Good intentions
Forum Replies Created
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I would see Dr. Kang at the Gibbeum Hospital. in South Korea He removes mesh if needed and will perfrom a pure tissue repair. You can find his posts in the Discussion area of the forum. Use Google to search for them though, the forum software does not work for searching.
http://gibbeum.com/main/main.php
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It’s just surprising that it was not mentioned. As you know, it has been spoken of as the new very significant problem in the field of hernia repair, by the Editor of the Hernia journal, less than two years ago. Other well-known names have called it the #1 problem of hernia repair. Nothing has changed except that now there is a feeling of defeat. Pain after hernia surgery is normal now.
https://link.springer.com/article/10.1007/s10029-022-02576-z
link.springer.com
Chronic pain after inguinal hernia repair is a real risk and a major issue - Hernia
Chronic pain after inguinal hernia repair is a real risk and a major issue - Hernia
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Where is the pain in relation to the entry ports? Robotic surgery requires opening the peritoneum from inside, if TAPP is performed, or via splitting the peritoneum away from the wall through the navel if TEP is used. With TAPP the space created needs to be big enough to place the mesh between the peritoneum and the abdominal wall, then it is sewed or stapled shut. Adhesions can occur at the suture line if the sutures are loose.
With the TEP approach sometimes the peritoneum is accidentally torn during blunt dissection (peeling) and needs to be repaired. There might be a suture in the peritoneum at that point.
Your surgery notes will tell you more about what actually happened during your procedure and how big the piece of mesh used was. Some doctors use the biggest piece that they can under the assumption that it will help avoid recurrence after shrinkage. Recurrence is still the greatest fear for the hernia repair surgeon. Pain is somebody else’s problem. Did your surgeon suggest a referral to a different doctor?
Regardless, once the mesh is fully entangled with new tissue there’s not much to be done except hope. 5 1/2 weeks is still early for healing, the body is still encapsulating the fibers of the mesh, but late as far as entanglement and shrinkage. You probably noticed a flattening and tightness of the mesh area after 2-3 weeks. That’s the new tissue grabbing on to the mesh and pulling it inward.
Keep moving, I found that there seemed to be painful areas that were helped by more vigorous movement. I assume that the disruption of fluid supply after surgery and healing caused a poor environment for the nerves in the area. Dr. Bendavid has published about this as a possibility for chronic pain.
Your surgeon is just tossing out ideas, be careful. It’s very simplistic to suggest nerve blocks when pain is involved. Nerve blocks and neurectomy have their own side effects. If nerve blocks work but the pain comes back the next suggestion would be cutting of the nerves, neurectomy.
Good luck. Get your surgery notes.
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In today’s world “best” often means highest throughput. That’s what healthcare is focused on.
If you can, you might try to contact Dr. Heniford or Dr. Matthews at Atrium Health. They are both aware of the problems with mesh and not afraid to acknowledge them. They’ve been on the hernia meeting presentation circuit. They might have some good advice.
https://atriumhealth.org/for-providers/brent-matthews
https://atriumhealth.org/for-providers/todd-heniford
atriumhealth.org
Brent D. Matthews, MD | Department of Surgery | Atrium Health
Brent D. Matthews, MD, chair of the Department of Surgery at Atrium Health, pursues the innovative frontiers of minimally invasive surgery.
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You might consider stepping over in to a new silo. The hernia repair people will only be thinking about neurectomy, most likely, if they have any ideas at all. Dr. William Meyers of the Vincera Institute has some unique views on core pain and treats many professional athletes, he might be worth talking to. Linked below.
I sent a letter and my MRI images back when I was considering mesh removal and got a very considerate reply. I heard about him on one of the running forums, apparently he treats many runners along with big-time professional sports athletes. They might/should have some knowledge of rehabbing from mesh removal, since they do remove mesh and many of their patients need to get back to their high performance levels quickly. Maybe they can accelerate your improvement without surgery. Consultations are free. Good luck.
vincerainstitute.com
Core Health Treatment & Recovery Clinic | The Vincera Institute
See why The Vincera Institute is a leading practice for the treatment and recovery of core muscle injuries, often mistakenly referred to as sports hernia or groin injury.
