[paul]

I had my bilateral inguinal/femoral hernia mesh REMOVED by Dr.Chen on 7/28/21. the mesh (2 pieces large Bard 3d mesh) was implanted here in bend oregon by dr mastangelo June, 2019. pain was killing me for 2 years. I found dr chen after research on removal docs, including drs Brown, Petersen, Towfigh, and chose him for initial consultation. he assessed what he suspected was the issue, mesh folded/clamshelled, he ordered a new MRI to be sent to him so he could see. had video conf with him 4 weeks later and he showed me the MRI and described it as riding too high and possibly folded/clamshelled, but tough to discern w/o seeing first hand. scheduled robotic surgery. another pre-op conference went over all risks and procedure itself. I’m now 7 weeks and 2 days out from removal and while sore from removal in abdomen, all mesh was removed, no nerves cut, swelling down 95%, a little right testicular sensitivity when bending, but diminishing incrementally weekly. all this to say that I am very happy thus far with dr chen. yes, he has a very small waiting room at UCLA, smaller given seating restrictions courtesy of COVID. he is very friendly, down to earth, comprehensive in his description of what he believes may be the issue, is not a zealot for mesh although he does use it. can do non-mesh, but depends….I don’t think there are ANY absolutes in this field unless you can see the future. he also planned to do tissue repair, if warranted, but he found NO hernias on left side, but on right side found inguinal and golf ball sized fat filled femoral, and he covered both with smaller, lighter Progrip mesh, as opposed to what was used prior. he did use robotic, although probably does laparoscopic as well. he’s head of the Lichtenstein Institute there at UCLA, covered under Medicare and BC/BS if that’s an issue. fyi, I’m 68, and have been dealing with Psoriatic Arthritis for 5 years as well, so my recovery may take several more months before I can jump on my road bike and train for the TDF! hope this helps.

[paul]

I had my bilateral inguinal/femoral hernia mesh REMOVED by Dr.Chen on 7/28/21. the mesh was implanted here in bend oregon by dr mastangelo June, 2019. pain was killing me for 2 years. I found dr chen after research on removal docs and chose him for initial consultation. he assessed what he suspected was the issue, mesh folded/clamshelled, he ordered a new MRI to be sent to him so he could see. had video conf with him 4 weeks later and he showed me the MRI and described it as riding too high and possibly folded/clamshelled, but tough to discern w/o seeing first hand. scheduled robotic surgery. another pre-op conference went over all risks and procedure itself. I’m 5 weeks and 2 days out from removal and while sore from removal in abdomen, all mesh was removed, no nerves cut, swelling down 90%, a little testicular sensitivity, but diminishing incrementally weekly. all this to say that I am very happy thus far with dr chen. yes, he has a very small waiting room at UCLA, smaller given seating restrictions courtesy of COVID. he is very friendly, down to earth, comprehensive in his description of what he believes may be the issue, is not a zealot for mesh although he does use it, can do non-mesh, but depends, uses robotic, although probably does laparoscopic as well, he’s head of the Lichtenstein Institute there at UCLA, covered under Medicare and BC/BS if that’s an issue. fyi, I’m 68, and have been dealing with Psoriatic Arthritis for 5 years as well, so my recovery may take several more months before I can jump on my road bike and train for the TDF! hope this helps.

[paul]

GI….ok, no planks for awhile doc 🙂

as much as i appreciate all your comments, most all of which have been incredibly insightful and helpful to me personally, i do want to clarify some info regarding your comment about dr chen. firstly, he never at first or second or third consult or even after he read the MRI, suggested or implied that the Bard mesh was placed improperly to begin with by dr mastrangelo in 2019. nor did dr chen say he thought it migrated/moved somehow, but only that it appeared to be folded or clamshelled based on his digital exam and his reading of the MRI. it was not until he got in there did he later say to me the day after the surgery on his rounds that the mesh had not in fact clamshelled, that it folded at the top across from end to end, but not has severe as he originally assessed, and that the position of the mesh was high in his opinion, but did not put the onus of bad placement on dr mastangelo or on mesh migration. i took from that after asking him about that yesterday that it could have been placed too high, it could have moved somehow as a result of subsequent and ongoing inflammation or whatever goes on in the body during healing, a number of rounds of fascial and pelvic floor massage therapy since 2019 by recommended specialized PT’s here in Oregon and in California in an effort to quite things down, but there doesn’t appear to be any direct evidence of any definitive cause. it was high causing me suffering….it’s now gone…no suffering from it….only recovery pain from it’s removal.

