Good intentions
Forum Replies Created
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MarkK is repeating Chuck’s words, in Chuck’s style.
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“. I was hoping Kody would report back to us as there are very few testimonials on here for any kind of repair. ”
Yes, it really is a shame that Chuck’s fake personalities and his/their constant badgering have driven so many earnest and honest people from the forum. He has kind of ruined things for everyone recently, including himself. Hopefully he’ll see the diminishing returns, assuming that he’s not trying to be destructive, and change his ways.
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I’ve noticed that several forum members have disappeared after one of Chuck’s personas starts talking to them. I’ve wondered if he was messaging them and caused it to happen. Kind of ironic if “Chuck” is really looking for information. He ends up driving the people away that might have a new view.
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Yes, definitely strange that Kody’s posts seem to be gone, as well as his account. Coincident with your appearance. One gets removed, another arrives. Maybe he wasn’t real after all. Just another one of “Chuck”‘s messes.
Carry on with whatever it is that you’re trying to accomplish.
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I couldn’t find a link to the full text from the BJS. But I did just find that it had already been published in Hernia, in June. Still a pay-per-view for the full article.
I wonder if they chose the GLACIER acronym as an acknowledgement of the slow pace of progress in the field.
https://link.springer.com/article/10.1007/s10029-023-02818-8
Original Article
Published: 13 June 2023
An international survey of 1014 hernia surgeons: outcome of GLACIER (global practice of inguinal hernia repair) study
K. D. L Nanayakkara, N. G. Viswanath, M. Wilson, K. Mahawar, S. Baig, J. Rosenberg, M. Rosen, A. J. Sheen, E. Goodman, A. Prabhu & B. Madhok
Hernia volume 27, pages1235–1243 (2023)-
This reply was modified 1 year, 2 months ago by Good intentions.
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This reply was modified 1 year, 2 months ago by
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Another month has passed and still not a peep from any of the societies, groups, collaborations, or individual members about the flawed and incomplete “Guidelines”. Incredibly unprofessional from an organization, the EHS, that has tried to assume the mantle of the ultimate global authority on groin hernia management. They are leaving all of their members and associated societies in the dark about what the specific deficiencies are in the ten chapters that are being “updated”.
This could end up being a good thing though. Independent surgeons should be questioning the veracity of the whole “Guidelines” enterprise. If it is not good enough to follow through on, then is it worth anything at all. What is it? It has not been updated on the two year basis that was promised. They have identified ten chapters that need work. They promised an update, specifically, on LinkedIn, almost a year ago. Yet, nothing at all has happened.
Still, esteemed professionals like Dr. Chen refer to the Guidelines in their presentations and publications. It’s a travesty. The law firms should be looking at the people behind the recommendations for the materials that are being referred to in the lawsuits. The device suppliers support the societies with funds, the societies create the recommendations to use their devices, the device makers make more money. It’s all out in the open, documented.
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Hernias don’t “travel”.
You said that you had a hernia repair scheduled for the 26th of September. Adam.
https://herniatalk.com/forums/topic/mesh-linked-to-causing-auto-immune-diseases/
Adam
Participant
After doing some reading on Google I’ve seen mesh being linked to auto immune diseases? Has anyone here had experience with that or heard of it before? It’s worrying me with my bilateral inguinal surgery coming up in 5 days on the 26th -
Here’s an opinion by a past member. Maybe you’ve already seen it.
Summary of research-forum experts? Watchful-JF -NFG- GI- Mike M- Bryant
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What did your surgeon say when you described the problem to him or her?
Having stitches is kind of odd for today’s surgery methods. Most use absorbable sutures for the fascia and muscle, under the outer skin layer, and glue on the surface. Could you describe the stitches? How many and where were they placed? Might be a clue.
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This reply was modified 1 year, 2 months ago by Good intentions.
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This reply was modified 1 year, 2 months ago by
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Watchful, that’s not Lichtenstein. That’s plug and patch. Different procedure.