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No idea where this post will end up, there is still no way to ensure that a post will appear at the end of the thread, like in a normal forum. It’s kind of disturbing that Dr. Towfigh refuses to acknowledge this. It makes you wonder about resistance to improvement. But, I think it’s still worth adding to the thread for anyone stuck in the early phases of mesh damage. There is hope for recovery, but it can take a long time.
I’ve posted over the years about the slow progress in recovering from the damage that the mesh implants did, after having them removed and trying to recover. I’ve found that a person’s main hope is to just become an expert in how their own body responds to their activities, and the clothes that they wear, and the length of time they need to wait when things get bad. It requires a continuous cycle of ups and downs, a sort of saw-tooth pattern, slowly rising, but with regular periods of pain and soreness along the way. I have an advanced degree in a field which is very logic and experimentation oriented and I still had to work extra hard to figure out how to heal myself. It is incredible to me that I allowed myself to get fooled in the beginning (I wanted to believe), and that the mesh could cause so much damage. But, also, incredible that the body will continue to try to get back to normal function if allowed to.
At this point in time the site of the mesh damage responds about like a normal body part would. Like a heel that gets sore if you walk too far in tight shoes, or an area that chafes if your clothes are too tight over an extended period. There is soreness and pain but it dissipates overnight or within a day or two. I am capable of wearing my old properly fitting pants now, looking like a normal person instead of somebody wearing pants two inches too big in the waist. I can plan for a whole day without worrying about taking a day or two off afterward to recover. I am back to living a normal life, without taking care of my damaged abdomen on a daily basis.
It is coming up on ten years since I had the mesh implanted. Seven years since I had it removed. It’s a shame that this in-and-out one hour mesh implantation has damaged ten years of my life, along with damaging the lives of family members that counted on me to be available for them. But it’s the world we live in today. The device makers continue to sell the bad products, the monetary legal damages are factored in to the costs of operation, and the surgeons are stuck implanting these poor devices, knowing that they are damaging 15 to 20 percent, at least, of their patients. Damaging the surgeons themselves in the process.
All for the money.
Good luck to the fellow sufferers. Don’t give up.
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Generally they are classified by size, in centimeters.
Before there was mesh, all hernias were repaired without mesh. There is no certain size beyond which only mesh will suffice. Actually, if you have a laparoscopic procedure mesh is required for all sizes.
Watchful has posted in the past that Dr. Bendavid used to cut nerves when he performed a Shouldice repair. But, like mesh versus pure tissue, each surgeon will have their own opinion and preference. Also, be aware that many surgeons call what they do a Shouldice repair when it is actually a modified method.
Do you know what type of hernia that you have? A direct hernia might do better with a certain procedure than a femoral hernia.
I have seen Dr. Echo’s name before as a hernia repair surgeon. If he is open to answering questions you might ask him how many repairs he has performed and how the results have been. If he gets angry that’s a bad sign. If he doesn’t know, it could mean many things. You might also ask him if he really needs to cut the nerve if you don’t have pain now. Your description sounds like the size change is what bothers you. Why cut the nerve if there’s no pain? It might actually increase the risk of pain.
Sorry that you’re running the gauntlet of hernia repair in today’s world’s. So many choices and so little way to verify what’s best for an individual with specific symptoms. Who knows, maybe “AI” will eventually cut through the chaos.
Good luck.
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Are you taking pain medication of any type? Even aspirin or ibuprofen? I’ve found that both of those can cause constipation.
Any hernia repair method usually involves some sort of manipulation of the hernia sac. I assume that any breach of the peritoneum could expose intestine to adhesion sources. Adhesions can be painful, as I understand things. I have not heard of them as common from open hernia repair but it might be a possibility.
It might be that you have two or more problems happening at the same time. There might not be a single solution.
