[drtowfigh]

I meant relied not relief.

That’s a very difficult question to answer without reviewing your whole story, imaging, and examining you. Usually we don’t blame scar tissue until all other more common things are rules out.

[drtowfigh]

Just to clarify:

– mesh works as a permanent barrier and the scar tissue is important to secure it as such. But scar tissue is weak. It cannot be relief upon on its own for bridged hernia repair.
– mesh is not found to be torn in the package
– certain very lightweight mesh have been reported to be torn. These were rare events reported with bridges repairs of the abdominal wall. Though theoretically this can happen in the groin, it would be a very rare event.

[drtowfigh]

[USER=”2777″]Mariel[/USER] hard to tell based on the photos.
There are excellent hernia surgeons at University of Washington.

[drtowfigh]

Thanks for participating in HerniaTalk.

Sounds like you have a hernia recurrence after laparoscopic inguinal hernia repair with mesh, with no other complications. That is, no direct mesh-related pain or reaction.

The next best step, if you’re symptomatic, is an open mesh repair.

Open Tissue repair after failed mesh repair is not considered standard as it’s expected to have a higher recurrence rate.

Mesh removal is not necessary.

[drtowfigh]

Hard to believe no reason for the pain was found.

I’d be suspicious that the imaging was misinterpreted.

Also, other problems like hip etc may be causing similar pain.

A better history of type of pain and location is necessary to determine if it’s nerve issue. Less likely with laparoscopic mesh.

[drtowfigh]

This is totally awesome. Thanks so much for sharing, [USER=”1916″]Chaunce1234[/USER]

[USER=”2608″]dog[/USER] in Israel, consider Dr. Yaakov Ullano. He may be able to do a nice tissue repair.

[drtowfigh]

Thank you all for your contributions in keeping this a live, robust forum. I personally know of many patients who have been led to curative treatment because of their interactions on this post. I’m sure there are many many more that we are helping.

[drtowfigh]

Thank you.

Dr Tomas is a great surgeon. I haven’t seen him publish or present his results to his peers. I will take his word for his success rates. I don’t agree with some comments he has made about perfect success rate using tissue repair for recurrent hernias and femoral hernias and large hernias. I encouraged him to publish that data as he would be the first in the world to be able to claim such success.

I offer tissue based inguinal hernia repair repair to a subset of my patients. My recurrence rate is around 7%.

[drtowfigh]

responded in the dedicated post about this.

[drtowfigh]

I read Article 13. It is not “research.” It is a communication in a non-peer-reviewed manner describing their selected findings.

From what I know about inguinal hernia surgery history, the Desarda technique is not new. Similar technique was used in the 1950s and was abandoned due to higher recurrence rate than other tissue repairs that have lasted the test of time. Perhaps newer experience, more controlled patient population, etc., may provide better outcomes. Unfortunately, Dr. Desarda has not been active in the surgical forums and conferences and when invited, he has not been able to answer our concerns and questions about the technique.

What concerns me most is that the technique is considered proprietary and surgeons are not encouraged to adopt it unless there is a financial kickback to Dr. Desarda for use of his name. That is not the typical spirit of surgical advancement.

[drtowfigh]

Agree with [USER=”2042″]Jnomesh[/USER]
If the original repair was done open and it is a simple recurrence, then laparoscopic repair is the next best option.
MRI pelvis will show the mesh as related to the recurrence.

[drtowfigh]

A good time for patients to push their surgeons to submit their data to the AHSQC. See pinned post about this.

[drtowfigh]

I blogged about it a couple of years ago. Can read here.

http://www.beverlyhillsherniacenter.com/2016/10/28/getting-out-of-the-narco-business/

[drtowfigh]

quote dog:

drtowfigh That would be GREAT news! I spoke with Dr. Jonathan Yunis MD FACS ..according to him.{he already does them} .. but recovery similar to open ..so what is benefits ,,Is it also your experience outcome please let us know ?

Depends on the patient. Less cutting than open. Different scars. It’s an alternative repair.

[drtowfigh]

That’s way to large to be healing ridge only. See your surgeon. And massage.

[drtowfigh]

The anatomy from the inside is different than the anterior open anatomy. So, there is no comparison. Also, the approach from the inside does not include a release of any tissues so it is higher in tension.

[drtowfigh]

This is best answered by a pain management specialist. There are a lot of prescription and natural options. Some may interact with other medications, have side effects that are not tolerable, etc.

[drtowfigh]

[USER=”2725″]VegasHernia[/USER] thanks for sharing. Please update us. Also, share your surgeon’s name.

[drtowfigh]

Very misleading

[drtowfigh]

quote scaredtodeath:

Dr towfigh… also as more meshes were removed to systemic reactions as time went on was there any underlying Common ground as why those pts developed these reactions

Yes, and we are doing a deep dive on this. Will publish those results specifically on mesh reaction patients.