drtowfigh

Great!

Laparoscopically placed mesh is best removed via lap/robotic method. I strongly advise against considering an open option.

The mesh is always stuck to the epigastric vessels and also in some way stuck to or close to the external iliac vein. Dealing with that is part of the skill of removal.

I recommend seeking consultation with surgeons like…[Read more]

– no downsides to taking the supplements around the time of surgery
– I do recommend bromelain and other anti inflammatory supplements to my patients
– zinc, vitamin c have already been shown to augment wound healing. No study has been shown they clinically improve outcomes from hernia repair, ie, hernia recurrence. And this study also doesn’t s…[Read more]

Thanks for sharing your recovery experience, @ajm222. Dr Belyansky is a skilled surgeon. Your experience is what most patients should be experiencing from lap/robotic mesh removal: surgical pain that improves over time, yet resolution of preoperative symptoms.

Just know that though you had built scar tissue from the repair, and that is likely…[Read more]

@chronicpain

Lucas S,
There is no need to travel. There are wonderful surgeon options in Germany: Muschaweck, Conze, Koch.

For mesh removal during a Lichtenstein, selective neurectomy may be necessary, as the process of mesh removal itself may cause nerve injury.

I’m not an advocate of laparoscopic triple neurectomy. As @momof4 mentioned, i…[Read more]

– it’s very possible you have mesh remaining. I commonly see situations where patients were told their mesh was removed and yet there is mesh still left behind
– many of your symptoms are neuropathic (from the nerves). That includes the liquid feeling. Nerve blocks may help address those.

Great discussion, everyone.

With regard to the rIPT (robotic iliopubic tract) repair, I only recommend it for normal weight (BMI) patients with small inguinal hernias.

So many questions! We got through most of them for you. However, we ran out of time again. I hope to return to answer a lot of your questions every couple of months or so. I know how much it means to you all!

If you missed tonight’s HerniaTalk LIVE Q&A, you can watch, like, and share it here: https://youtu.be/LBZGJr_UNKE

Thanks to all who participated tonight. We had great questions posed about laparoscopic and robotic surgery pros and cons and options for various hernia repairs.

If you missed it, you can watch and share the whole hour here: https://youtu.be/I28UYkaH9Ao

as far as we know, there is no way to modify your collagen status in the groin.

The fact that you have a hernia implies there is a lack of mature strong collagen. It’s not a visual or tactile thing.

Marcy is not a reconstruction, rather a simple closure of a hole. It is considered a valid repair only for indirect hernias and only in children and some women, but not adult males. The repair depends on tissue integrity, which has clearly failed if you have an enlarging indirect inguinal hernia. Patients, in particular males, with inguinal…[Read more]

Can’t cherry pick one study. The size of hernia, your anatomy, your medical history and risk factors, surgeon experience, etc, all factor in on what is considered best repair for you.

The Marcy repair is not indicated for adult males.

I recommend you find a surgeon who can perform a variety of repairs and have them guide you as to their recommendations rather than choosing a repair type that may not be suitable or appropriate for your need.

Our hour was jam packed with expert information about mesh infections, intestinal fistula management, and how to optimize to get the best hernia repair.

If you missed it, you can watch and share from here: https://youtu.be/ypUHTX64gNM

No. The final position of the mesh is the same. The approach for TAPP starts intra-abdominally, so bowel is visible. But the mesh placement is in exactly the same place.