Here is a link to one of your previous posts where you describe the surgery by Dr. Conze. Good luck.
https://herniatalk.com/forums/topic/experience-with-muschaweck/#post-52742
herniatalk.com
Experience with Muschaweck - Hernia Discussion - Hernia Talk
Experience with Muschaweck - Hernia Discussion - Hernia Talk
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Hello @Wez27
It might help to get more fine details about the previous surgery. The range of possible materials and methods is very wide, and you might find that there are better options elsewhere. It’s been discussed on the forum that many surgeons don’t actually have a choice when it comes to the mesh that they use.
I can’t get a clear image of what you’re describing. You said that lap was used to repair an umbilical hernia, but that now you have a recurrence above the incision site. A recurrence would be the umbilical hernia returning. A hernia above the incision site would be a new hernia, an incisional hernia.
I would not assume that you have weak tissue and are prone to hernias. I don’t think that that is the primary reason for umbilical hernias, and incisional hernias are not uncommon.
The words “bigger mesh” imply that a piece of mesh already exists at the incision site. That would mean mesh at the umbilical site and at the incision site. It might be worthwhile to get a full picture of what exactly has been done in your past surgeries before moving forward. You don’t want to get on to the treadmill of mesh after mesh after mesh. Since you’re having unexpected results it is completely reasonable to get a second opinion. Your surgeon should not be offended and might even welcome it.
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Dr. Peter Billing of Transform Weight Loss removed the mesh in me after it had been in for three years. He does not advertise as a hernia repair or mesh removal surgeon but he has gained a following for mesh removal through word of mouth. He seems to be just a very capable surgeon who understands anatomy and takes the time and effort to get the mesh out with minimal extra damage. I would see him again if I was in the same situation. I have had no regrets about the mesh removal or choice of him as surgeon. It’s been over seven years. Healing from mesh removal does take a long time though. So plan ahead.
He is in Kirkland, WA.
https://www.transformweightloss.com/meet-our-team/
transformweightloss.com
Meet Our Team - Transform Weight Loss
Meet our Team Transform Weight Loss is a weight loss center designed to help our patients and clients achieve and maintain their weight loss goals. Founded by renowned weight loss specialist Peter Billing, MD, FACS, we offer personalized weight loss … Continue reading
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Sorry for the odd order of replies. It’s a glitch of the forum software.
One thing that might help you is to wear clothes that do not put pressure on the painful spot, or cause it to move when you’re walking or sitting. It seems obvious but I have found that the irritation from pressure on my own painful spot would not manifest as pain until afterward. Most pant waistbands cross right over the painful areas created by hernias and hernia surgeries.
I’ve also found that keeping track of activities can help identify correlations. Basically, you have to become hyper-aware of the spot and take care of it, allowing it to heal. It might take months before you get back to your normal routines.
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Some place like the Cleveland Clinic Chronic Groin Pain Clinic, with Dr. Krpata. He might know enough to head off a problem while it is still small. Link below.
I would still get the surgery notes, even if just for your records. I got mine and sometimes I still wonder if the surgeon who said he did my surgery is actually the one that did it. For his status in the Clinic his notes were surprsingly poor.
5 1/2 weeks is still early. Try to make it work.
https://my.clevelandclinic.org/podcasts/butts-and-guts/chronic-groin-pain-clinic
my.clevelandclinic.org
David Krpata, MD joins Butts and Guts to discuss hernias, chronic groin pain, and treatment options that can bring relief to patients.
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The mesh lawsuits slowly trudge along. The timing is incredible. Anybody who thinks that they will be “made whole” if things go wrong is completely wrong. Besides the fact that money can never equate to health.
January 8, 2025 – Covidien MDL Moves Forward
The Covidien MDL, which has long been overshadowed by the Bard hernia mesh litigation, continues to make significant progress. Our expectation is that the Covidien cases will ultimately yield higher settlement amounts than the Bard cases, given the scope of the injuries and the design defects alleged in the Covidien products.
