ajm222
Forum Replies Created
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Every surgeon I’ve ever spoken to has said they’re intended to last for life. I have a number of friends who’ve had mesh for over ten years without issues. Mesh is not intended to be redone after a certain short period of time. If someone has complications, that’s a different story. Most apparently don’t.
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The repairs are definitely intended to be lifelong. You may hear some people suggest they’re only good for a decade or something, but that isn’t accurate. But as with everything in medicine, the reality is that they haven’t been doing this long enough to have a ton of data on people 20, 30 or 40 years after a mesh repair. Most issues do show up soon after surgery, but it’s possible to have complications much later, at any point. But those are reportedly rare, or at least that’s what the experts will tell you. In short, the repair should last as long as you need it to, and you shouldn’t expect complications.
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I think most of the patients get involved with mass tort and class action suits when they reach out to law firms. Most of the big firms do not do personal injury suits, where the doctors or hospitals themselves are sued. The firms typically sue the mesh manufacturers on behalf of the client. So they get your information, create a claim file on your behalf, and then you basically wait 3-5 years or longer for enough other patients to bring claims so that enough pressure is applied to the manufacturer to possibly settle for a small amount, which is then shared with the population of patients (after the firm takes the standard 40%). That’s my understanding. I doubt most patients consider personal injury claims against their doctor or the hospital where they had surgery, though obviously that does happen. But it’s far easier to submit a claim with a huge firm and then wait for some small compensation several years later because you don’t have to do much beyond provide some basic info, and you’ll never be on the hook for any legal fees since they only charge you if there’s a payout, and it’s only a percentage of any settlement.
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I don’t have the exact numbers billed to insurance for mine. But I can tell you I paid about the same for removal as I did my original surgery. So many variables, and gets complicated when insurance is involved. So something like 4K give or take a K. But I think I’ve also seen private quotes between 10K and 20K.
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I only had mesh (Progrip) on one side – my right. I had an indirect inguinal hernia. I don’t know if all surgeons have the same belief about doing only one side at a time. I had thought I’d heard of some doing both together but not really sure. I’m guessing some will definitely do that. And mine was removed by Igor Belyansky in Maryland. Mine was robotically placed in February of 2018 and robotically removed in February of last year (2021). My symptoms were weird and mostly discomfort and regular moderate soreness from my groin and even up my whole right side on some level. I didn’t have any nerve issues or auto-immune issues. I just never felt right after the surgery and bothered me constantly.
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oh, and most mesh removal surgeons generally advertise that about 75-80% of patients who go through removal with an experienced surgeon see improvement, about 15-20% stay the same, and about 5% are worse off. not sure about how many people can honestly say they are ‘back to normal’ after removal (that’s probably not as common), but most are glad they did it and are better off than they were with the mesh. the % improvement is very individual. i am personally better off, but not 100%. but happy i had it removed, and i believe i still will see further improvement hopefully over time as it’s been less than a year for me. i work a normal work schedule and run 3-4 miles 5 days a week and do tons of yard and house work regularly.
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if your mesh was placed laparoscopically, you definitely want it removed robotically. there actually isn’t much tissue removed at all. the trick is the dissection of the mesh from the tissue it has adhered to. it is not an extremely dangerous procedure when done in the hands of the few mesh removal experts who have done hundreds of these. that said, it’s higher risk than the original surgery, and it’s a whole different animal. basic recovery isn’t all that different from the original surgery. but I think full recovery takes longer. i had mine removed in an outpatient surgery and was moving around pretty good the next day. then for several days i felt a lot of discomfort, but it was mostly from the robot I think more than anything. after a week or two, just like with the initial surgery, I was up and about and working. but the original surgery isn’t doing as much dissecting and cutting etc, so the full healing process is quicker. i think after removal, your body will be healing on some level for quite a bit longer. but you’ll still be able to be active soon after surgery.
