[jgens99218]

Alan…. What NFG12 said is spot on correct. Once mesh is in you and things go wrong then numerous unpredictable results are likely if mesh is removed or nerves are cut. It is not what we want to hear but it is true. Good Luck JG

[jgens99218]

Momof14

Really the forums that I was referring to were more general forums like Topix, Ehealth forum etc. Not from reputable websites set up by surgeons like Herniatalk. I apologize as this has distracted you from my main point regarding mesh removal. I still do not think it is right for any surgeon to troll these general forums where people are usually distressed and desperate for relief. To me there can only be one motivation for the surgeon coming to you in these general forums. If a patients wants to go to a surgeons site then fine.

JG

[jgens99218]

I had my mesh removed over 2 years ago by Dr. Kevin Petersen. I had many of the symptoms that Groundfaller describes in his post. My mesh was implanted laparoscopic but removed open mid line, big mistake. I should have waited but i was distraught and desperate after suffering for a year after mesh implantation. A lot of people have come to me for advice and to hear what happened to me. Mesh removal is risky. Obviously the more experience the surgeon has the better as is with any surgical procedure. The mesh removal is a bad bet if only because mesh is not meant to be removed and the inguinal meshes are in a very complex area of the body which is kind of like a super highway of vessels nerves cord structures etc. Unfortunately once a complication arises after a mesh implant then it is either wait it out and hope or have it removed. Both are uncertain choices.

Another poster “Mesh” has described his nightmare with Dr. Petersen. I too am far worse after my mesh removal and was also offered very little (actually none) information regarding the possible complications of removal. The only answers this doctor will provide is if you ask him specifically about something and then the answers are often contradictory to any medical information available, or any symptoms you actually are experiencing especially in regards to nerves and regrowth. Be careful, mesh removal almost always involves nerve damage. Mesh removal almost always results in a recreation of the original hernia or leaves you a prime candidate to re-herniate. If mesh is hopelessly adhered to other structures or vessels the surgeons will leave some of it there. The most common advice for chronic pain before or after mesh implant/explant is a Neurectomy, also another bad bet and gamble. The best way to avoid all of this is to not have mesh implanted in the first place. The debate about mesh or no mesh will carry on I am sure but it is undeniable that people experiencing pain after mesh implant can safely say that the cause was because of a mesh implant. Chronic pain only happens in a small percentage of patients but when you have say 5% of 800,000 people then it is a big number that is worthy of being recognized and addressed. Surgeons are way too quick to implant mesh unnecessarily and way too quick to remove it as well. If you insist on a mesh removal do not have your Lap mesh removed openly. Do not go to a doctor who advertises surgery or participates in online forums or Facebook websites. Do not have your mesh removed unless absolutely necessary, it is a measure of last resort.

One last thing. From many mesh removal patients I have spoken with. The pain after mesh removal, especially nerve pain, seems to happen later in the recovery process, at around 3-6 months, this is almost always a nerve related pain by that time. The same is true for post Neurectomy pain. A lot of mesh removal patients think they are fine but later on…….. look out. I urge you to go to Dr. Petersen’s website and look at the picture of the piece of nerve that was removed with the mesh from one of his patients, see link below.

http://www.noinsurancesurgery.com/he…sh-removal.htm

I promise you this nerve will not grow back by itself or without an extensive nerve graph or transplant and even with nerve surgery there are no guarantees on the other hand if a nerve develops a neuromatos condition because of the mesh as pictured then your also in trouble.The result in either case is chronic pain.

This picture in itself summarizes every concern anyone should have about mesh implantation-removal and it’s complications. There are other complications but this is the big one and the amazing thing is it is posted right on his website.

Scary,

JG

[jgens99218]

Neurectomy with 2nd surgery

Doctor Towfigh

I am in Massachusetts do you recommend any doctors near me that are well versed in pain management after mesh removal surgery? I have met with Doctor Earle once but I am not sure if nerve related issues are his forte. Certainly doctor Earle is a skilled hernia surgeon.

Also what would you recommend as an approach to treatment? I am afraid that medications, physical therapy. Nerve block Injections and various other modalities result in temporary relief and are not a long term solution. Half the battle is knowing what is actually causing my issues. I believe it is nerve related but cannot determine if it is neuroma, nerve entrapment, or what. This is further complicated by the fact that proper neurectomy can result in aberrant nerve sprouting and possibly not provide permanent relief.

I do know that I do not have a hernia recurrence. I am puzzled to think I may still have non nerve related issues this late in my recovery?

No win situation.

