[Alephy]

I have posted many questions about biological (by which I mean re-absorbable meshes derived from animal tissue) meshes, and tried to get hold of papers that wold indicate the higher recurrence rate (some doctors claim these meshes fail at the two years mark) but I could not find any.

From the papers I have read it seems these meshes pose a (much?) lower risk of chronic pain; also from a common sense point of view at the very least even if you had problems with them, they will eventually be gone, which avoids the need for the very difficult removal surgery.
I still don’t know whether less scar tissue results from the implants (which would be a good thing), as this in the end may still cause pain I guess…

It is interesting that during the emergency surgery they resorted to the bio mesh.

Incidentally there are few papers out there that reject these meshes on the basis that they are too expensive, which sort of highlights one of the pillars of the hernia conundrum i.e. money 🙁

If and when I will get surgery, a bio mesh will be my first choice (should I decide to go with a mesh)….

[Alephy]

I am confused, did you have a mesh repair or a Shouldice?

[Alephy]

What I think nobody knows is what the reaction of the mesh might be after few/many years, based on age/life style, activity level (also including athletes here): can one assume that very rarely problems will arise after few years from the mesh surgery with no pain? or are we looking at a potential time bomb?

[Alephy]

The ultimate mesh if it will ever exist will be the one that minimises scar tissue growth in my opinion; this is a major downside of the implants….I am wondering what kind of PT athletes do after the surgery to minimise the formation/impact of the scar tissue, although the process I guess cannot be stopped?

I find it really outrageous that many surgeons still claim that the mesh is “inert” and does not cause any reaction (some told me this to my face during consultation!)

[Alephy]

You mean at the Shouldice clinic they told you that the hernia was too small, and that they did not feel it was bad enough to treat it surgically? Sorry if I misunderstood…

[Alephy]

Thanks for the info!
I can add that I know for a fact that a professional football player for the AC Lazio squad (in Italy) was operated with a mesh for an inguinal hernia some years ago; I can’t recall how long he was sidelined but I have a feeling that given the particular strain footballers sustain in the inguinal area (they are subject a lot to sports hernias) it is no surprise that they are off the pitch for many weeks….(a meniscus surgery in comparison keeps them out only for a very short period of time)

[Alephy]

Thanks for the link!
I am wondering on how long it will take for this to be “common practice”….is it something that will become mainstream in the years to come, together with the Robotic approach?

[Alephy]

I would think if they decided to go for a CT scan (like they did with me), they will most certainly look at the whole area. When considering surgery I was told by a hospital that they would first do a full checkup to avoid “bad surprises” during the surgery e.g. cancer or other unexpected situations…on the other hand hernia specialists have told me it is not needed, and some went as far as saying that only physical examination by a specialist is needed i.e. not even Ultra Sound…go figure…

[Alephy]

I find it interesting and worrying that there is still a discussion on whether mesh or non mesh repairs are more at risk of chronic pain….I am sorry to say this but I am starting thinking that an awful lot of scientific papers in the medical science field are garbage. Personally I think that there are some situations where mesh is the best option. For the rest there is a financial side that has nothing to do with the science. Incidentally I also think that in the long term the ideal solution goes beyond a repair towards a regeneration, if you know what I mean (don’t know if this is a mesh in the end)

[Alephy]

Oh and also if there is an hernia size limit for the Ovitex meshes, and if they can be used on a bilateral laparoscopic too…

[Alephy]

I would like to ask if there are also Ovitex meshes that dissolve over time (are absorbed by the body?), and if these meshes are used the same way (for the same hernia types) as the ones which are instead permanent. I seemed to have read something about this but I am not 100% sure what is meant really…

[Alephy]

Is the mesh close to the nerves also when placed laparoscopically?

[Alephy]

Thanks a lot Dr. Szotek!

Do you think you could send me their e-mail addresses (also via private message in case this is more appropriate), so I can ask them some questions (mostly logistic/cost/insurances etc)?

Thanks again!

[Alephy]

Thanks a lot for your answer!

[Alephy]

It was indeed a nice discussion!

Did I understand right that while allergies to the meshes are very rare, reactions are more common?
Also, did I understand right that the risk of these body reactions is lower with bio (organic) meshes?

As I have urticaria would this warrant the use of such bio meshes rather than the synthetic ones then? As the discussion also mentioned reinforced organic meshes (I think the ones made with pig tissue were mentioned), do the Ovitex meshes also have a lower risk somehow?

Thanks a lot!

[Alephy]

Thanks Dr. SzoteK,

I am currently based in Switzerland, I would be thankful if you could let me know of any surgeons here or in the neighboring countries that use these particular meshes. I am still considering options so this at the moment would be just for information purposes should I decide to go forward with surgery…hope it makes sense…

[Alephy]

OH btw less inflammation also means less likelihood for urticaria attacks probably I guess🤔

[Alephy]

Is it correct to say that less inflammation response means less likelihood of pain and body reaction? Btw the article caught my eye as it also mentions absorbable meshes (in positive terms), for which there is not as much evidence. I think it is possible to infer from animal trials if they are in pain or not…albeit always done for short perios of time…from my side though I don’t like at all the idea of being cured at the expense of animals suffering 😔

[Alephy]

Thanks for the info Dr. Szotek! I wonder, are the Ovitex meshes only sold/available in the US?

[Alephy]

Thanks a lot for your answer! May I also ask what you thoughts are on the Ovitex absorbable meshes? I know you mentioned in the past that these meshes end up causing recurrences…

Thanks a lot again!