[Good intentions]

Again, thank you. But how do we, the patients, get this information? How do we know if our surgeon is a contributor to the AHSQC? And what “quality” is measured? A simple questionnaire would probably tell a lot. My surgeon is close to one thousand mesh implantations. I would love to see the comments or results of people who are doing fantastically. Then I could just focus on my problem. But I have no idea if it’s my surgeon, or the materials, or me that are the problem. It’s all hidden. If he doesn’t hear from them, they’re considered a success.

I have a degree in a science and the art versus science argument is really not relevant. The art would be used on top of a solid scientific base. Starting at art suggests that success is in the eye of the beholder and that the surgeon is not responsible for any outcome. Because it’s art.

“What is most important is that your surgeon has an interest in doing what they are doing, listens to the patient, and is involved in self-education.” What is most important is that the results of the surgery give a good outcome with a long-lasting high quality of life. I don’t care if my surgeon is interested or listens, but I do care that they use what works and not what doesn’t.

Besides that, how do we find out which surgeons are learning and keeping up? Where is that information?

Again, I appreciate what you’re doing, and I know that working in the medical industry bureaucracy is frustrating, but there must be some way to define what is best for the patient besides waiting for a lawsuit? That seems to be the main driver for change. It shouldn’t be that way. There should be more weeding out of the materials and methods that don’t work, and less independent experimentation. We’re not supposed to be lab animals.

[Good intentions]

Thank you for the reply. I did not mean material gains. I meant contracts with the mesh companies. It might not even be the surgeon who has the contract.

I have heard the statement about losing money on mesh implantation. It doesn’t make sense. That’s not how businesses are run, costs are adjusted to break even at least, in a non-profit organization.

I really appreciate your contributions, but your comments are the general platitudes, with no useful detail, that leave everyone wondering. No offense intended. For example, why are there so many different types of mesh, from so many different companies? If the procedure is as easy and as safe as suggested, what purpose would be there be to have all of these different products? Somebody is making money here. A person could argue that there must be flaws in the materials and methods because medical device companies see a need for new products. There must be, they don’t do research for fun. How do we patients get the information behind the reason for the new products.

We all go in to the specialist’s office expecting that they will be up to speed on the state-of-the-art. Then we’re supposed to tell them what we want. But we don’t have the information we need to make an informed decision.

“There are a lot of quality of life studies performed on patients with and without mesh implantation”. Where are the quality of life studies comparing the different materiasl and methods of implantation? “With and without mesh” is not really the question, it’s “what is the best mesh and method to give the best quality of life”.

[Good intentions]

quote sngoldstein:

Hernia mesh fixation questions

I don’t fixate mesh except in rare circumstances. Other people fixate all the time. What works for one surgeon may not work for another and we are all quite opinionated and maybe a touch egotistical. Either way, what matters is that your surgeon does what works for them, has good results and happy patients.

How can there be so many different ways to do things, that all give good and happy patients? Who is keeping score? If a surgeon has bad results does he/she tell their fellow surgeons to avoid this method? How does a patient know which surgeon has good and happy patients and who doesn’t?

If every surgeon is learning as they go, and developing their own special way of doing things, that would mean there has to be mistakes early in a surgeon’s career. It suggests that we should all avoid new young surgeons because they are still experimenting, and we should only use surgeons with tens of years of experience, because we want tens of years of good life after the surgery.

There should be standard methods, proven to give good and happy patients, after hundreds of thousands of mesh implantations. It seems like it’s still the wild west out there.

[Good intentions]

quote vtjbrent:

I had my mesh successfully removed 6 weeks ago. Bilateral mesh was completely taken out during the same surgery..

Thank you for sharing this. Your situation mirrors mine in many ways. I had Bard Soft Mesh implanted laparoscopically about 2 1/2 years ago. It never settled in like it was described that it would, I had to devise my own methods of getting my abdomen in to a condition that I could tolerate, and I wake up every day thinking about having it removed. I used to be very athletic – running, biking, and playing soccer. Now I focus on working out in the gym to just the right degree to allow me to be somewhat comfortable during normal activities like sitting at a desk or walking around. I’m too physically healthy to obviously need surgery, but the distraction degrades all other aspects of my life.

Please post back with the results of the healing from the surgery, if you can. It looks like it’s been nine weeks since you had the surgery. It would be fantastic if Dr. Towfigh could describe what she found, although from what I’ve learned, there was probably nothing unusual. Your mesh was probably exactly as it was intended to be, for recurrence avoidance purposes. But not quality of life.

To the Herniator – your reply almost perfectly exemplified the problem with the mesh implantation industry. A focus on avoiding recurrence, and a safe procedure. vtjbrent’s point was all about a degraded quality of life, but you replied with an answer about safety.

Anybody considering mesh implantation to fix a hernia should make the surgeon prove that they have satisfied and happy patients. There is no reason at all that the surgeons shouldn’t know by now what works and what doesn’t, for quality of life after the implantation. But nobody seems to be trying to determine that. The mesh companies are all selling their weave patterns and materials and shapes but with no quality of life correlations. After thousands, or hundreds of thousands of implantations, those comparisons should be possible. Many surgeons and organizations seem to be captured by the mesh company they work with though, and are making financial decisions first, with the patient second I think.