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My first appt with him was super easy to set up. This was back maybe in the first half of 2019, and he and the hospital do things a little differently now. But I think I sent a letter with no expectations one desperate day, and then got a call just a week later from his office and an appt scheduled just a few days after that in-person with him. Turns out they accepted my insurance even though I was out of state. I thought I didn’t send any imaging to him, but now that I think about it perhaps I did because I believe I remember him saying my mesh looked fine. Can’t remember if that was the initial appt or a later one, but probably the first. So I am guessing I sent the letter along with a CD. I think it was a CT scan. But no trouble at all getting that first appt. I have since referred a couple of folks to him from other states and despite the hospital changing some of their policies and him often saying he was getting out of the mesh removal game and focusing primarily on complex abdominal wall repair, he has taken both of them. And I presume he will still occasionally do simple hernia repairs as well.
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Lots of great surgeons in that area. One you may consider is Dr. Igor Belyanksy in Maryland. He’s one of the top robotic surgeons possibly in the world, but will also do no mesh repairs. Hernia and abdominal wall expert. Great guy, too, IMHO. I used him for my mesh removal. I also really like Dr. Levi Procter here in Richmond, VA. He also used to be a regular contributor to this site. NY also has Drs. Samer Sbayi and Brian Jacob, who are super well regarded and have great bedside manners from what I understand. The former in particular specializes in no mesh repair. Finally, Eric Pauli in Hershey, PA is another highly regarded surgeon.
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another great hour.
on a somewhat related note, i had mesh removed in february by Dr. Belyansky. he said he got 100% of the mesh out, but I have come across a couple of patients that had been told the same but found out later that wasn’t entirely true. i wonder if really getting all the mesh out is more difficult and uncertain than it seems.
regardless, i still have some soreness in the area. i am wondering if there’s any chance that some mesh remains, or something else may be causing the continued soreness. 8 months may still be somewhat early. i’ve heard some have seen improvement over many years. i also know that i was told i may need to accept a new baseline long-term as removal is a pretty major surgery and things may never quite get back to normal. just wondering what your thoughts were.
i have hit my out of pocket max for the year and wondering if getting an MRI is worth the trouble, to see if there is anything else going on. the pain i have i believe is somewhat improved since the removal but still present and similar to what it was before the removal. not sure if yet another MRI would show anything different. none of the previous MRIs showed anything concerning in the first place. but wondering if remnants of mesh might show up.
thanks
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great, thank you very much the clarification!
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this is very interesting and helpful. thanks for sharing. if i could go back in time, i would have done an open tissue repair for my hernia under these circumstances.
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yeah, you’ll be feeling all kinds of stuff for a while – some painful and some just weird. but as long as things are improving a bit month over month, I think you’re good. but it can take a while and there are definitely ups and downs, so you just have to extend the timeline. i can certainly understand the impatience. i always freak out with every little twinge and worry about everything, so that was also really hard for me. still is.
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hey there paul –
i really should have journaled my recovery, but didn’t. but i do remember that the first week was rough – not because of removal pain but just swelling and feeling like my whole abdomen was huge and tight. i also had some discomfort at the trocar sites, particularly a lot of pulling and tugging on the side where the mesh was removed. it was more dilated and my surgeon said to expect it to feel more uncomfortable for a while. he had to put a stitch there as well.
after that it was just a lot of ups and downs. some pain and soreness and feeling like the area was kind of weak, plus some tightness and pulling at various spots. over time all of that has steadily improved. at 6 months i am still dealing with some of that but at a level that doesn’t bother me very much.
i will say that at 2 months i completely dismantled a huge playset in our backyard and hauled it all to the local trash dump over a period of several hours. and i have probably done more in the last few months in terms of yardwork (to include tons of heavy lifting) than i had done in the previous several years. and i am now starting to run again almost daily, whereas i had only been running every other day at most while i had the mesh in.
so in general i would say all of the various symptoms slowly got better over time, very slowly. and i am hoping that continues over the next 6 months, one year, two years, etc. the tightness, pulling, soreness and weakness have all improved.
