Good intentions
Forum Replies Created
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I lamost hate to do this but I read further down that page and came to what seem like outright lies. Pasted them below. So I think that he is actually, ironically, increasing his liability by furthering these untruths. It’s a mess out there, in the mesh repair field. The NHS in the U.K. seems to be very firmly behind promoting mesh. It’s very bureaucratic system, from what I’ve read, I assume that the doctors have little freedom to choose what’s best for the patient.
Excerpt (incredible in today’s world, where it’s so easy to check facts, that somebody would say this):
“Are there any alternative treatment options and what are the risks involved?
There are non mesh repair techniques but this involves using large amounts of sutur material and the recurrence rate is higher.Prior to using mesh the majority of hernias were repaired using a darn technique and the incidence of recurrence was more than 30%. The use of mesh in hernia surgery has reduced the recurrence rate to less than 5% and in many cases, including our own cases, to less than 1%.
Although the risk of complications from not having any surgery is low, the NHS sees patients with bowel obstruction following inguinal hernias everyday.”
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He has the sales pitch down to a T. Covering himself by disclosing the potential problems, saying the words, acknowledging the percentages, which look terrible, but seemingly oblivious to what the words actually mean. The best that a person might think is that he is really just ignorant of what “chronic pain” means to the patient. He doesn’t know that living with constant pain is not really “living”. He is a mesh mechanic, trained in how to make a sale. I would not call him a true physician.
Excerpt from the web page:
“What is the most effective treatment option for a hernia?
Patients who have a hernia or who have been diagnosed by a hernia expert, I believe mesh is the most effective way of treating these patients. The use of mesh in hernia surgery has reduced the recurrence rate to less than 5% and in many cases, including our own cases, to less than 1%.The incidence of chronic pain has to be documented and should be part of the consent process, but it is also very important to realise that if hernias are not repaired there is a risk of strangulation, peritonitis, bowel perforation and bowel resection. These complications are extremely serious and if such a complication as peritonitis were to occur, there is a mortality associated with this.
What are the benefits of using mesh in hernia surgery?
The main benefit of using mesh is the recurrence rate. Before mesh was introduced almost a third of all hernias came back. The use of mesh in hernia surgery has reduced the recurrence rate to less than 1%.What percentages of those who undergo surgery likely to develop complications from mesh?
Undoubtedly, 10% of patients who undergo the operation with mesh can experience chronic pain in their groin – which, in the majority of cases can last up to a year. That has to be balanced with the fact that there is a risk of severe complications if you don’t have mesh repair.The incidence of chronic pain after mesh repair has been reported to be between 10 and 15%.”
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I was looking through some older posts and came across some information from Dr. Kang that is relevant to this Topic. I will just post an excerpt and link to the original Topic.
From Reply #19071, in https://herniatalk.com/forums/topic/no-mesh/ Dr. Kang also repairs “sports hernias”::
“You will find that many doctors have their own different definitions of sports hernia. Although the same name of ‘sports hernia’ is used, doctors have different opinions on which area is damaged. So, the area of surgery also differs frequently depending on the doctor. Thus, many of you who searched information of sports hernia might have been confused.
I have so far performed about 500 sports hernia repairs mostly for professional soccer players. From my experience, I believe that the sports hernia is an event where the external oblique aponeurosis of inguinal canal is injured. So, I have administered a simple surgery, which repairs the external oblique aponeurosis only. They successfully recovered and made come-backs to their sports.”
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Hello @drbrown
Could you elaborate on what you mean by “pure tissue” repair? I’m not sure what, exactly, it is meant to mean. In my mind, a pure tissue repair would only be “pure” if absorbable sutures or mesh were used for the repair, leaving no foreign materials after they were absorbed. But I see that even an expert like Robert Bendavid seems to describe the Shouldice method as a pure tissue repair, even though they use stainless steel sutures. I would consider this a suture-based repair, recognizing that the sutures remain forever.
I think that the term “pure tissue” might be getting improperly used because it sounds good, similar to the term “tension-free”. Can you clear things up?
Thank you.
https://slingthemesh.files.wordpress.com/2019/06/bendavid-and-iakoviev-revival-pure-tissue.pdf
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4/23/2018…quite a while ago, coming up on two years. I don’t remember seeing this post maybe it was in the Unapproved section at the time.
Hopefully he learned that there is little reason to have a mesh implant for an indirect hernia. None of the main reasons used for using mesh on direct hernias really apply to indirect hernias, as I understand things. The tissue is probably still strong, there is no weak spot in the fascia. The internal ring is just a bit too big. The methods that Dr. Kang and Dr. Brown have described for simply making the ring smaller via sutures seems very sensible and simple. I don’t know why anyone would consider mesh for an indirect hernia, even the surgeons. The side-effects and risk are much greater than the potential for recurrence.
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Hello dev @dev
Many forums have a link in each post to use to report it as spam, or for breaking forum rules. I am fairly certain that the post above this one is spam.
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Here is a paper that describes how the lightweight concept might actually be making things worse.
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Dr. Belyansky has commented on Twitter about plugs being “evil”. It sounds like he might believe that the other mesh forms are okay. The “lightweight” mesh concept does not have much long-term data supporting it. I think that it was an idea that could easily be introduced to market using the 510(k) process so They did it. Dr. Bendavid has published very well thought out papers showing how the “lightweight” concept itself was flawed and might actually create more toxic environment for nerves.