Judge M. Page Kelly recently issued Case Management Order 15, outlining a new schedule for key pre-trial activities in 2025. This includes deadlines for general corporate discovery, expert discovery, bellwether trial case selection, and pre-trial motions. These steps will culminate in the first bellwether trials, expected to begin in late 2025 or early 2026. The outcomes of these trials will be critical in shaping settlement negotiations and determining Covidien’s liability.
December 1, 2024 – Closer Look at CMO #55
CMO #55 order establishes the Intensive Settlement Process (ISP) to facilitate the resolution of cases and appoints Ellen K. Reisman and John Jackson as Special Masters to oversee the process. Their duties include supervising settlement negotiations, mediating disputes, and ensuring that the ISP progresses efficiently. The Special Masters will report quarterly to the Court on the ISP’s status.
The ISP is scheduled to begin in January 2027. This is not a typo. If you want to opt-out and settle your claim, you are put on ice for over two years.
Monthly settlement conferences and mediations will then commence to address unresolved claims. Plaintiffs will be required to submit comprehensive settlement packages in advance. If cases are not resolved in the initial conferences, formal mediations will be held under the supervision of a Special Master. Costs for mediations will be evenly divided between Bard and the plaintiffs participating in each session.
The ISP will remain active until all unresolved claims have been addressed, providing an opportunity for plaintiffs to negotiate settlements efficiently. However, if cases remain unresolved by June 2029, claimants may opt out of the process and proceed under the applicable docket control orders. So if you plan is to take your case to trial, the plan is to make you wait for over four-and-a-half years just to get the ball rolling again. Will this leave a lot of plaintiffs very bitter? Yes.
lawsuit-information-center.com
Currently, thousands of hernia mesh lawsuits are pending in courts across the country. Our hernia mesh lawyers are handling these cases in all 50 states. This page: Discusses this litigation ...
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Dr. Ondiveeran, shown in your link, would be worth seeking out. He seems very open-minded, rational and independent-thinking. Most surgeons just do what they are instructed to do by their clinic or hospital supervisors. And mesh is the mainstream repair method today, it is faster and more cost-effective for the institutions.
Dr. Jacob is quoted also and illustrates the mind-set that people who avoid mesh are just getting advice from the inernet. Then gives the “tough luck, it is what it is” view, “they need to be willing to accept that”. Kind of protective of the status quo.
It’s from 2017, back when their was a big push to understand the problems. Unfortunately, little progress was made and things have stayed the same.
Dr. Jacob – ““In New York, some patients come to me having done their own online research and they have decided that they don’t want mesh,” said Brian Jacob, MD, assistant clinical professor of surgery at Mount Sinai Hospital, in New York City, and the owner of nychernia.com. …
Patients need to understand that research has shown that hernia repairs without mesh can have higher recurrence rates and still have some reports of chronic pain, and so they need to be willing to accept that,” Dr. Jacob pointed out. “
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Dr. Ondiveeran – “Polypropylene reinforcement has been the gold standard since Irving L. Lichtenstein, MD, promoted it in the 1980s. “We are really doing very well with it. Recurrence rates are low, about 2%. But recurrence isn’t the only concern,” said Hari Kumar Ondiveeran, MD, at the 2016 annual meeting of the International Hernia Collaboration.
“What about pain? What about the feeling of discomfort young patients complain about having a foreign material in the groin? What about immune response? Is polypropylene as inert as we think it is? And what about cost?””
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Maybe he was getting a CT scan with barium sulfate contrast agent. That’s the one you drink.
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I would bet that he went to Dr. Muschaweck. She is the surgeon the big clubs use for abdominal surgery.
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He scored yesterday and seemed pretty happy. Of course, when I had mesh inside I felt good while active. It was the after-effects of physical activity that were intolerable. Time will tell.
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Delay, delay, delay.
Here’s the latest on the hernia mesh lawsuits. Anybody who thinks that they will have timely recourse for mesh damages is delusional. The law firms and device makers have all of the resources and time to wait people out.