also, i did have sensitivity and pain in my testicle on the right side. that also has improved quite a bit in just six months. again, very incrementally but without question it has improved. in fact, it’s mostly gone i guess. but it took a while. i definitely continued to notice it for several months, and it’s maybe still vaguely there. but the trajectory is positive.
i think you have to just be patient and listen to your body and stay as active as you can (but don’t go too crazy, at least for the first month or so) and plan to re-evaluate after 3 and 6 months. no specific dos and dont’s really. the surgeons never have any good advice. it’s always just listen to your body. everyone’s experience is different and i think you just need to figure that out for yourself. but again, i think at least for a month or so be active but don’t go crazy. then slowly start pushing yourself a bit more and more.
hope that helps
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I believe I read the cremaster does regain it’s function eventually in most cases
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Good luck! I think in my case I just need more time to settle down hopefully. And my head gets in the way of things, and I have a touch of PTSD from all of this and tend to overreact to the slightest sensation. And I’m the sort of person that would do that anyway. It’s even worse now.
I actually went out for almost an hour and a half today, both walking and running. Probably ran almost three miles and walked a couple. Feeling pretty good. Just some tugging on my right side, adjacent still to that larger incision where the mesh was pulled out and the extra stitching was done to make sure I didn’t develop an incision a hernia or anything. I also think on that side there was more action with the tools and such, so more scar tissue and inflammation, that I hope gets better and better over time. Not painful – I just notice it some when moving around.
I also need to drink more water and maybe stop drinking alcohol every weekend, at least for a while. It’s inflammatory and can make swelling worse and cause dehydration. Probably need to take a few months and just focus on my health.
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Glad you’re doing better. And good you’re getting the repair. Though I think as hernias tend to get larger, it’s less and less likely they will become trapped and strangulated. But if you’re going non-mesh, probably best to get it done while it’s smaller.
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Thanks. Yes, that is one viewpoint where I’ve done a 180 myself. I really think it was both the mesh but also the robotic surgery that has given me issues over the last few years. You are placing three or more separate holes (albeit small), in the upper part of the abdomen which is more visible and also more prone to herniating itself (though again only a small chance), and disrupting the peritoneum and fascia throughout the whole abdomen and groin, all of which will need to heal. Yes, maybe you can technically walk around the day of surgery and have less focused incisional pain, but I found both of my robotic surgeries to be exceptionally uncomfortable for a week or so at least, and the removal surgery was particularly brutal. Pain in the inguinal area was almost nothing – it was the enormous amount of swelling and discomfort in my whole torso. I just felt very ill for quite a while. And a number of my current issues are higher up surrounding the upper abdominal fat and near the trocar incisions, though I also have some mild lower abdominal discomfort as well from time to time. Just tightness and tugging and unnatural feelings. I am hopeful that with the mesh out, all of this will eventually heal up ok and feel more natural with time, but I am learning it could take much longer than expected. And of course you hear horror stories about adhesions and things that could develop years later. Less likely with lap procedure, but I’m not sure I trust much of anything anymore.
I’ve also been reading some stories of folks who’ve had abdominal surgeries, and the internal healing seems like it can take up to two years in some cases to feel normal, mesh or no mesh. That’s just crazy. They certainly don’t advertise it this way. If I had everything to do over again I would have of course done an open tissue repair. Mesh completely unnecessary I think for a first time typical smallish inguinal hernia, and having a modest incision below my waist that did not at all involve my entire abdominal cavity would be much much more preferable.
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also, for clarification, Billing said 1 1/2 to 2 years and Brown said 9 months, lap vs open. But I couldn’t tell which was which. Was the 9 months for open or lap? Would think that lap would be shorter. Thanks.
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When doing robotic removal, there is typically enough scar tissue left behind to cover the original hernia defect. This may or may not hold long-term, but I don’t think a further tissue repair can usually be done at this time, beyond a stitch or two to reinforce things. Typically a tissue repair, if needed, would have to be done at a later date in another surgery. If the mesh is removed openly, a tissue repair could be done at that time. And of course there are cases where mesh is removed and replaced by new mesh during the same removal surgery.