Good intentions
Forum Replies Created
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Do you have more details on the type of mesh used, and the size? There is a variety of materials for the surgeon to choose from, and the quantity depends on the surgeon’s choice also, along with location. The type of surgery, TEP vs TAPP, would be good to know too. The notes from surgery should have these details. Certain types of mesh seem to have more problems than others. After four months the mesh will have been “incorporated” in to the surrounding tissue so it’s unlikely that the problems will resolve on their own.
I had a similar swollen feeling with Bard Soft Mesh, after activity, while sitting. Not severe pain but constant discomfort. It felt like I had a wide flat sponge in my abdomen. I had to leave my pants unbuttoned to avoid pain. My surgery was laparoscopic TEP with mesh placed on both sides.
It looks like Dr. Prats is learning and using the main-stream guidelines, which call for using large areas of mesh to cover and extend beyond as much of the potential hernia areas as possible. It would not be a surprise to find that he also had mesh placed on the left side.
https://www.leadersurgical.net/doctors
Good luck. There is a much good information on this forum. It can take some time to find a solution though.
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quote Pwuenstel:Brief description of my situation, I had an open left inguinal hernia repair, and varicocele in 2016. Medium pro loop mesh was used. Since then I have had pain at mesh site and also pain in left testicle. Has anyone else had similar results?
The issue is at this point we don’t know if the testicle pain is from the hernia repair, or varicocele. To this day, I don’t know why he surgeon did the varicocele while fixing the hernia, as there were no symptoms. But either way, i do still have pain at the hernia site from the mesh, so the mesh removal may kill two birds with one stone.
I don’t have any direct advice or experience with that type of mesh. But I do recall a recent tweet from Dr. Towfigh about what looks like a plug and onlay mesh removal, Perfix brand, and some comments in the tweet about plugs in general. Another herniatalk member posted this originally.
https://twitter.com/Herniadoc/status/1021561699290116097
Here’s a link to the Proloop product. It’s a little scary to see, with all of the disordered loops, and will probably take some work to remove.
http://www.atriummed.com/EN/biosurgery/Documents/009966-PROLOOP.pdf
Can I make a joke?… better two birds with one stone than killing two stones…
Good luck.
What do you see?
This is a medium size Perfix #plug #mesh that has balled up, aka #meshoma . It was causing chronic groin & nerve #pain due to erosion into the spermatic cord, so I excised it. He is now #pain free!🙏🏻#meshcomplication #hernia #chronicpain #itsnotjustahernia pic.twitter.com/EgnLh0ULXR
— Dr. Shirin Towfigh (@Herniadoc) July 24, 2018
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Good luck Dave Graham. Can you give some detail on what your surgeon plans? It sounds like an open surgery. Will it be with mesh or pure tissue?
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Also search “Mark Zoland, MD | Hernia Surgeon | Pelvic Health Summit” using Google and it should be the first video result, that I referred to above.
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Dr. Zoland seems like he has the approach to his work that we’d all like to see in our doctors. He offers very good advice in the video, about asking questions and pressing forward until you’re where you want to be, that anybody seeking help could follow.
It’s a little bit ironic though that he is primary author on a paper that starts out by discussing chronic pain but does not mention mesh as the primary source of chronic pain after surgery. And he uses large areas of mesh for his repairs. If he could expand his expertise in to addressing that area of chronic pain he could probably help with the problem. The mental conflict is probably great though, so I can understand trying to avoid it. He seems to be firmly in the laparsocopic repair with mesh camp. I don’t see how anyone can talk about chronic pain without mentioning mesh as a source. It’s not mentioned anywhere on their web site either.
Good luck with your recovery. Many people do just fine with mesh repair, so don’t let my comments make you nervous. Dr. Zoland seems like a good surgeon.
This is a second attempt too post. I got “Unapproved” on my last try. Search “Referral Patterns for Chronic Groin Pain and Athletic Pubalgia/Sports Hernia” on Google and it should be the first result.
https://glsnyllp.com/blog/what-is-an-inguinal-hernia-and-how-should-it-be-repaired/
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Dr. Zoland seems like he has the approach to his work that we’d all like to see in our doctors. He offers very good advice in the video, about asking questions and pressing forward until you’re where you want to be, that anybody seeking help could follow.
It’s a little bit ironic though that he is primary author on a paper that starts out by discussing chronic pain but does not mention mesh as the primary source of chronic pain after surgery. And he uses large areas of mesh for his repairs. If he could expand his expertise in to addressing that area of chronic pain he could probably help with the problem. The mental conflict is probably great though, so I can understand trying to avoid it. He seems to be firmly in the laparsocopic repair with mesh camp. I don’t see how anyone can talk about chronic pain without mentioning mesh as a source. It’s not mentioned anywhere on their web site either.
