Good intentions
Forum Replies Created
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Here is some verbiage from the single reference that Medtronic references in their marketing literature, regarding “satisfaction” with the use of Progrip mesh by the patient..
“The grips are biodegradable, and when the tissue grows into the mesh, the grips break down, leading to a reduction in the overall tension and chronic strain of the foreign body.”
“Most patients had a sedentary job or lifestyle or were retired or unemployed, and they performed little or no exertion on a daily basis. Hours of physical activity outside of work varied, with the most common activities being walking, golf, and other exercise.”
“Overall, the vast majority of patients were satisfied with the surgery, and all patients would recommend the procedure to family and friends.”
“However, longer-term randomized data are required to better assess the benefits of this approach compared with the other techniques available.”
But they never said how the patients were interviewed or what questions they were asked. It’s fascinating to dig in to the references and see how “light” they are. Not much to them.
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I can’t say much about what you might be experiencing or what to do about it. The mesh is usually not discernible by imaging for most “image readers”. Many people have gone through tedious MRI’s and examinations and been told that the mesh was perfect and there was nothing to be done only to find when they had removal that the mesh had moved and/or folded. It is not easily seen by imaging.
The reality though, in the end, is that it doesn’t matter where the mesh ended up. If you don’t have another hernia there is only pain management or mesh removal. Or just living with it. Discomfort from mesh repair is not uncommon. Read ajm222’s posts and you’ll see somebody who is kind of stuck in the middle, like you might be. Not bad enough to take action, but bad enough to be worried.
Wish I could give some advice for direct action that you could take. But the fact that you are fully functional and not in pain means that you are a “success” by mesh industry standards. Good luck.
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The term “tension-free” was created when Lichtenstein started using mesh to repair hernias, as I understand things. The definition was very narrow, focused on the sutures used for a non-mesh repair. I’ve attached a link that gives a good general definition of “tension”, below.
https://www.evergreenhealth.com/hernia-repair-types
The narrow focus of the term is about the sutures and the way that they pull on the tissue. But, the reality of a mesh repair is that a new kind of tension is produced. A broad tension from the scarring in of the mesh, which causes the mesh to pull tightly together as the new collagen shrinks. When I use the word “tension” I am using the broader, literal, definition of tension, not the term used to promote mesh repairs.
Another term that is used that sounds good but is actually not correct, in my opinion, for today’s hernia repair is “minimally invasive”. Again, if you use the word literally and look at what happens during a laparoscopic repair you can see that laparoscopic mesh implantation is not minimally invasive. Actually, literally, compared to a suture repair, I think that it could be called “maximally invasive:”. I don’t think that you will find a surgeon who can give a rational reason for calling laparoscopic mesh implantation “minimally invasive”. It’s just not.
I think that the term has been carried over from the original uses of laparoscopy for things like appendectomy or gall bladder removal. In those cases, where the surgeon has to create a large incision to get to the organ, laparoscopy probably actually is “minimally” invasive. A small incision allows the surgeon to remove the offending organ with minimal disruption of surrounding tissue. For mesh implantation a very large area needs to be dissected, splitting the peritoneum from the muscle wall, to create a space for the mesh. A suture-based hernia repair would only “invade” or disrupt the area local to the hernia. I’m not saying that one is better than the other just the use of the term is disingenuous. It’s not true.
If you browse through the device makers’ pages and product literature you’ll see that much of what you, and your surgeon, read is market and sales literature. It’s for selling the product.
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Bilateral laparoscopic mesh implantation, even robotic assisted, usually involves placing very large pieces of mesh, much larger than the defect they are meant to fix. Get your surgery notes and they should have the dimensions of the pieces that your surgeon started with. Do the math and compare to your abdomen and you might be surprised at how much area is covered, assuming that the mesh was laid flat around the abdomen. It won’t you make me feel physically better but you might feel more secure understanding where the tension comes from.
Also, Progrip uses absorbable material in its construction. It takes months for the material to dissolve and be absorbed. As it does the body will attach more firmly to the remaining synthetic fibers. That might be why things are still changing, many months after surgery.
Good luck. You are probably physically fine so your doctors will have trouble finding a reason to take any action.