as far as the mesh establishment, i hear ya! i’ve done a wee bit of research on the institutionalization of mesh implants since i had the repair, and i see the negative stuff and risks, seen all the SAGE stuff, seen Dr T’s vids, etc., etc….but my bad that i didn’t do enough research prior to the initial placement or i may very well have gone a different direction or at least garnered 2nd, 3rd options back in 2019. but i was too trusting and naive and with me it’s like, oh something wrong, get ‘er fixed asap. a lot more to be said there, but quite frankly, from info i’ve received from dr brown and dr petersen and the good dr T here, there is an appropriate use of mesh depending on each patients history, symptoms, etc., etc.

so for now, i’m holding dr chen harmless about his use of the Progrip, which he advised was lighter, smaller, and less subject to movement once placed….and the fact that he said that if he had found a hernia on my left side which was covered with the Bard mesh, he would most likely would have done a Shouldice type tissue repair there….but there was no hernia he could see….so i know he is an advocate of mesh use, but i don’t think he’s a zealot about it. if i have complications, i may sing another tune. as far as the right side inguinal hernia and the golf ball sized femoral which was revealed after removing the initial mesh, he felt it best to use Progrip given the situation and i’m guessing the time he was in there with mr. robot and my time under anesthesia, which was pretty close to 3.5 hours. the thing is i’ve personally known a doctor, a lawyer, a physical therapist, a fellow cyclist, and a couple of others, that have had inguinal hernias, albeit one side only, and all have had mesh of various types implanted….and none of them had the issues i had and the range of time is from 3 years to 5 years.

again, i appreciate your insights and comments and hope they don’t stop as they are and will be helpful to me and many others on this site as they struggle with the $%^&-load of issues hernia related. and, for sure, no planks for awhile:)

[paul]

GI….sorry, didn’t see your post until this minute, hence after my tele-med visit with dr chen, so didn’t posit the ?’s you asked. here’s what I know. Dr. Chen, over my 3-4 visits with him, has always been understanding, compassionate, professional, and optimistic. I choose dr chen after evaluating dr brown’s and dr Peterson’s responses to questions I posed to them and their responses. on my 1st in person consult with him, he did a thorough digital and dermatome exam, and while seeming to confirm my issue as mesh related, ordered a new set of MRI’s so HE could see them, rather than having them read by a radiologist. after doing that, he was pretty much convinced that my bilateral large Bard 3d max mesh was causing my pain, not so much a “reaction” to the mesh other than an assumption based upon MRI and palpation, that my mesh had folded at the top from ASIS to ASIS, and possibly clamshelled as well on both sides. on 7/27, the day before the removal, in his office, he again suggested that diagnosis, and said he’d do all he could to remove all the mesh and repair any hernias if found, tissue repair preferred if possible, but if not, Progrip. on op day he discovered that while the mesh hadn’t clamshelled as previously thought, it was way too high up, and while slightly folded at the top, wasn’t as severe as he thought, but very stiff and hard. he couldn’t defintively say if it was previously placed too high or it had moved since inserted 6/14/19, but given that both sides were too high, my own assumption is that they were placed too high in the first place. could have moved due to inflammation or something else, but to have both sides move, while possible, regardless, the mesh way too high seemed to be the biggest issue, as well as the hardness of the mesh…you don’t want to see the pic he showed me! turns out that on my left side, there was a small “defect” but not herniated, and he wondered why that mesh was placed there at all in the first place. on the right side, there was a small inguinal hernia still, as well as a golf ball sized, fat filled, femoral hernia covered by the Bard. he was able to remove all mesh from the right side also, got rid of the fat filled femoral hernia, but still had to use the Progrip (smaller sized) to cover both the small inguinal and the larger femoral, as he felt that both were too large for a Shouldice repair. he didn’t have to do any major neurectomies or mess with the vas or sperm cord, on either side, save for a right side paravasal neurectomy due to the cord adhering to the mesh, but was able to preserve it….he did have to “quilt” together whatever peritoneum was left from mesh on both sides.

so, 3 weeks in today, like I said, I’m way less swollen across abdomen and scrotum, do have some hardness at the 4 port sites, some swelling still use above abdomen, when bladder gets full from all the damn water (not beer) I’ve been drinking, it does put more pressure across that area until it’s all expelled. sitting is still problematic but not as bad as it was last week, putting on socks and shoes….same same. I’ve been walking 2 to 3 times a day for ;15 to :20 to help with healing. have been off the Tramadol for 1.5 weeks, only using 2 625mg Tylenol twice a day, which may or may not be taking the edge off, if there is such a thing. I use heat/cold intermmitently over my abdomen to potentially reduce swelling/ease pain.

dr chen said today that I appear to be doing well after just 3 weeks, suggests I wait another week or two before I start to do some stretching, another 2 beyond that before I start with planks, core stuff and then as I feel comfy, get back to my cycling….and work my way up to Tour level 🙂

any other ?’s or comment from you or ajm are always welcomed and thanks to you both for your advice.