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I posted on a similar topic a while ago. Linked below.
My main advice would be to educate yourself about what is involved in removal, know what was done during the implantation (neurectomy, lipoma dissection, etc.), and choose a surgeon who will leave you with good odds of a successful recovery.
Secondly, don’t expect to be immediately “well”. The original implantation caused damage, the foreign body reaction causes damage, and the removal causes damage. On top of the original hernia damage. It will take a long time to heal.
I think that I’ve only seen one person on the forum that had a bad mesh removal. They have posted several times, recommending that people avoid any type of surgery. Very “anti-removal”. That person obviously regretted the decision to have their mesh removed. Can’t remember the name or the posts.
Then there is Peter C. He had mesh removed but, from what I gather from his posts, it was removed as a secondary part of surgery for a different problem. It wasn’t clear why the mesh was implanted in the first place.
https://herniatalk.com/forums/topic/mesh-removal-satisfaction-survey/
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Here’s another interesting summary that gets in to the details of the premise being suggested for the problems. They distinguish between polyester and polypropylene. Some of it seems exaggerated but I guess that’s what lawyers do. Looks like they have their sights set on Progrip also.
It’s like reading an exciting novel in serial form.
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Here’s a summary of the Covidien MDL. Parietex is a brand name used for many mesh products including the common flat mesh sold by Medtronic.
https://www.aboutlawsuits.com/covidien-mesh-lawsuits-bellwether-trials/
https://www.medtronic.com/covidien/en-us/products/hernia-repair/mesh-products.html
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It has been pretty fascinating to follow the progress of the lawsuits focused on various hernia mesh products. Also kind of difficult since the various law firms that report on them generally don’t present information very well.
One thing I’ve noticed is that they seem to be working from a starting assumption that all mesh products are inherently “good” and that they need to find a specific defect in material or manufacturing proce4ss to show a failure on the corporation’s part. Instead of just showing that the products available are generally deficient and inadequate and that the benefits are oversold, and that the corporations know this but are letting the harm continue. They should be taking the J&J talc/asbestos path, or the tobacco or oil company strategy and showing that the corporations are valuing profits over public damage.
This summary page shows some of that. Apparently one of the cases tried to use a fire in a manufacturing plant as evidence of negligence. Instead of just showing that it’s a bad design that even the global “guidelines” recommend against.
Anyway, it’s just one benefit of getting tangled up in this mess. A new form of entertainment.
Apparently there is a new class action suit against Medtronic for their Covidien mesh. It slipped in over the last year, didn’t even notice it.
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September 23, 2023 – Coviden MDL Has Trial Dates… in 2025
The federal judge overseeing Covidien hernia mesh lawsuits in federal courts nationwide has given approval to a proposal for preparing six bellwether cases and selecting two of them for trial in early 2025. While progress has been somewhat slow in this litigation and 2025 seems like light years away, getting a trial date gets the clock moving on pushing Coviden to make meaningful settlement offers for the over 600 plaintiffs in this litigation.
…While the facts are different, this litigation is tied in the Bard MDL psychologically. A big verdict in Stinson next month would not only help the Bard plaintiffs but the other hernia mesh class actions as well.
October 28, 2022 Covidien Mesh Lawsuit Update
At a recent status conference in the Covidien hernia mesh class action MDL, the parties advised Judge Patti Saris (D. Mass.) that 170 Covidien hernia mesh cases are currently pending in federal courts, 5,700 lawsuits pending against Covidien in Massachusetts state courts (Covidien’s home state). The central issue at the status conference was the proposed discovery plan submitted by Covidien. The plaintiffs’ committee is vehemently opposed to the proposal because it would give them under one year to complete corporate discovery.
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Your post seems tailor-made to draw Dr. Towfigh’s attention. That is an amazing list of symptoms, diagnosis, and treatment.
