[Good intentions]

I think that he was saying that Dr. Belyansky does remove mesh that had been placed via open surgery. He does both.

” had my mesh removed by Dr. Igor Belyankski-Although he removed open placed mesh his expertise is definitely in robotic/laparoscopic removal of mesh placed this way.”

Here is one his older posts where he describes the 3DMax. There are others with more detail. He used the term “hard as a rock” often, as I recall.

https://herniatalk.com/forums/topic/right-laproscopic-inguinal-hernia-surgery-with-numbness-and-pain-on-right-leg/#post-15402

“I really don’t want to worry you but wanted to chime in that I had the 3D maxx mesh implanted 6 years ago and had issues from day one. They weren’t debilitating but occasional flare ups were.
about 10 months ago I did experienced debilitating pain and after much exhausting journey found out that the mesh had folded. The only surgeon to see this on a cat scan was dr. Igor Belyanski in MD. I ended up having to have the mesh removed.”

right laproscopic inguinal hernia surgery with numbness and pain on right leg

[Good intentions]

Jnomesh was actually one of the first 3DMax patients on the forum, as I recall. He often described how his removal surgeon found it balled up and hard inside him.

I came across another lap mesh patient. Ian J. A new mesh, a product called Polymesh. He was on the forum about a year ago but stopped responding after Chuck asked him to “chat”. Not sure why.

https://herniatalk.com/members/ianj/

I searched for Jnomesh and came across another lap mesh patient looking for solutions. dmpain. Honestly, they are so common that you almost don’t notice them. On for a few posts, gone, back for a few more later.

https://herniatalk.com/forums/topic/long-term-pain-bounced-between-sports-hernia-and-complications-from-hernia-repair/

https://herniatalk.com/members/jnomesh/

Long-term pain: bounced between sports hernia and complications from hernia repair

[Good intentions]

Thanks William. I looked through some of the BHS pages and they are the typical “we do it best” marketing pages of almost all hernia repair facilities. They seem to be claiming credit for all of the “tension-free” mesh methods. Pretty proud of themselves.

But, without the numbers, it’s just more salesmanship. At this point, I barely look at work reported without the numbers. It’s just chest-beating and crowing without the long-term measurements of success, using the things like quality of life, chronic pain, and recurrence as measures. Their publications page is dated, the most recent is from 2009.

The patient stories page is full of the typical vague terms and words. One patient climbed Mt. Kilimanjaro. Woohoo? There are few dates on the patient blog site and there are only 146 reports. Sorry, but to me the BHS looks like a typical hernia repair mill.

This Topic is really about finding numbers that will allow a patient to eliminate the worst choices. Worst mesh product, worst procedure, even worst surgeons or clinics. The BHS site doesn’t have any numbers that help.

[Good intentions]

And, of course, this circles back around to a registry. With a well-designed registry these numbers would fall right out. Which is, of course, a reason that the device companies would not want to have one. The less people know the better off they are.

[Good intentions]

In short – just trying to find another tool to use for a “process of elimination”. A patient might not be able to find the best procedure but they can avoid the worst.

[Good intentions]

David M I think that is a whole separate discussion, about the cause. At this point many surgeons are dismissing the problem as unreal or just the result of people in today’s world being weaker than people in the past. The problem has to be recognised first, as Dr. Campanelli did in his Editorial, so that professional researchers at the medical device companies and universities have a reason to work on solutions, and/or so that consumers can avoid the bad products. As long as the denial continues not many people will put effort in to working on it.

The point of my post here is about the relationship between the volumes. If more product is sued you would expect more problems to be reported. The ratio of problems to product used gives the probability of problems for specific products. A similar comparison, which the professionals should have figured out and which the medical device companies probably already know, is “what is the ratio of problems to the specific device?”. For example, plugs have been identified as “not a first choice” or “evil”. But, according to Dr. Towfigh’s past remark, and a past forum post, linked below, plugs are a very high volume product. So, are the bad plug cases actually a small percentage of overall plug usage? Or not.