JG

[jgens99218]

Neurectomy with 2nd surgery

Thank You Dr. Towfigh

My issues display symptoms neuropathic in nature, burning,tingling, and unusual hard to describe pains that I have never experienced before. The pain is erratic and I actually have some days that are not that bad and other days that are not very nice.. I thought after 19 months any Non-Neuropathic pain would have resolved or healed? Not sure how much longer to do nothing about this?

I am not sure where to go from here because given the nature of nerve injuries there are not many options. If I have developed neuromas then what would be the best course of action? My understanding is neurectomy is a last resort.

Thanks

[jgens99218]

Neurectomy with 2nd surgery

Dr. Towfigh

Are you able to respond to my question regarding what happens to a nerve that is cut during the mesh removal process, see my original question below? Since I still suffer from pain 19 months after mesh removal I want to know if the cut remains of my nerve/nerves were just left hanging there what is likely to happen to them if a re-connection never happens? Will it always form a neuroma? if not does the nerve just heal over at its cut end? Wouldn’t either condition result in permanent pain?

Thanks

JG

[jgens99218]

Neurectomy with 2nd surgery

Dr. Towfigh

If mesh is removed and a part or section of a nerve is removed along with the mesh what is likely to happen with the damaged or cut nerve if the nerve end is not buried into muscle/tissue (neurectomy)? In other words if the damaged or cut nerve is just left hanging there. When I say cut I also mean portions of the nerve are missing.

Can you also confirm the definition of neurectomy? I understand it to be when a severed nerve (proximal end) is buried into muscle/tissue, is this correct? I do not know if there is medical terminology for when a nerve is severed and is left untreated from there?

Thanks, JG

[jgens99218]

Post surgery thoughts

WasInTN

“If in future something goes really wrong”…… It’s the Mesh!!

JG

[jgens99218]

Post surgery thoughts

WasInTN

Nicely written and I agree with everything you mentioned but for me, and others the question of utmost importance is should one have a petroleum based foreign material implanted into their body (Mesh) that may cause more of in issue than they had with their original issue, a hernia? Outside of complications arising from physicality that disrupts one’s hernia repair, (recurrence), most major issues that result from a mesh based repair is do to the mesh.

To have mesh or not to have mesh that is the question?

A surgeons skill and common sense on behalf of the patient is certainly essential for a good outcome.

JG

[jgens99218]

Chronic Pain After Inguinal Hernia Repair (Boston)

Michael

I can send you a file you can read about Radiological Scans and Mesh detection. Also I am from Massachusetts you can Email me if you like jgens99218@comcast.net. I can provide you with a lot of information should you want or require it.

You can also Google “The Radiologic Appearance of Prosthetic Materials Used in Hernia” And open or download the PDF.

or as summarized here :

http://www.ncbi.nlm.nih.gov/pubmed/24261353

JG

[jgens99218]

Chronic Pain After Inguinal Hernia Repair (Boston)

Michael

Mesh is not easily seen by an imaging scan, if you can even see it at all. Judging by your symptoms it is very likely the mesh is your problem. You also likely have some nerve involvement among other issues. I suspect the mesh implant was not done correctly in the first place and if the mesh has folded or balled up then you will have to have it removed. Unfortunately mesh also shrinks and a lot of times new pains arrive later then one might suspect. You need to see a mesh removal specialist. The good news is Dr Towfigh and Dr Chen are two of the best available. Mesh removal can have negative results as well but it may be the lesser of two evils. Good Luck

JG

[jgens99218]

Central Pain after Neurectomy

http://www.network54.com/Forum/557220/thread/1460331290/last-1460792008/Untitled

[jgens99218]

Diagnostic laparoscopy as the definitive means of hernia detection?

Wes

Let’s be clear. Removing mesh is never fairly easy. In fact is is extremely difficult and must be done by an experienced mesh removal surgeon, even then there is a high probability of long term complications. Lap placed mesh requires the peritoneum to be removed with the removal of the mesh. As Dr. Goldstein said diagnostic lap surgery has it risks and would be determined by your surgeon based on your condition. Some surgeons will insert mesh as a preventive measure if they are already there inside you. Example while fixing an inguinal hernia on one side. Once the mesh is in it doesn’t like to come out so think twice about getting mesh unless absolutely necessary.

JG

[jgens99218]

Diagnostic laparoscopy as the definitive means of hernia detection?

Dr Goldstein

Rarely have a read a response that provides an answer so clearly and concisely.

Just wanted you to know.

JG

[jgens99218]

Pain Diary

Thank You

[jgens99218]

Pain Diary

Dr Towfigh

As I last posted in the thread “Options after open triple neurectomy + meshoma removal” (still unanswered) If the standard neurectomy is done correctly in the first place then why would a neurectomy “higher up” be necessary? Why wouldn’t the higher up neurectomy just be done in the first place?

Do you think 21tom’s resolution is just a matter of time?