Good luck with your recovery. Many people do just fine with mesh repair, so don’t let my comments make you nervous. Dr. Zoland seems like a good surgeon.
https://www.youtube.com/watch?v=fC0msBF8ufM
https://glsnyllp.com/blog/what-is-an-inguinal-hernia-and-how-should-it-be-repaired/
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Here’s a story I just came across. It’s not a mesh story but it is about a surgeon whose name comes up. Dr. Meyers of the Vincera Institute. A young soccer player, Kellyn Acosta, who just got selected to the US Mens National team had surgery on February 22 and is almost back to full speed.
I see these stories and often wonder if “sports hernia” is used to cover all types of abdominal repair procedures these athletes have. I would guess that they report pain and the doctors do whatever they need to do to get them back to full performance.
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quote ajm222:Forgot to mention my grandfather had an inguinal hernia repaired with mesh in the 70’s. He died around 2007. Never remember him mentioning any issues with the repair. I never asked so I don’t know any of the details and no one else still alive does either, but it seems it worked OK for him for all those years. I never heard him complain about it or heard anyone discuss it.
I also have a friend who had a repair done in high school. He’s now 39 and no issues at all. My neighbor across the street has had 3 (!!!) inguinal hernia repairs over the last decade or so (both open and lap) and currently has no issues. He’s a hard core runner, too. Last surgery was at least 5 or 7 years ago. And a friend from college I consulted had two repairs maybe 7 or 8 years ago and he said he’s been perfectly fine ever since. Lastly, another good friend I spoke with (all of these people I discovered had repairs done after posting something on Facebook before my surgery) had two separate surgeries and while he had some big complications after the second surgery (housebound for a month and issues walking because of numbness in the legs), he says he has no remaining issues currently and all is well. His first one was done about 5 years ago (open) and the second was done early last year or the year before (lap). Interestingly they were both on the same side but he didn’t seem to think it was a recurrence.
It is surprising how the mesh problems seem to be getting worse over the years instead of better. One thing that I became aware of as I was searching for a repair method is the increase in the use of laparoscopic methods, and the associated growth in mesh coverage area. Laparoscopy allows a much larger area of the abdominal wall to be covered and the literature seems to supports placing as much as the surgeon can fit, even to the extent of what looks like prophylactic dissection (take a look while we’re in there) and placement (there’s a sign of a potential future hernia). Of course this is just a view from internet stories and research. This type of correlation would be readily evident if a hernia repair registry was in use.
My surgeon actually seemed proud of the size of the pieces of mesh he was able to use. I made a comment about how a 4″ x 5″ piece of mesh was pretty big, and he corrected me to “no it was 6″ x 6” “. Before my surgery he had remarked about how he dissected a space and cut the mesh so that it “couldn’t move”, and that he was doing things differently than he had the year before. I should have asked more questions then but I assumed that he was perfecting a good technique. In retrospect I think that he was adjusting for past problems.
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quote JHue:If V.A. care is the only health care someone has available, there is at least some comfort in knowing that for “many years [as you put it]” this would seemingly suggest consistency in procedure, even if not the best available per individual patient need. However, high V.A. doctor turn-over rates may negate the notion of a doctor having done a sizable number of hernia operations.
Reiterating my major point, the length of time the V.A. has done a procedure one way (based on cost savings) does not indicate anything of rate of complications, which may or may not be better or worse than other procedural options privately developed over the same period the V.A. has been doing hernia surgeries.
That is an excellent point. I oversimplified, and conflated the surgeons with the hospital, which is a big error.
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You’ve probably had your appointment already, but “dog” has done quite a bit of research on the technique. Dr. Kang has also commented generally about many of the suturing techniques.
https://www.herniatalk.com/8427-letter-to-me-directly-from-prof-dr-desarda-m-p
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You might get more details on the procedure used. There might be some useful details there. There are many different ways that individual surgeons do things, on top of the many different ways a hernia can be repaired.
There are members here also that would probably love to know who your surgeon was. Apparently, and unfortunately, your difficulty in finding a surgeon who understood your problem is not uncommon. Can you tell more about your search?
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It depends on the procedure used. Mesh is popular for covering all potential hernia areas, even if the focus is on one small one, when used in laparoscopy. Find images of mesh placement for a laparoscopic repair and you’ll see that they cover lots of extra area.
Dr. Kang has written quite a bit about the difference between a suture, or pure tissue, repair of the two types. You might look for his posts.