If you get on to the MAUDE database you can find a huge number of reports about specific devices but there is no context with the total volume of their usage. This is what the FDA should be doing, identifying the probability of problems with a product. If I knew that 20% of people with plugs had problems, and only 10% of people with Lichtenstein had problems that would help me make a decision, along with other information about the work needed to fix the problems. But I don’t know if a database exists that would allow someone to define those percentages. The numbers have to be out there. Somebody should be drawing those correlations.

https://herniatalk.com/forums/topic/plug-and-patch-hernia-repair/

I had created a Topic about the MAUDE database in the past but Google and the forum’s search engine can’t find it. Here is a link to the database.

https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/search.cfm

Plug and Patch Hernia Repair

[Good intentions]

Thanks for following up Herminius. Your story is similar to mine, I was an active soccer player too, but my hernia was obvious, and the pain was after playing, over the following days after a game, while doing things like raking leaves in the yard. I also waited much longer before having the mesh removed.

I’ve written this before but I recommend keeping a log of your activities and of how you’re feeling. I found that the effects of certain activities did not manifest until a day or two later. Because the whole situation is so mentally traumatic it’s often difficult to remember exactly what you were doing in the days before some new soreness shows up. By keeping a log or diary you can look back and see the correlations. I found some unexpected correlations, like the fact that when I stretched my arms upward I would feel tightness/soreness at my pubic bone days later. This took years to resolve, I assume that the damage left down there after the mesh was peeled off took time to correct itself.

If you get the time and would like to share maybe you could tell us what Dr. Krpata found. Folded mesh, properly placed mesh, problems? Any reasons for the pain.

[Good intentions]

Watchful is right for patients that give up and do not do any research. No research at all = the highest chance of a bad result.

alephy’s reference shows that not all publications can be trusted. But it does not show that all publications should be mistrusted. It just shows that people need to understand the sources of the information that they are seeing. The registry based studies seem most valuable. We need more of them.

Thanks for posting this alephy. It reminds of the reply to the “International Guidelines for Groin Hernia Management” by the EHS, from some experts in data analysis. They showed that the premise for reviewing the data used to create the Guidelines was flawed and that the recommendations were not valid. Maybe that’s why the updated Guidelines are so far behind schedule. Years behind.

[Good intentions]

Doesn’t work. The Forum web site is starting to have major problems. We can’t paste old links in to a post. Pasting as “plain text” still pastes an embedded link.

These words might work – herniatalk.com/forums/topic/pintos-hernia-repairs-by-dr-kang/

It works. Highlight those words then, right click, choose “Go to …” and it will take you there.

• This reply was modified 1 year, 5 months ago by  Good intentions.

[Good intentions]

Let me try a different paste method. A person should be able to put this test in the address window of their browser to get to the page.

https://herniatalk.com/forums/topic/pintos-hernia-repairs-by-dr-kang/

Here is is in embedded link form –

https://herniatalk.com/forums/topic/pintos-hernia-repairs-by-dr-kang/

Pinto’s hernia repairs by Dr. Kang

[Good intentions]

There does seem to be something wrong with the site now. I pasted a link in the post above to a Topic with the title “Pinto’s hernia repairs by Dr. Kang” and it opens a completely different link. I also put the title in the site’s search box and it came up as –

“Search Results for ‘Pinto’s hernia repairs by Dr. Kang’
Hernia Discussion › Forums › Search › Search Results for ‘Pinto’s hernia repairs by Dr. Kang’

Oh, bother! No search results were found here.

[Good intentions]

I’m not 100% sure, maybe sensei_305 or someone else knows, but I think that the owner of the web site has to jump through a few hoops to make their site’s content searchable on Google. Google is a profit-generating business. Nothing is free.

Dr. Towfigh is right that the posts are there, they just don’t get found by Google Search. If you type “site:herniatalk.com pinto” in to the search box you’ll see everything that Google finds on the site that has “pinto” in it. If you click the “Tool” word in the upper right of that results screen, you can set a date range to narrow things down. I did that and did not find the posts that I had found earlier, linked below, from 2021. Google doesn’t see them. But they are there.