How long from the first symptom until you sought treatment? How long did you keep working after the first symptoms? Are you still working, despite the pain? Hard to imagine a 20 year old woman doing that type of physical labor at a company like UPS.
Good luck.
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No Name, I wrote another novella. Hard to stop sometimes. The method described in that Northshore paper is really just a typical Lichtenstein and/or plug and patch method. Open the canal, move things around, place the mesh, fixate it, close and hope.
Dr. Reinhorn’s TREPP method does not enter the inguinal canal at all. It’s like laparoscopic surgery mesh placement without general anesthesia or close exposure to bowel. As far as inguinal hernia repairs go it might be the least invasive.
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I wrote a bunch of stuff below then realised that it didn’t really address your question. I think that the method described is completely different from the TREPP method of Dr. Reinhorn. TREPP comes in from the side and creates a space behind the inguinal canal in to which a piece of mesh with is placed. The inguinal canal and spermatic cord are not touched. In the paper you linked the method describes that the inguinal canal is opened and the cord manipulated just like a Lichtenstein repair.
Here’s some of what I got from the paper –
I’m not as clear on the different methods as some of the other forum members, but it looks to me like the Northshore people have created a sort of combined Lichtenstein plus plug repair. One disturbing thing about their explanation is that they conflate the use of a mesh with an absorbable component with the new method of placement and fixation. They introduce the Ultrapro as the primary factor and the new slitting and fixation as secondary. They didn’t clearly explain why they needed to do things differently. The fact they decided that they needed something new suggests that they have been having problems with their own patients. Northshore is one of the typical hernia mills. And the study is tiny, just 24 patients.
Overall it really looks like somebody doodled up a new method on a napkin and started using it on patients. They’re not happy with the results of whatever they have been using, they came up with something new, tried it on 24 patients, and now are publishing a paper about it. Pretty amazing when you sit and try to absorb it. Any surgeon can do whatever they want with a piece of mesh as long as they get the patient to take liability for problems. Same problematic material, just different ways to get it in there.
From the paper –
“Methods
Upon Institutional Review Board approval, all patients who had undergone open repair of an indirect inguinal hernia using the Ultrapro mesh and the “double slit” technique between June 1, 2007 and November 1, 2012 at a single institution by one surgeon were contacted. Written consent was obtained for retrospective analysis of operative data as well as an additional office visit for prospective collection of long term follow up data. Inclusion criteria included males who were at least 18 years of age and at least 6 months out from the operation. Chart review was conducted to obtain retrospective perioperative and short term follow-up data. Long term outcome data was obtained prospectively at the additional office visit by having the patient complete a Carolina Comfort Scale and be examined by the
operating surgeon. This data was then analyzed with particular attention to chronic pain and incidence of recurrence.…
At follow up, 18 (79.3%) reported no groin pain (0/10) while 4 (16.6%) had mild groin pain (1/10), and one had (4.1%) moderate groin pain (4/10), none of the patients experienced testicular pain (Table 2). Carolinas Comfort Scale was given to all patients and revealed very minimal pain, mesh sensation and movement limitations (Table 3).
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I have to admire Chuck’s ability to draw people in to responding, like I’m doing now. And his persistence. It really is a shame that he’s wasting these qualities for this mission that he’s on, to create chaos and confusion on the forum. One giant “acting out”, to use the psych term.
Here is No Name/ UhOh!’s old profile page with his backstory.
https://herniatalk.com/members/uhoh/
I think that any mesh method that has mesh inside the internal ring next to the spermatic cord would be considered as a plug method and has the potential for problems. If you read the papers about TREPP, the main point is that the nerves and structures inside and around the inguinal canal are not disrupted during mesh placement. TREPP is about how to place the mesh with the least damage possible.
Reinhorn’s work is also interesting because he uses a type of mesh that is not common for inguinal hernia repair. He has not described why he chose that mesh over the standard open-pore uncoated mesh. In the end though there is still mesh sitting on top of structures that tend to get bound to the mesh as the body tries to encapsulate the fibers. It’s probably just as hard to remove as lap placed mesh.