“<b style=”background-color: var(–bb-content-background-color); font-family: inherit; font-size: inherit; color: var(–bb-body-text-color);”>December 2, 2024 Update
A new case management order CMO introduces the Intensive Settlement Process (ISP), a structured framework aimed at resolving cases efficiently by appointing Ellen K. Reisman and John Jackson as Special Masters to oversee its implementation. These Special Masters are tasked with supervising negotiations, mediating disputes, and ensuring timely progress, reporting quarterly to the Court on the ISP’s status.
The time horizon on this will be depressing for many. The process is set to launch in January 2027, requiring plaintiffs to endure a significant delay of over two years before active settlement efforts commence. The ISP will continue until all claims are addressed, but unresolved cases by June 2029 will allow claimants to exit the process and resume litigation under docket control orders. For plaintiffs hoping for a quicker resolution or trial, this extended timeline—at lease four-and-a-half years if Bard’s offer is not nearly where you want to be—will prove deeply frustrating for many victims.”
https://www.lawsuit-information-center.com/bard-hernia-mesh-lawsuits.html
lawsuit-information-center.com
Hernia Mesh Lawsuit Against C.R. Bard
C.R. Bard is defending over 18,000 hernia mesh lawsuits alleging that its mesh devices were defective, resulting in injuries and complications for thousands of hernia surgery patients. Our hernia ...
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Apparently there has been a settlement of some kind in the Bard mesh case.
It is interesting that, unlike most class action defective product lawsuits, these products are still on the market and in use. I think that the suit is the Perfix plug lawsuit.
BD is still “fighting” it. The settlement summary report shows though, how they have just rolled the damages payouts in to their financial balance sheets. Just part of doing business. They can now calculate the percentage of future patients who might sue and use the estimated payout number to set the price of the products. It’s not a healthcare company, it’s a medical device company. They are not the same thing.
Also funny how the term “vast majority” appears in the text. Like surgeons discussing mesh results with their patients – “the vast majority do not have problems.”.
https://news.bd.com/2024-10-02-BD-Reaches-Agreement-to-Resolve-Vast-Majority-of-Hernia-Litigation
news.bd.com
BD Reaches Agreement to Resolve Vast Majority of Hernia Litigation
No admission of liability or wrongdoing; settlement structured to eliminate uncertainty for all stakeholders related to settled cases. Settlement amount within current product litigation reserve...
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I am only suggesting that you take extra time and care before deciding to go ahead with another surgery, with the same surgeons. Your gall bladder removal should have been a simple laparoscopic procedure. From what you wrote it seems that it is the cause of your problems today. Maybe the surgeons are not as skilled as others might be. It is well-established that surgeons need a large number of “practice” laparoscopic surgeries before they become proficient. Maybe you are one of those “training” cases. It is a subject that is not well-discussed. Was your gall bladder removal done via open or laparoscopic methods? You didn’t actually say. It can be done both ways.
Your surgeons might be considering extreme measures to avoid the shame of another failed surgery. In other words, they might be suggesting something that is more for their benefit (avoiding a recurrence) than yours. One obvious question is “why do they suggest open surgery when normal laparoscopic procedures should work?” I had two TAPP procedures to remove mesh within 5 weeks, and have had no problems in the seven years since. An open abdominal surgery actually increases the risk of incisional hernia. Reducing that risk is one of the real benefits of laparoscopy. What they are suggesting increases your risk of future hernia. I linked to a recent paper about it below. A 15-20 percent chance of incisional hernia after laparotomy (open surgery).
In short, they have failed once so seeking the advice of other experts makes sense. They will certainly keep trying to help you but they might not have the ability.
As I went through my own hernia and mesh problems I was surprised at how many different opinions there were about the best path forward. People at high levels in their own organizations were more concerned with their own welfare than mine. It’s just human nature.
Be careful. It’s very tempting to just give in and trust the surgeons. But there are good ones and bad ones. You have to find the good ones and avoid the bad ones
“Despite advancements in techniques for abdominal wall closure the incisional hernia rate following laparotomy is as high 15% to 20%.”
https://www.ncbi.nlm.nih.gov/books/NBK435995/
https://my.clevelandclinic.org/health/procedures/21614-gallbladder-removal