I am an older low body fat male who had Bard Soft Mesh implanted. Soft Mesh is Bard’s lightweight version of their “Gold Standard” mesh. I was physically active and the lightweight mesh was never right. I knew it needed removing at close to two years after implantation, after trying to live with it for that whole time. I had it removed at three years. https://herniatalk.com/forums/topic/one-year-seven-months-since-mesh-removal/
The plugs are more difficult to remove I think because they make a bigger chunk that leaves a bigger void behind. More three dimensional, than the two-D flat prosthetics. The “scar plate” has to be removed with the plug.
I think that you could find a doctor who will remove the mesh and do a suture-based repair. Dr. Billing for laparoscopic, or Dr. Brown for open.
Good luck.
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Hi alephy. Sorry for the delay in response the email Notification process does not work for my account.
I hate to send you to the Search function but I have written quite a bit about my situation. As I’ve mentioned in other posts, I had the mesh removed and there was no hernia remaining to repair. I’m not really waiting for anything anymore and coping well, like anyone who has suffered a serious medical condition might.
Here is one Topic that I pulled up using the Search function of the site. There is a lot of information already collected and posted on the site by many other people. I hate to put you off but my original descriptions are probably the best.
Good luck.https://herniatalk.com/forums/topic/one-year-seven-months-since-mesh-removal/
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Many people have a bump or ridge at the incision line. That would be different than “swelling”. The ridge should be getting harder and smaller with time. Swelling would be soft and uncomfortable and probably get worse with activity.
At six weeks everything should be stable and constant on a day-to-day basis. Change would be slow and gradual.
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There is only a single “official” bad mesh according to the International “Guidelines”, and that is the plug and patch. But all of the others are on the menu as “mesh” choices. They are not rated, they are considered to be all the same, apparently.
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The proposed solution is almost identical to what happened to me, except from a male perspective. Bard Soft Mesh, bilateral laparoscopic implantation, TEP procedure. Released for full activity at ~20 days. Mesh removed three years later.
I think the the most important thing a person can realize in this situation, if they can afford it, is that if you get a suture repair and it fails you can follow it with a mesh repair. If you get a mesh repair and have problems, you’re stuck with the effects for life.
Your surgeon was reciting the talking points for the use of mesh over suture repair. I’ll bet that he/she does not really know how their patients are doing now. If you ask for specifics you’ll probably get “I have not heard anything bad”. Tracking costs time and money and might show something disturbing. Best not to know. It’s just today’s reality.
Good luck.
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It’s mainly true and it’s a big selling point for mesh repairs. Many people can go back to full activities, but many of them might just feel terrible or uncomfortable while doing the activities, and/or after. But the hernia is gone.
The focus has shifted from the complete well-being of the patient to the narrow focus of fixing the defect alone. Then letting the next doctors worry about the pain, with “pain management”. It’s trending more toward specialized assembly line manufacturing principles than medicine.
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If you search your name using the Search box in the corner your old posts will be found. In the meantime.
How did you start a new thread? I can’t find the function. I’m on a computer, not a phone. Windows.
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Notifying @drtowfigh @good intentions @good-intentions
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Hello. The site looks interesting. Of course there will be bugs to work out. Here are a couple of things I see right away.
There is no visible way to start a new Topic, or thread. I am using this one since it is possible to reply to an existing topic, apparently.
The MEMBERS list under FORUMS seems to show only members that have logged in since the change. Only 7 members as I write this. No way to find old members that have not logged in yet.
My screen name has been changed from “good intentions” “to “good-intentions”. A hyphen has been added. It shows on the site without a hyphen but I have to use a hyphen to log in. Can it be changed to the original name, for continuity? I think that the notification function will require the hyphen.
Thanks for keeping the site going.
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I forgot to say that mesh removal leaves a different situation behind than when you first had the hernia. The hernia is often covered with scar tissue and does not need repair again. The surgeons who remove mesh know what to do about the old defect site.
Don’t forget that Dr. Towfigh is down in Beverly Hills. She removes mesh when appropriate.
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Here is Topic with some details about my experience and Dr. Billing’s practice details. “Billing” is his name. There is also a comment from dog about Dr. Brown. Look for dog’s topic on his choice of Dr. Brown. If I find it I will post it, it’s on the forum somewhere.
https://www.herniatalk.com/12176-one-year-seven-months-since-mesh-removal
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@cshelter Read Dr. Kang’s posts in the link below and you’ll see the difference between a surgeon who truly specializes in a certain area of surgery, and the one-size-fits-all mesh implantation process that is being taught to today’s new surgeons. It’s sad to see how dumbed-down such an important profession can get. Mesh implantation is simple to teach.
I think that there is still hope for you in the long-term. I am two years plus a couple of months out from mesh removal and I am getting closer and closer to being fully healed. Once the mesh was out the true healing started. It’s taken a long time but the body will just keep trying to get things back to the way they were designed to be. I can’t remember the details of your situation I think that I was confused with your initial posts. If you have mesh it can still be removed. If you don’t have mesh a doctor like Dr. Kang or Dr. Brown can probably get you to a baseline that you can really start healing from. Keep trying, there are true experts out there.
Here is the post where Dr. Kang goes in to great detail about his methods and why they are different.
https://herniatalk.com/forums/topic/no-mesh/