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Here’s a poster presentation from Dr. Towfigh’s Beverly Hills Hernia Center.
Page 243 in the pdf Program file of the AHS 2023 meeting. It’s a tiny study, only 52 patients. Look related to Dr. Towfigh’s recent survey, which originally did not include pain as a symptom.
https://custom.cvent.com/9D6126EEBC1B404DA11E747D5B4411CE/files/955da81f74bd4068b0c320dd2aba1bdb.pdf
P98. Mesh Removal Outcomes in Patients with Mesh Implant Illness
D Huynh, C Oh, I Capati, S Towfigh
Beverly Hills Hernia CenterBackground: Most hernia repairs in the US are mesh-based. This practice is supported by research showing superiority of outcomes compared to tissue-based repairs. However, we have shown a small but growing population of patients with mesh-related systemic reactions, known as Mesh Implant Illness (MII). Common symptoms include: bloating, swelling, fatigue, headache, rash, fibromyalgia, and joint pain. As yet, there is no standard of care for this population. We report our outcomes of applying complete mesh removal as part of the treatment for suspected MII.
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Upon short-term followup averaging 10 days, MII-related symptoms improved in 62% of patients after mesh removal. By long-term followup averaging 2 years, 74% of patients reported resolution of their MII-related symptoms [Figure 1].
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More research is required for this developing disorder, with the goal of eventually reducing, preventing, and resolving MII.
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I browsed through the Program for the meeting and was kind of surprised at how much it looks like the program for past meetings. Many of the old topics are discussed, looking at similar questions like lightweight versus heavyweight mesh.
Here’s a study from a part of the world that hasn’t been discussed much. Japan. It’s a poster, so it is brief, but it might be the precursor to a full paper in the future.
From page 188 in the pdf Program file linked above.
P49. The Frequency And Risk Factors Of Chronic Postoperative Inguinal Pain In Japan: A Prospective, Longitudinal Nationwide Survey
M Narita, T Tasaki, Y Miyaki, H Miyagaki, M Kataoka, T Nitta, T Kimura, R Toshiyama, N Hama, Y Kawaguchi, N Shimada, I Sakamoto, K Takehara, Y Oshima, T Kusumoto
National Hospital OrganizationBackground: Chronic postoperative inguinal pain (CPIP) is known to be the most debilitating complications after inguinal hernia repair, while very few evidence has been reported in Japan. To determine the frequency and risk factors of CPIP, we perform a prospective, longitudinal multicentre observational cohort study.
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Methods: Between September 2018 and March 2021, patients aged 20 years or more who planned to undergo elective inguinal hernia repair at 22 community hospitals, not hernia specialized centers, in Japan were enrolled. This study was registered in UMIN-CTR (Registry number; UMIN000033936) prior to enrollment of the first subject.
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The proportion of patients reporting sense of discomfort was 22.5% at 3M, 21.4% at 6M, 18.0% at 12M, and 15.7% at 24M. The proportion of patients reporting hyperesthesia on the skin around the wound was 6.6% at 3M, 6.5% at 6M, 5.7% at 12M, and 4.9% at 24M. The proportion of patients reporting pain at ejaculation was 2.2% at 3M, 2.6% at 6M, 2.8% at 12M, and 3.3% at 24M. Hernia recurrence was observed in 1.1%, 1.5%, 2.3%, and 2.4% of patients at 3M, 6M, 12M, and 24M, respectively.
Conclusion: This is the first large prospective cohort study aimed to demonstrate the frequency of CPIP in Japan. Although its frequency is decreased over time, it can be problematic even at 2 years after surgery. Caution should be paid in patients with preoperative pain at rest, preoperative habitual intake of analgesics, and history of transabdominal prostatectomy. Laparoscopic surgery and/or technique without mesh fixation may be the option to avoid CPIP.
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