I also see that some early posts were from Pinto2.

Edit – I clicked on the link below and something else came up. Not sure why. So it might not work, but it’s only a couple of weeks old, if you scroll back on the main list of posts.

https://herniatalk.com/forums/topic/pintos-hernia-repairs-by-dr-kang/

Pinto’s hernia repairs by Dr. Kang

[Good intentions]

Don’t forget to take a stool softener before surgery. Don’t test things too quickly, hopefully the original hernias will tighten up enough when the mesh is gone to avoid a recurrence. Healing takes time.

I put the link to your first post below. You didn’t post as much as many people do when they are looking for solutions. You didn’t even make it to one year after the initial repair, but several others on the forum have done the same. When you know, you know. I assume that you did a lot more reading and researching before settling on Dr. Krpata. Could you share a little bit about yourself and how you came to your choice? I think it helps people to see a logical rational path to a decision, especially when so many experts seem to have no opinion at all.

Good luck.

https://herniatalk.com/forums/topic/looking-for-advice/

Looking for Advice

[Good intentions]

I read through your story again and, to be frank, it looks like your first surgery was not as “neat” as it should have been. You said “lesions” but I think that you meant adhesions. That is one of the big worries of all laparoscopy surgeons, adhesion of the intestines to the abdominal wall via a damaged peritoneum.

You didn’t say whether your surgeon used the TEP procedure or TAPP. The big advantage of TEP, apparently, is that the peritoneum is never opened, so the abdominal wall, the fascia, and the intestines never come in to contact with each other. The adhesion problem is dramatically reduced. But, a good TAPP surgeon is aware of these problems and will take extra care to close the peritoneum tightly after placing the mesh. In other words you really should not have any adhesions or colon problems. It’s not “normal” for mesh implantation. Scar tissue problems are not common for a simple mesh implantation.

The adhesions are probably why your surgeon used an open procedure to remove the mesh. Because the adhesions were blocking his entry points, or because he was worried about causing future incisional hernias at those points. The adhesion path seems to be one of those vicious cycles where attempts to remove the adhesions can cause more adhesions.

These are just thoughts from all of the reading I’ve done, I have no professional training in the area. As you probably realize all of these surgeries are really not healthy for you. Besides the multiple areas that have to heal you have all of the anesthesia to worry about.

To the points about getting a second opinion be aware that if the other experts were all from the same business group, or partnership, they have a vested interest in not finding fault with their partners’ work. It’s just one of those realities of business. You’re in a tough spot and you’ve already started down the “try something new” path. Be careful, and objective about what is going on. Your situation is more complex than most of the horror stories in this forum. Your surgeon might be trying very hard and honestly but he might be in over his head.

Good luck. Here are some articles that might help your thinking.

https://www.science.org/doi/abs/10.1126/science.abg5416

https://scholar.google.com/scholar?as_ylo=2019&q=surgery+adhesions&hl=en&as_sdt=0,48

[Good intentions]

There seems to be something happening in the Bard 3D Max world. The volume of reports in the FDA MAUDE database has jumped dramatically since 2019.

Put 3D in the Brand Name box and leave the other boxes blank. The attorneys seem to be getting ready to identify 3D Max products as a problem. I searched for other products like SoftMesh that was used on me and nothing comes up. It’s a poor database but it might mean something. Maybe Bard (BD now) made a change in the product and it was a mistake. Make sure to change the date range, it starts with just a one month span.

https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/search.cfm

[Good intentions]

Hello again Edward and welcome to the Forum.

Even though you trust your surgeon it would still be wise to get a copy of your medical records, for sharing and for long-term history. There is still a wide array of different opinions on how to best perform a mesh implantation. For example, prophylactic neurectomy is often performed. In other words the three main nerves in the groin area are cut, on the premise that this can avoid future pain, and the premise that they serve sensory functions only. There might be something in the procedure he performed that is a clue to someone with expertise, like Dr. Towfigh.

3D Max is a polypropylene mesh that that is very common in lap mesh repair. Nothing really notable there as far as immediate biological response, like an allergic reaction. But, who knows for sure.

