Good intentions
Forum Replies Created
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Dr. Towfigh can be contacted directly at the Beverly Hills Hernia Center. I don’t think that she does any evaluations through the HerniaTalk forum.
https://beverlyhillsherniacenter.com/
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It’s been quite a while since I added anything to this thread or others. I’ve found that my plan to avoid pressure on the area of the mesh remnant so that it could heal and shrink as scar tissue is known to do, is working very well. I stopped wearing the suspenders a few weeks ago and am back to wearing a belt. I am also working out more vigorously and have started running again, trying to get some speed and endurance back (I had a goal of running a 5K in under 18 minutes. I don’t think it’s going to happen but at least I can train without pain).
The main message is that it takes the body a long time to adjust to the damage that mesh and mesh removal causes. If you’re in a situation like I’ve described in past posts try some new things. Track what works and what doesn’t. And give your body the chance to fix itself. I still have it in the back of my mind that the last piece of mesh might need to come out. But, progress is sitll being made without it so I’m just going to keep going.
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Why would you take a second opinion from the internet over an in-person opinion from a world renowned expert in hernia repair who has worked on world famous athletes?
“She proposed me to have a bilateral groin revision. I would like to have this confirmed by a second opinion before moving to a revision surgery.”
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Thanks for posting, with the updated details about changes at the Hospital. I have Dr. Kang as my next option if I have problems with the remaining piece of mesh inside me or any type of hernia recurrence. Good luck. Healing takes time, even with the best repair methods. Don’t rush it.
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There is a surgeon who has posted on the forum, who is now averaging over $400,000 per year, over the last three years, “consulting” for a device maker. It’s incredible. And the device results are unproven in the long-term. The device makers are running the hernia repair show.
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I’m sure that there are parallels with mesh implantation in general.
“Earlier this year, Dr. Blatnik fixed a bad component separation surgery where the original surgeon had cut into the wrong muscle plane. The patient’s intestines were bulging out of her sides, another Mickey Mouse hernia.
Dr. Blatnik said he immediately recognized the name of the surgeon who had operated on the patient because that he had seen that surgeon teach component separation at a course sponsored by a device company. The surgeon has received more than $130,000 in payments over the past decade from companies including Intuitive and Bard, which manufacturers hernia mesh, The Times found. “
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Thanks for the article William. It is about much more than just surgeons learning techniques on Facebook. It shows how many surgeons learn surgery “on the fly” with their early patients suffering the most damage.
“Dr. Rodolfo Oviedo performed the faulty surgery. Ms. Moran said the company had paid him $4,400 for it.
Dr. Oviedo acknowledged that he had made mistakes but said he had improved. “At some point I was doing it wrong, and nobody’s perfect,” he said in an interview in June, when he was the director of robotic education at Houston Methodist, a major hospital in Texas. He said it was only at some point after the surgery that he learned of his potentially serious errors.
Four months later, Dr. Oviedo offered a new explanation. He said that he had learned of his mistake in real time and had repaired the damage while the patient was still on the operating table. He said the patient, with whom he followed up for 18 months, had not experienced complications. (Dr. Oviedo left Houston Methodist for another job in July.) “
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More –
“In June of 2021, W.L. Gore & Associates, a medical device company that makes surgical mesh used in hernia repairs, posted a video tutorial on its website. It promised to be a step-by-step guide to component separation surgery.
A surgeon narrated as he cut the patient’s abdominal muscles, releasing tissue so he could close a hernia. But he was operating in the wrong place and likely created a new hernia, according to four surgeons who reviewed the video.
“It absolutely trashed the abdominal wall,” said Jeffrey Blatnik, who directs the Washington University Hernia Center. “It was so offensive to the point that we reached out to the company and told them, ‘You guys need to take this down.’” “
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Medicine for profit.
From your article –
“Other hernia surgeons, including Dr. Menor, learned component separation at events sponsored by medical device companies. Intuitive, for example, makes a $1.4 million robot known as the da Vinci that is sometimes used for component separations. Intuitive has paid for hundreds of hernia surgeons to attend short courses to learn how to use the machine for the procedure. The company makes money not only from selling the machines but also by charging some hospitals every time they use the robot.
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In interviews with The Times, more than a dozen hernia surgeons pointed to another reason for the surging use of component separations: They earn doctors and hospitals more money. Medicare pays at least $2,450 for a component separation, compared with $345 for a simpler hernia repair. Private insurers, which cover a significant portion of hernia surgeries, typically pay two or three times what Medicare does.”
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Read through the old posts. The activity on the site has dropped to almost nothing compared to before the change to the new format. But the old stories are still in the Forum section. Nothing has changed, the same mesh is used in the same ways, with the same problems.
If you do decide to go with a mesh implant and have problems soon after I would recommend having it removed as soon as possible. My body is sitll changing after three years of mesh irritation. I think that if Ihad had it removed right away rather than trying to adjust to it I would be much better off today.
Also, beware the surgeon who is a big fan of mesh, that feigns ignorance of the problems or blames the patient. Somewhat ironically, a surgeon that rmeoves mesh is probably a good choice since they might have some insights in to what works best and what does not.
Good luck.