[paul]

thanks so much for ‘splaining a bit more. I agree with all you suggest, even more so since I had mesh removed from both sides. dr chen sent me a slew of images of the removal and the subsequent repair as well as a pretty horrid image of the bilateral mesh itself….no wonder I was dying’….23 centimeters across/length, about 12cm wide/high. my main issue is patience, which my wife reminds me of often as not being one of my many virtues, so all things bendy and jostly and twisty are going to have to wait. thanks again for your help!!!

[paul]

ajm…..thanks for sharing your story….I’ve posted mine elsewhere but I want to share this with you and ask for your opinion/advice on my situation if you have some time.

what did you do and didn’t do 4 weeks post removal, 8 weeks, 12 weeks…..I should be able to grok the remaining increments.

I’m 2 weeks and 3 days out from bilateral bard 3d max mesh removal via robotic 4 port surgery, peritoneum “quilted” back together. abdominal swelling has been reduced 60% or so from ASIS to ASIS, with reduced swelling also around where new, smaller, Progrip was placed, just on right side this time, to cover the previous inguinal and femoral hernias.

scrotum swelling is down also but testicles pretty tender, right more than left.

I’ve very cautious about getting in/out of bed, etc, but I making a point to walk for :15 twice a day, whether outside or in the house (due to air quality lately here in oregon).

if my bladder gets full, which it does since I’m drinking loads of water, hardly a beer, then pressure on top of pubic bone is pretty tough until I expel.

so I’m wondering what the do’s and don’t are from your perspective given the timeframes I posited at the beginning. any info would be appreciated.

[paul]

CI….thanks, very helpful. I have a zoom with dr chen on Tuesday for a post op check-in, and I do have some recovery questions for sure. while I do go for actual walks for around ;30 every day, I also get up and around from the recliner every hour or so and walk around the house as well as doing some pelvic tilts and kegles, and some diaphragmatic breathing. I’m just worried about messing up all the peritoneum quilting that dr chen had to do after both sides of the mesh were removed as well as disturbing the newly placed mesh on right side. when I do.my walks, I feel tight in both RA’s as well as inner hip flexors, which I assume are pretty inflamed and tight. I think that this coming Wednesday, 3 weeks post, I’m going to start doing some overhead stretches, bridges as tolerated for a couple of weeks, then progress to some additional core stuff. I wish I could run, that being a no-no for a couple of years, but road cycling was my passion which I plan to get back into….as soon as my tesitcle tenderness calm down. any other feedback you have for me would be appreciated.

[paul]

I’ve posted elsewhere recently, but wondering if you or GI could share what you did and didn’t do 4 weeks post removal, 8 weeks, 12 weeks…..I should be able to grok the remaining increments. I’m 2 weeks and 3 days out from bilateral bard 3d max mesh removal via robotic 4 port surgery, peritoneum “quilted” back together. abdominal swelling has been reduced 60% or so from ASIS to ASIS, with reduced swelling also around where new, smaller, Progrip was placed, just on right side this time, to cover the previous inguinal and femoral hernias. scrotum swelling is down also but testicles pretty tender, right more than left. I’ve very cautious about getting in/out of bed, etc, but I making a point to walk for :15 twice a day, whether outside or in the house (due to air quality lately here in oregon). if my bladder gets full, which it does since I’m drinking loads of water, hardly a beer, then pressure on tp of pubic bone is pretty tough until I expel. so I’m wondering what the do’s and don’t are from your perspective given the timeframes I posited at the beginning. any info would be appreciated.

[paul]

bilateral inguinal/femoral mesh removal on 7/28/21. discharged on 7/30/21. I have been keeping notes and I’ve been walking :15 every morning since 8/1/21 on a dedicated walk. pretty sore across 4 port sites and a bit below and just above pubic bone and from l to r ASIS, but I figured walking is better than not. swelling/bruising reduced somewhat since discharge on 7/30, just don’t know how long before totally gone. I certainly do feel relief from pain that the Bard 3d max mesh large was causing in the first place, and now am just feeling some pain/swelling,from where new progrip was used….or could be that that’s the side dr chen pulled out both pieces of the xl bard. either way, I’m optimistic about recovery but need to take it slow over the next couple of months, especially since doc had to basically “quilt” my peritoneum on both sides back together. best news is no nerve issues, no nueroectomy….whew!!! any advice on how long for and how to recover would be helpful.