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[USER=”3109″]Gymnastmom2011[/USER] notifying
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Here are some links to Dr. Towfigh’s past work in the area. Since you’ve already spent some time discovering that most doctors only know how to diagnose certain types of hernia, going in with a plan backed by reference sources is probably a good idea. Good luck.
https://pelvicpainrehab.com/female-pelvic-pain/3565/hernia-may-cause-pelvic-pain/
https://www.google.com/search?q=dr.+towfigh+hidden+hernias&rlz=1C1SQJL_enUS862US862&oq=dr.+towfigh+hidden+hernias&aqs=chrome..69i57.6739j0j8&sourceid=chrome&ie=UTF-8
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There is a topic about “sports hernias” on the site. The symptoms are different from a normal hernia. https://www.herniatalk.com/6882-in-depth-sports-hernia-guide-infographic
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Dr. Towfigh [USER=”935″]drtowfigh[/USER] has the expertise in hidden, or occult, hernias. https://twitter.com/herniadoc?lang=en
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Dr. Towfigh [USER=”935″]drtowfigh[/USER] has the expertise in hidden, or occult, hernias. https://twitter.com/herniadoc?lang=en
There is a topic about “sports hernias” on the site. The symptoms are different from a normal hernia. https://www.herniatalk.com/6882-in-depth-sports-hernia-guide-infographic
Here are some links to Dr. Towfigh’s past work in the area. Since you’ve already spent some time discovering that most doctors only know how to diagnose certain types of hernia, going in with a plan backed by reference sources is probably a good idea. Good luck.
https://pelvicpainrehab.com/female-pelvic-pain/3565/hernia-may-cause-pelvic-pain/
https://www.google.com/search?q=dr.+towfigh+hidden+hernias&rlz=1C1SQJL_enUS862US862&oq=dr.+towfigh+hidden+hernias&aqs=chrome..69i57.6739j0j8&sourceid=chrome&ie=UTF-8
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Here’s a good video from a SAGES presenter.
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3nd try, got Unapproved. Removed links. I’ll try to post them later. Good luck.
The Prolene Hernia System (PHS), plug and patch, Onflex, and a variety of others, are implanted via open surgery. Knowing the details of your surgery will help. “Open” repair is also known as anterior approach. From the front. If you want to search more.
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2nd try, got Unapproved. Maybe too many links.
The Prolene Hernia System (PHS), plug and patch, Onflex, and a variety of others, are implanted via open surgery. Knowing the details of your surgery will help. “Open” repair is also known as anterior approach. From the front. If you want to search more.
https://www.jnjmedicaldevices.com/en-US/product/prolene-polypropylene-hernia-system
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The Prolene Hernia System (PHS), plug and patch, Onflex, and a variety of others, are implanted via open surgery. Knowing the details of your surgery will help. “Open” repair is also known as anterior approach. From the front. If you want to search more.
https://www.jnjmedicaldevices.com/en-US/product/prolene-polypropylene-hernia-system
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This Topic covered about everything. Very recent. Same type of surgery, very generally.
https://www.herniatalk.com/13630-post-hernia-repair-nerve-pain
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The type of material used and the procedure will offer more clues. I’m repeating myself but I am serious. The more you know about what was done the better the advice you get will be. The field of hernia repair is very chaotic, “open with mesh” does not tell very much.
Also, keeping track of when the pain is worst and best and what activities preceded these conditions could tell you something. It looks like it’s been a total of four weeks. Still early.
Good luck. [USER=”3086″]abrill[/USER]
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[USER=”2580″]DrBrown[/USER] Dr. Brown, andrew1982 says that his surgery was a non-mesh procedure. I asked about it in Post #26.
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Was it an open procedure or laparoscopic? It sounds like some nerves might have been damaged during surgery.
If it was just fat in the defect then I don’t think “strangulation” was happening. Maybe they assumed it was because of your pain.
[USER=”3104″]Carys[/USER]
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And, here is a paper written to show the benefits of the PLA. They used 3 months as the “chronic pain” threshold. In other words they don’t know much about the effects after three months. Things might get better.
Good luck. [USER=”3017″]SFIrishGuy[/USER]
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The data about the PLA degradation is sketchy and undefined. Internal data from animal studies and estimates. Seems like a good idea, close enough to send to market.
Sorry to be cynical. But, doing that things that speed the degradation along might help.
- 9. Estimate derived from the use of information under license from the following IMS Health information service: Hospital Supply Index for the period Sep ’06 – Jun ‘12. IMS expressly reserves all rights, including rights of copying, distribution and republication. Based on typical prices of anatomical mesh and absorbable fixation in the US.
- † Based on pre-clinical animal and/or benchtop studies.