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That seems unlikely, combining mesh of any kind with a Shouldice-type repair. The only report I’ve seen of anybody doing something like that is from Dr. Grishkan’s practice. And he used a Gore mesh, PTFE based, not a biologic.
Can you supply the surgeon’s name?
Here is something about Dr. Grishkan’s method. The site has some bad information, like describing nylon mesh as a type of polypropylene.
https://herniasurgeries.com/hernia-surgery-technique-with-mesh/
herniasurgeries.com
The Modified Shouldice Hernia Surgery Technique - WITH MESH (Panel 5) - Hernia Center of Ohio
Panel No. 5 There are rare cases where surgical findings demonstrate insufficient or very weak tissue to perform a Shouldice repair. These can be due to multiple prior failed hernia repairs, the prior use of mesh and a history of … Continue reading
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Most of the development work was done for ventral repairs. The product was introduced for the inguinal hernia repair market based on a 31 patient study by a single surgeon. There was a two year followup study done of 157 patients, but it was not a typical inguinal hernia mesh implantation method. The surgeon sutured the defect closed first then placed the mesh. So, it’s not really applicable to what a typical patient would get. It does look good for marketing purposes though. Good luck finding a good one-to-one comparison with synthetic mesh.
https://finance.yahoo.com/news/tela-bio-highlights-results-bravo-110000480.html
“Robotic Reinforced Biologic Augmented Repair (ReBAR) of Over 150 Inguinal Hernias: 2-Year Outcomes
AHS presentation on Wednesday, September 14th, 11:20-11:30 a.m.ET
This retrospective study examined the two-year recurrence rate of the robotic-assisted reinforced biologic augmented repair (ReBAR) of inguinal hernias from June 2018 to April 2022. All repairs employed the standard robotic transabdominal preperitoneal (rTAPP) approach combined with the novel ReBAR technique, which consists of suture closure of the defect followed by a biologic mesh reinforcement. After two years, only three recurrences were identified from the 157 inguinal hernias repaired using the ReBAR technique – a rate of 1.9%, and only two SSOs were identified in this cohort.”
finance.yahoo.com
24-Month BRAVO study results showed a 2.6% recurrence rate in diverse clinical scenarios Robotic Reinforced Biologic Augmented Repair (ReBAR) study showed a 1.9% recurrence rate at two-year mark MALVERN, Pa., Aug. 04, 2022 (GLOBE NEWSWIRE) -- TELA Bio, Inc. (NASDAQ: … Continue reading
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It is still a very new product. But, really, it is not much different than any of the other biologic meshes.
The stock price has dropped dramatically since it went public at $13 per share even though the general stock market has increased dramatically. It’s just one of several of their products but there’s not much sign that it’s meeting its promises.
https://finance.yahoo.com/quote/TELA/
finance.yahoo.com
TELA Bio, Inc. (TELA) Stock Price, News, Quote & History - Yahoo Finance
Find the latest TELA Bio, Inc. (TELA) stock quote, history, news and other vital information to help you with your stock trading and investing.
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Is your surgeon claiming not to know of anyone that performs mesh removal? If they are willing to do an injection they must be aware of mesh removal. It’s mainstream surgery now.
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Hernias are typically “located” by the material that pushes through the weakness in the abdominal wall. During mesh implantation that material is either dissected or pushed back to where it came from. After mesh implantation the whole area shrinks, removing any signs of the previous hernia.
But, direct hernias are defined as weaknesses in the posterior wall of the inguinal canal. So if that’s what you had then that’s where a surgeon would look. The posterior wall will still be the posterior wall.
An exploratory lap procedure would have been a TAPP procedure. Often the mesh can be seen through the peritoneum, but if you had a TEP implantation the peritoneum was never breached so there will be no signs of where it was placed. During my mesh removal the peritoneum looked perfect, everything was smooth and normal.
When you say that you can feel the edges of the mesh with your finger do you mean that your finger feels it or that pressure with your finger allows you to feel it inside?
Anyway, overall, if you have mesh problems you’ll need to find a surgeon that has removed mesh and had success. They are the only ones that have real world experience in mesh problems and solutions, and will be confident enough to break through the perfect looking peritoneum to remove the mesh or find out out what is wrong with it. Because from inside the peritoneum there will be no signs of problems.
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I would contact the Shouldice Hospital. They might be able to recommend somebody.
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The Gibbeum Hospital with Dr. Kang seems to meet your desires. Mainstream hernia repiar today is mesh implantation under general anesthesia. Many different types of mesh possible but the basics are the same for the majority of patients.
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I’m not sure what you mean by “will do”. If you just talked to the surgeon do you not know their name?
Here’s a video about Ovitex biologic. It does not appear to be absorbed or decomposed or replaced by body collagen at all. It looks like it probably did when it was implanted, 1.5 years earlier. It peeled out pretty easily. You can clearly see the polypropylene reinforcement fibers on the surface.
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“Bumping” this to the top. I have no idea where this post will end up in the thread but the thread should become more visible in general.
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You should be able to find somebody who does the Desarda repair. Researchers in India have published about it.
https://www.sciencedirect.com/science/article/pii/S2049080121004362