Thanks JG

[jgens99218]

Pain Diary

21Tom

How has it been going for you recently? We have not heard from you in awhile, I for one am concerned.

Please provide us with an update.

Thanks

JG

[jgens99218]

Options after open triple neurectomy + meshoma removal

Dr. Towfigh

It is sometimes unclear to me when answers are provided regarding “Neurectomy”.

For the sake of this question I will assume “Neurectomy” means the transection (completely cut or separation) of a nerve that is then buried in muscle tissue. This is done to prevent Neuroma?

Joy states that she had a triple Neurectomy but was still in pain 18 months after the procedure. You state that neuroma is a known risk after neurectomy? I thought the buried nerve prevents this neuroma formation?

If Joy had nerves that were cut and properly imbedded into muscle tissue it would seem she should no longer experience pain (at least pain caused by nerves). It would seem that another nerve operation “higher up closer to the Spine” would be unnecessary?

Any clarification would be greatly appreciated.

JG

[jgens99218]

Swollen Groin after Mesh Removal

Joy

My Email address is jgens99218@comcast.net. Feel free to contact me and we can further discuss any issues.

JG

[jgens99218]

Swollen Groin after Mesh Removal

Fromindia

This Friday will be 10 months since my mesh removal. As I have discussed previously in this thread my mesh removal has remedied the problems I used to have but have caused other issues. Currently my issues are what I believe to be nerve related. This is not uncommon with mesh removal as the nerves are almost always irritated, or damaged from the mesh removal process. Other potential damage includes but is not limited to transversalis fascia, spermatic cord, vessels & arteries (among other significant risks).

After 2 years of research and discussions with many of the leading hernia specialists in the country, mesh removal patients, hernia discussion forums, countless website testimonials, as well as my own experience, I have concluded the following (my opinion of course):

There is no real difference in risk whether you have mesh removed openly or laparoscopically. The school of thought is laparoscopic is less invasive? From an aesthetic point of view this is certainly true. However with laparoscopic surgery here is a lot going on with trocars and their manipulation as well as “blazing” a trail to the surgical site. good access to the surgical site should be considered with either method. Perhaps the most important thing to consider is who is operating on you.

Nerves: Technically nerves grow back. Do the proximal ends always end up joining to it’s distal end? Sometimes! Some people are more prone to feeling nerve related issues than others. Some people have no ill side effects from nerve damage or separation. Medications for nerve related issues, if they work, just mask the cause and do not cure anything. These medications also come with a whole host of side effects and withdrawal concerns. This also is true of anesthetic and or steroid injections. Nerve resection or Neurectomy is also a tricky business which can result in complete success or worsening of the original problem.

I am totally against the use of mesh to repair a simple hernia. In my case I believe that the mesh contraction caused most if not all of my problems. I also believe that the mesh that was implanted on my right side was not necessary and done more as a precaution (a somewhat common practice) although in my operative report my surgeon states “he did have a small hernia”. I believe that when mesh is implanted unnecessarily it lends to complications. In my case there was no hernia evident after my mesh removal. This was confirmed post operatively by my current hernia surgeon (an expert) through physical evaluation, Ultrasound and MRI. I think a pure tissue repair with absorbable sutures are your best bet. Is this method a higher risk for reoccurance?, Absolutely, you would then need to modify your physical lifestyle accordingly. There is just too many things that can go wrong with mesh and although the risk for complications from mesh are low, let’s say 1%, then if 500,000 operations are performed this year that equals 5000 people suffering in pain! The use of mesh should be limited to situations where there is no other viable alternative.

Now for the mesh removal issue. I believe mesh removal is a bad bet. I also believe people react to soon when they experience issues with their implanted mesh. Time is a great healer and although the pain and suffering is not good and difficult to bear, acting too quickly often times makes matters worse.

Given enough time (how long??) then the removal gamble MAY pay off. I think waiting at least 12-18 months would be a rough guideline and waiting even longer depending on the intensity and frequency of your pain. Make no mistake about it mesh removal surgery is very risky. Try to remember that mesh was not designed to come out once implanted. This stuff has to be “filleted” out of you so to speak while dodging an obstacle course of vital anatomical structures. Unfortunately once mesh is in you and you experience a problem with it then you have tough decisions to make. Also we do not know (surgeons or patients) everything about mesh, nerves, surgery, patients characteristics etc. No two people are quite alike.

Will I ever be the same as I was before mesh? Nope. The goal now is to have any current issues be manageable preferably without medication and enhanced through diet, lifestyle and physical/behavioral therapy. I feel I am slowly improving still and time will tell where I finally end up.

I know this is more than what you asked me but I felt compelled to write SOME of my feeling in this matter and hope that it helps others that are in a similar situation.

Good Luck, JG