[paul]

GI…..thanks for that helpful info and suggestion. I have been keeping notes and I’ve been walking :15 very morning on a dedicated walk. pretty sore across port sites and a bit below from l to r ASIS, but I figured walking better than not. swelling/bruising reduced somewhat since discharge on 7/30, just don’t know how long before totally gone. I certainly do feel relief from pain that the Bard was causing in the first place, and now am just feeling some pain from where progrip was used….or could be that that’s the side dr chen pulled out both pieces of the xl bard. either way, I’m optimistic about recovery but need to take it slow over the next couple of months, especially since doc had to basically “quilt” my peritoneum on both sides back together. best news is no nerve issues, no nueroectomy….whew!!!

[paul]

today marks one week since my bilateral Bard 3d max, large, mesh was removed. 2 pieces of mesh were installed 6/19 by dr mastrangelo in bend Oregon to repair bilateral inguinal and right side femoral hernias. long story, but never got better and been in constant pain. turns out mesh folded at top and was thought to have been placed too high. dr chen at ucla successfully removed mesh from both sides robotically, found no significant hernias on left (there were allegedly 2 in 2019) and one inguinal and one femoral on the right, which he repaired with much smaller, thinner, lighter, Progrip.

I am still very sore at incision (4) points, black and blue at abdomen across pubic bone, scrotum purple and swollen as well, but less so incrementally every day. soreness is constant, worse sitting and standing, so try not to do that….I spend the day in recliner, getting up every hour or so to walk a bit.

any recommendations for recovery appreciated.

[paul]

thanks again for you response and glad to hear that it’s a work in progress and that you’re doing fine all things considered. i’m sure it’s tough to give up some of the things that make life worth living, but it’s short term in the whole scheme of things.

[paul]

ajm….thanks for posting. i hope you get more responses. i’m headed for UCLA in a couple of weeks to get my BARD 3d MAX bilateral mesh removed as it apparently has folded and clamshelled. of course i’m anxious about the whole ordeal but i feel i’ll be in good hands. still, i’m concerned about post op recovery and the same issues you asked about…let’s hope somebody here (besides “good intentions” who has been great) can add their personal or professional opinion. thanks again!

[paul]

point of clarification….i had my initial repair done in bend oregon.

[paul]

Good Intentions. thanks so much for the info. i read your story last week and remembered it well. my bilateral inguinal hernias and a femoral hernia were lap repaired 6/19 here using bilateral Bard large 3d MAX in bend oregon. never felt like it was a success and doc said my pain was normal and it would take time for scar tissue to heal. several post op visits later, same stray and no improvement, in fact got worse. after much research and another hernia surgeon in CA who ordered more Ultrasounds, the conclusion was, mesh is working but you may be one of the 30% of patients who have issues with the mesh, not toxic rejection, just chronic pain. i was referrd to dr chen at ucla, dr brown and dr Peterson as possible docs who might be able to remove my mesh. i narrowed it down to dr chen and he did physical exam as well as new MRI and read images himself. his opinion is that my mesh had folded at top, clamshell, and while i don’t have nerve pain per se, it’s more of a foreign body pain between my ASIS and area between top of pelvis and navel. he suggested that if i couldn’t live with my 6-8 level pain 24/7, then he’d attempt to remove it all. i’m scheduled to have that procedure on 7/28. i’ve had 2 conversations with him since april and i feel very comfortable with him, his knowledge, his experience and his approach, which is, we’ll try to get all of the mesh without impacting the 3 major nerves, but understanding that that may not be possible. also, if the small hernias are still present, he may have to use smaller Program mesh to cover them. i feel like i’ve made a good choice in moving forward with the procedure, but having read all the “horror” stories on this site and others, of course i’m anxious, knowing that either the good news stories don’t get told or the “success rate” is lower than 70-85% as suggested. i’m not going to change my decision, but just needed to know what to expect recovery/healing wise from others who’ve had mesh removed successfully. again, thanks for you post(s)

[paul]

horror stories

[paul]

i’ve read many of those here, in SAGES, and elsewhere. i was wondering about real patients’ experiences since it’s patients who are posting all the hour stories here.