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Depends on whether the onlay part of the mesh needs removal and also whether there is a deep protrusion of the plug into the abdominal pelvic space.

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Great!
Please let your surgeon and others know about HerniaTalk

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It may just be a tight repair since the scar tissue and the mesh itself shrank a bit. I recommend time. If it’s very very uncomfortable, then mesh redo. I have been using the hybrid Ovitex mesh in these cases where the mesh inflammation and stiffness is an issue.

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[USER=”3093″]Reborn334[/USER]
You need to be seen by a specialist. Im sorry it’s been over 2 years and you haven’t been given definitive diagnosis and treatment.
Sounds like you had an open survey as the Perfix plug is not made to be placed laparoscopically.
Tharp type of mesh has known complications such as meshoma (balling up) and erosion. Removing it is complex and best outcomes are from those of us who do that for a living.
Nerve pain is not the only reason for hernia repair related pain. Often with the mesh plug it’s the mesh mass itself.
Imaging is a must. I bet you the CTs you’ve had already show this as a problem. Hernia recurrence is just one problem and your doctors need to diagnose other findings from the CT. I prefer MRI.

where do you live? Perhaps we can help you get to be seen by a specialist near you.

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Hernias should be repaired if they give problems otherwise, most of them can be observed with minimal risk.

Ultrasounds May Miss hernias, but it’s rare for them to incorrectly show a hernia when there isn’t one there.

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Mesh can cause reactions which can include burning or tingling in the feet and hands. That’s very rare but I have seen it. So, if there is a plan for mesh removal, then you must have a non-mesh alternative plan to repair those hernias. Dr Nguyen is a good resource for you.

before doing any removal surgery, it’s important all other causes for your symptoms are thoroughly examined.

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[USER=”2987″]dh305[/USER]
shall I assume this was a laparoscopic repair?
everyone reacts differently to surgery. Some really have minimal inflammatory response. Others form an intense inflammatory response which can prolong their healing symptoms.
If symptoms are mild (eg twinging) and not life altering, these have been shown to resolve within the first year. We don’t react to the minor symptoms much and mostly provide assurance. For symptoms a bit more intense, perhaps there is a fluid collection that requires aspiration or perhaps the mesh is slightly folded. Imaging can help with that.
but you’re right. There is no science when we say you’re a slow healer.

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Sounds like a robotic TAPP repair. This is a standard procedure and the Progrip mesh has good results.

this far out from surgery, you may be feeling a tugging or a pulling from the mesh. The mesh scars down and can shrink. The only nerves at risk from this are the genitofemoral nerves and those associated with the vas deferens that go to the testicle.

I would start with imaging. That will confirm the placement of the mesh. In the meantime, gentle stretching and hip extension may help

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I have no faith in neurologists when it comes to these matters. They don’t see enough hernia patients to understand what we do and what can be done. Also, there are very few peripheral nerve specialists, and those that are deal with diabetic neuropathy and such. Ie, medical peripheral neuropathy not surgical.

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This not uncommon with tissue repairs. It’s why we moved to less tension mesh repairs. Patients used to have hospitalized for a week with these repairs.

I don’t disagree with your surgeon. Symptoms should subside by 3 months. But in the meantime, medications (amitriptylline) and local injections should help temper the symptoms.

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Germany:
Muschawek
Conze
Koch
Reinpold

UK:
Aali Sheen

Belgium:
Muysoms

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We have never shown a correlation between inguinal hernia repair and spinal instability. Hernias have been repaired for centuries so any correlation would have been determined.

ia it possible you have two problems? L4-5 and L5-S1 problems do not manifest as groin pain, rather all is below the groin crease. Perhaps you have an inguinal hernia recurrence that is missed?

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Sound like you have a small hernia that is not rerouted in imaging. If you have a diastasis that complicates the situation a small bit.

I recommend re review of your imaging. I read the images myself as radiologists May miss small hernias.

if you’d like to see me in person or send me your images and records via online consultation I’m happy to help solve this puzzle. You can contact my office to set this up. I don’t know why you haven’t had this resolved. It sounds like an obvious abdominal wall issue.

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The Kaiser system in Northern California has a new surgeon who is their go-to for post inguinal hernia repair chronic pain. His name is dr a David Nguyen and he works at KP Oakland.

I would start with an MRI to check the mesh placement. Ultrasound is not helpful once mesh has been placed laparoscopically.

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I disagree with the last statement—the laparoscopic mesh can be injected, as Dr Brown noted.

Numbness is to be expected from the neurectomy. Laparoscopic neurectomy has different outcomes depending on how far back the nerves are cut. I have Shy’d away from this procedure except in radical situations for the very details provided by Dr Brown.

shall I assume this was secondary to a prior hernia repair?

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Swelling from surgery can cause weird symptoms. Unless the pain is very clearly a severe debilitating zinging in the direction of a single nerve, then time may help heal. Anti-inflammatory measures include ice packs, naproxen and sometimes injections to help reduce the swelling.

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Some thoughts:
– laparoscopic repair with mesh is the best outcome for these problems
– you may have a diastasis recti which is contributing to the failures of the two repairs

See a hernia specialist. Your care needs to be tailored to best meet your needs.

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The MRSA history complicated things. If it were me, I would be hesitant to place a pure synthetic mesh and would opt for Ovitex permanent hybrid mesh.

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Sorry to hear your problems.
1. not clear why you had biologic mesh (porcine bladder) used for your hernia repair. Biologic mesh absorbs and do the hernia can recur. It is not considered standard for hernia repairs.
2. Sounds like the biologic mesh failed. It balled up. You had a lot of seromas which is common with biologic mesh. That’s why drains are used.
3. with a mesh infection, all of the implant must be removed in it’s entirety, especially when balled up.

I agree with 2nd opinion. And you definitely need mesh. But not pure biologic mesh. I would use a hybrid mesh such as Ovitex Permanent or a lightweight synthetic mesh if it can be placed under muscle to reduce risk of mesh infection

– what was the Swiss cheese hernia from in the first place? Ie, what prior surgery caused it?

– what bacteria grew from the infection?

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Good question. Very hard to know. Online reviews are not necessarily accurate for surgeons. Other healthcare providers may have some insight if they work with them. This forum is also very reliable.