How soon after the implantation did you feel the testicular pain and the left side pain? Obviously it was soon but was it immediate? What type of pain was the left side? Very localized and specific or diffuse?

Also odd that the surgeon performed open removal after laparoscopic implantation. Most lap surgeons would have removed it by the same method.

Finally, the involvement of the colon still seems odd. In both TAPP and TEP the body is placed in a position that lets the intestines drop away from the abdominal wall, where they are safe and out of the way.

These are just observations and questions. All surgeons sound confident in their work. I don’t think that a person can be a surgeon without a high level of self-confidence.

Anyway, the surgery notes might have some clues. A good surgeon will not be offended if a patient with problems wants to take a look at them. They are available to all patients just by asking. Most places can send them by internet or on a DVD.

[Good intentions]

Thanks for clarifying. There’s a reason I don’t do complex things early in the morning. I felt compelled this time though.

So, rewording with more correct dates – bilateral implantation of the same 3D Max that Chuck had, late spring of last year, “revision”, whatever that means, 2 and 4 months later, (about one year ago), spinal stimulator 7 months later (no mention of what was happening in those 7 months), emergency surgery on the colon one month ago (although the colon is not involved at all in a mesh implantation), and the “exact same symptoms” remain, but those were not described.

Edward, if you are a real person, I apologize for making your post more complex. There is a forum member who has been creating new personas in order to make up stories, basically trolling the members of the forum. He had a bad mesh implantation experience and has been worried about the after-effects.

So, if you are real feel free to add to your story in a way that will make your legitimacy apparent. Sorry, but these alternate personas seem to be a new internet thing.

[Good intentions]

The story has many similarities with “Chuck Taylor”‘s story. The writing style is similar also.

You went from 4/22 to 6/22 to 3/23 and then apparently had emergency surgery on 6/23 the day after revision surgery, then the last event was 8/22. The spinal stimulator trial was a month before the mesh implantation. Is a “spinal stimulator” a method of treating hernia pain? By the dates there was a spinal stimulator, mesh implantation, “revision” (unclear what that means) 2 months and 4 months later, emergency surgery the day after the first revision, and a MRSA infection. This all must have happened over a year ago since it’s only July. Very confusing story.

Could you retell your story in chronological order? It doesn’t really make sense. What were your initial symptoms and how did you end up getting spinal stimulator treatment? Good luck.

[Good intentions]

Just a followup to point out something I missed – not all mesh repairs are the same. Sorry Watchful but you’ve kind of lost your rigor. Combining open Lichtenstein with laparoscopic TEP mesh. They are completely different methods of repair. The only commonality is the use of mesh. It’s the big trap that everyone falls in to – combining all procedures that involve mesh as “mesh repair” and all different types of mesh as “mesh”. Simplifying the whole complicated situation down to pure tissue versus mesh.

“I know 5 people who had mesh repair of inguinal hernias. 2 lap TEP, and 3 Lichtenstein.”

[Good intentions]

Sorry Watchful, but I don’t believe that anyone actually has “zero” issues after any surgery. The other question that I didn’t ask (you didn’t answer the others) is, are they back to the same level of activity as before? “Fine” is not zero.

Besides the odds of problems, the magnitude of the corrective efforts is very important. Getting another pure tissue repair after a recurrence is orders of magnitude less significant than a mesh removal.

Personally, having gone through it, the damage that is possible from a mesh removal is barely comprehensible until it’s happened to you. To surgeons also. People need to consider what could happen if they get a poor result. Odds versus cost of failure.

We’re all just repeating ourselves now. Let’s get some details. I was finally able to fit into my old pants size, just last week. Soon after mesh implantation I had to go up two inches on waist size to reduce the pressure at the waistband, right below my navel. This did not change after mesh removal, my lower abdomen was like a plastic bowl. My pants have been getting looser and looser over the last few years and I finally pulled the trigger and bought a new pair of shorts. It feels so good to not have all of that extra fabric flopping around to actually feel like my pants fit correctly. It’s been over eight years.