As they can play through chronic pain with medication.

[Chaunce1234]

I believe that Dr Towfigh offers tissue repair to thin patients.

For what it’s worth, Shouldice Clinic in Canada has weight requirements on their repairs, which suggests that a tissue repair works best on people who are not obese. They routinely prescribe diets to people if they come in and don’t fit into their BMI criteria, telling them to come back after they have lost weight.

quote Good intentions:

See work by Dr. William Meyers, Dr. Ulrike Muschawek, and Dr. William Brown.

Seconding that comment by “Good Intentions”, those three doctors routinely work on professional athletes and thin patients, and my understanding is that whenever possible they default to using tissue repair.

[SighFigh]

Good Intentions,

Would you mind telling me what surgeon you used for the last repair? You can send it me by private message if you don’t mind.

thanks in advance!

[SighFigh]

I’m glad to see things have improved for you. I was wondering if you had a tissue repair after the mesh was removed.

Yeah, I can’t quite judge the success or failure of mesh from what data i’ve seen or by any anecdotes. It seems under the care of a hernia specialist mesh is going to be less risky than if the repair was done by a general surgeon who might not be aware of the problems with mesh. I met with a local surgeon and mesh was recommended but I didn’t hear him mention anything about reducing any risk of chronic pain. He focused on recurrence. He told me he has about one patient a year with chronic pain. I think he said he repairs just under 200 hernias per year. It seems I’ve seen that mentioned here on this forum before, and I was told the same thing more or less when I called a hernia specialist who does a majority of his repairs with mesh. I also have to wonder about long term mesh results. How will the mesh be in 5,10 and 20 years?

[Good intentions]

quote SighFigh:

Good Intentions, and Dr. Kang, thank you both for the info.

Good Intentions, did you have the mesh removed?

I did have it removed and I’m doing well. I had immediate benefit after the removal, but the full recovery is taking longer. Three years of constant irritation seems to have thickened the tissue of my lower abdomen to a leathery, less flexible quality. It’s taking a while to loosen up but progress is consistent.

There was someone on the forum recently, ajm22 I think, asking about the best surgery to have and I recommended waiting, if possible. There are some interesting things happening in the field. The “standard of care” seems like it must change relatively soon. Things seem to be getting more clear about what works and what doesn’t. Mesh has many problems.

ajm22 was about to have mesh implantation not long ago but he has not been back. I’ve found that this is fairly common on the forums, which is somewhat disturbing. People are usually happy to tell about their successful journey through a traumatic experience, especially after they’ve received helpful advice. I’ve only seen two people, on a different forum, actually come back and describe successful mesh implantation results. I think that most just don’t want to talk about it, which is telling.

[LostNPain]

I have low BMI and am very physically active. The mesh they used for my inguinal hernia was bard soft mesh also. I also have pain during and after exercise.

[SighFigh]

Good Intentions, and Dr. Kang, thank you both for the info.

Good Intentions, did you have the mesh removed?

[Good intentions]

quote SighFigh:

I’ve seen some doctors on this forum say that mesh can be a superior repair when applied correctly when compared to tissue repairs. Does this observation also apply to thin people? I’ve seen it mentioned
that thinner people can be more sensitive to mesh implants.

Would it be better in some instances for a thin person to pursue a tissue repair for an indirect hernia?

My own experience and conclusions are that when you see a description of “thin people” or “low body fat” you should mentally replace it with “active people”. Active people tend to be thin, and the surgeons and doctors reporting that “thin people” have problems are only seeing a static body, not considering activity level.

My problems with Bard Soft Mesh all came from trying to be active. Running, hiking, biking, playing sports – all caused irritation, swelling, and other problems, which lasted days and weeks after the activity. It was impossible to get close to my previous activity level, without having constant soreness and pain.

So if you are thin because you’re active, then consider it that way. If you do some research on what the surgeons known for working on professional athletes do, you’ll find that most, maybe all, of them avoid mesh, and most have negative comments about its use. See work by Dr. William Meyers, Dr. Ulrike Muschawek, and Dr. William Brown. When I was looking for someone to repair my direct hernia I came very close to traveling to Canada for the Shouldice procedure but I allowed myself to be convinced that laparoscopic mesh implantation would work. It was the worst decision of my life.

[drkang]

Hi, SighFigh.

I don’t think some people are fit for tissue repair and the others are fit for mesh repair.
According to my experience of more than 6,000 non-mesh repairs, it always works very well for anyone who has an inguinal hernia.
I know most surgeons would disagree with me.
But, I am just saying from my experience.

Thank you!