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I gained a bulge just below my navel extending a few inches on either side, after my laparoscopic surgery. It doesn’t seem to be fat, just a stiff layer of tissue, almost like some sort of protective measure that the body takes after being injured. Even my physician noticed in when I went in for a physical, he poked at it like it didn’t belong. It doesn’t seem to follow weight gain or loss with the rest of my body either. I assumed it was a side effect of the large area of dissection from my TEP procedure. It’s still there even after mesh removal.
What type of hernia did you have repaired, and what procedure and material was used?
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Here is a topic with a list of surgeons that Chaunce1234 has collected. Dr. Billing removed my mesh. Dr. Towfigh removes mesh on a regular basis. They both use laparoscopic techniques, Dr. Towfigh uses robotics at times also, apparently. They both will consult over the phone, I believe.
The list starts at Post #4. There are several more surgeons on the west coast.
https://www.herniatalk.com/6259-seeking-an-experienced-hernia-mesh-removal-surgeon
Dr. Towfigh had some advice for your type of situation in a past post, #4 here – https://www.herniatalk.com/47-mesh-removal
Good luck.
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Can you give more information, like your general location, how far you are able to travel, and the type of repair that you had? There is good advice available here but there is no general recommendation that can be made. The more detail the better.
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Hello katie. I don’t think that the “top” removal surgeons have been defined. There really aren’t that many who you could say specialize in it. And they all seem to do it differently. Some use an open technique. Some use TAPP laparoscopy. Some are using robotics. Some do a triple neurectomoy as a matter of course. And the methods used depend on the individual patient’s situation, I believe, for some surgeons. Others do it one way every time, like Dr. Petersen in Las Vegas.
I think that Chaunce1234 has put a list together in past posts. And several of us have made individual recommendations. I think that you’ll find them if you search the forum posts.
I am about nine months out from mine and still feeling the effects of the mesh and the removal. The mesh really made a mess of my abdomen while it was in there and it’s still adjusting. I can’t tell where it’s going to end up.
Good luck. Ask lots of questions.
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quote Jen74:Well my GI doctor said everything came back normal. Well I went to get a copy of the report and the CD today and was reading the report and on the impression it says: “No intra-abnormality to explain etiology of patients symptoms of lower left pelvic/abdominal pain. No evidence of appendicitis or diverticulitis”. Well I started reading over the whole report and in the section where it talks about the Body wall it states that there is a small umbilical hernia!
Your doctor probably just read the summary, like many of us do, and the doctor reading the image was only looking for what he’s been trained to look for specific to how your symptoms were reported to him. Lower left pelvic/abdominal pain. The umbilical hernia was just a side observation.
Good luck.
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To be clear, I do research for a living, but not in the medical field.
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Yes, the design could have made sense, with more care taken to control the other variables. But as it stands, they have overlooked the knit pattern, and, possibly, other factors, like partially absorbable components that seem to be used in several Ultrapro products. Ultrapro is a brand name that Ethicon uses for many different devices. One more way that cause and effect are blurred, making it very difficult to determine which products are good, and which are bad. It’s not even clear which Ultrapro product that they are evaluating. I copied the Ultrapro product page link below.
One interesting fact, is that even though Bard offers a lightweight version of their “gold standard” mesh, they couldn’t find, apparently, enough surgeons that used it, even though they found enough that used the “heavy” mesh. It would have been very obvious that Bard Mesh and Bard Soft Mesh should be the subjects of the study, from the beginning. Makes me think that they compromised to Ultrapro lightweight, or vice versa to Bard heavy, when they couldn’t find the proper devices for a good study.
I do this type of work for a living so these things stand out to me when I see them. The concept is a good idea, poorly planned, but well-executed. Much talent and expertise was wasted to produce a nice paper that doesn’t really show anything, except for the collection of more general data showing that “mesh” causes significant pain and discomfort, even for open surgeries using the Lichtenstein method. That finding has value alone, I think.
https://www.ethicon.com/na/products/hernia-mesh-and-fixation/hernia-mesh/ultrapro-hernia-system
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I came across another long-term success story. Open “mesh” repair in 1985, relaying his story in 2005. Twenty years, and an active athlete. Stories like this are probably what have led other surgeons to think that any mesh anywhere is okay.
https://www.hillrunner.com/jim2/id93.html
The surgeon, Dr. William Howard, has, unfortunately, died fairly recently. His story is worth reading.
http://www.baltimoresun.com/news/obituaries/bs-md-ob-william-howard-20160111-story.html
His Sports Medicine Clinic is still there though. Might be a good starting point for people in that area.
https://www.medstarunionmemorial.org/our-services/sports-medicine/