[Jnomesh]

I agree-it’s weird that he encountered the lapro mesh from the other side when he entered via open method. Since lapro is fork behind the muscle and the open repair is from the front you’d think this wouldn’t be possible.
id ask him what type of mesh was used. The only thing I can think of there are some types of mesh that are implanted openly but have 2 flaps -one goes behind the muscle and one in front-so maybe this is where he encounter some of the mesh form the lapro repair.

[Jnomesh]

I decided to weigh in earlier bc you said you were in some pain/tightness in the area and it’s been a good amount of time since your initial surgery (well over a year ) and in addition most of you your pain I think you said comes after running.
So to me that kind of automatically puts you into a different camp then some people who after at most a few months out from their surgery are say 100%.
Your situation isn’t necessarily something to be worried about and like you mentioned isn’t like a lot of the stories you read on this forum, to me it’s just a reminder that something is being aggregated at the repair site and you are lucky that you have a indentifier that makes the area act up (running).
With those two pieces of information I would proceed to just air on the side of precaution.
Experiment with your running routine and make changes until hopefully you get to the point where You can enjoy running and also feel no pain due to it at the same time.
Good intentions is right in the sense that mesh behaves by its own set of rules and how it acts and incorporates into muscle and tissue and the pain symptoms you are feeling post running can be a reminder of that.
The fact that you said when you take off a couple of weeks from running you feel better to me logically indicates that running is aggravating something and the odds are if you haven’t felt this before surgery then it has something to do with the surgery.
Hopefully, you can modify your running routine to the point where you are pain free.
Best wishes.

[Jnomesh]

I think taking a few weeks off is a very logical way of examining your issues. If you feel better then I would try and change your running regimen and see if it helps-ie maybe less often, more days rest I’m between runs, shorter runs or less stenosis runs.
I enjoyed lifting weights before my mesh hernia surgery and I can say I never felt right post surgery and a lot of my symptoms came about after a workout post mesh repair. With rest they mostly subsided. For 5 years I altered exercises and eventually reduced the amount of lifting weight I was using with better results .
Surgeons Like to make out the hernia repair as of people will be Superman and can do whatever they want. Personally I think this is a flawed reasoning. Understand that you have a piece of plastic in you that is on, attached to and near a whole bunch of anatomical structures.
id try as best it enjoy your hobby and pastime without over doing it and pushing yourself.
Unfortunately for me 5 years after surgery the pain and symptoms I was feeling the first 5 years became 10 fold and the mesh had to be removed as it was eventually found to be balled up and rock hard and on all sorts of structures it wasn’t supposed to be.
And although I’d like to think this was a rare occurrence I do believe it is served as a reminder that you did have a surgery and do have a permanent piece of plastic inside of you-this do your best to lead a balance life when it comes to sports and activity-the pain you are having is a reminder of your repair area-try not to overdo it and push thorough it-experiment and find a balance if there is one between modifying your workout, living pain free, and most of all not aggravating something in that area and making things worse down the line.

[Jnomesh]

Since the block is primarily used for diagnostic purposes it may be that the illioguinal nerve is not the root cause of your pain. There are 2 other major nerves in the groin area so maybe they are the cause. Usually the doctor will move on to the next nerve and do another block of a different never if the first nerve block did not ease or eliminate pain symptoms.

[Jnomesh]

I rx a consult with at least 3 top hernia mesh removal specialists. Ignore local surgeons.
Igor Belyanksk in Annapolis MD, and Sherwon Towfigh are definitely two with consulting .
and there are others mentioned in this site that can be the third.
For dr. Towfigh you can pay for a online consult if you can’t travel and Belyanksk will review your case for free-send all copy of scans and op reports and write up a letter explains your history and questions.
Mesh can I’m many cases be removed safely and structures repaired naturally but you have to goto the best of the best.
Be willing to travel and pay out of pocket for this speciality care. Go in with realistic expectations-you may not ever be 100% again but their is hope you can have a higher quality of life than currently.

[Jnomesh]

I will say that until I had my mesh removed I had for the prior 5 years had 2 or 3 MRI’s due to pain and discomfort .my mesh was for inguinal hernia not umbilical. The MRI’s repeatedly showed no hernia recurrence but all reports noted that there was fat protruding laterally out of the mesh so not near the inguinal canal.
Finally the pain increased to the point where I sought out hernia specialists who were also mesh removal specialists.
When I sent a cat scan to dr. Belyankski (who ended up removing g my mesh) he noted that my mesh has shifted and he thought he saw a snail hernia recurrence.
When he got in there to remove the mesh the e mesh was folded up into a rock hard ball-there were no hernias present and when I asked him what was it that he though was the hernia recurrence he said it was the mesh pressed up against the colon.
So I don’t know what to make out if that dinosaur fat found in my mesh like yours but I’m gonna gather it’s not a good thing and if it doesn’t signal a recurrence then it may well signal a problem with the mesh (folded or shifted thus allowing fat to seep around it)
My advice to you is to seek out a surgeon who is not only a hernia specialist but a specialist in removal. This way you are covered for whatever the surgeon may encounter.
What normally happens is that surgeons will enter the abdomen the opposite way the mesh was implanted and slap another mesh in there without when exploring the original mesh.
When dr. Belyankski saw on my cat scan that my mesh was folded his first response was that the mesh needed to he removed because a faulty mesh shouldn’t stay in the body especially when someone is complaining of pain-you wont hear many surgeons say this-there first course of action just seem to slap more mesh in there .
But being someone who thinks quite logically this made perfect sense especially bc I was also feeling mesh pain-a brick like feeling in my stomach.
So that’s my advice. Something isn’t right and most times the original surgeon isn’t the answer.
Also get a copy of your operative report. See what type of mesh was used and research it and see if anything remarkable was found during your surgery

[Jnomesh]

Search these threads. I believe dr. Towfigg said it is better to cut the nerves lower this a anterior approach is better for neurectomy and that the nerves have more motor function the closer to the spine they are. I’d clarify before I’d proceed

[Jnomesh]

Momof4 were that able to for certainty say it was the lateral femoral cutaneous nerve with any special tests or only based on symptoms?
also what is the name of the ground breaking procedure. is it any different then the other surgical options offered for merlagia paresthetica (LFCN)?
im pretty sure I have damage to this nerve caused by mesh balling up. But it only impacts me when I’m sitting and not when I’m walking or lying down.
so I don’t want to mess with any surgery or really anything right now but would be interested in hearing more about the surgery and surgeon(s)
You can also PM me. Thanks

[Jnomesh]

I’ had a consult with dr. Jacobs however it concerned pain issues from a previous hernia repair with mesh from another surgeon.
i can tell you he was very thorough and took his time to piece everything. He spent a good hour with me and my wife.
he was the first surgeon to feel it was the mesh inside of me causing my issues.
Tue only drawback in my opinion was that at times he could be a little over confident borderline on being kind of cocky for lack of a better word.
He also is private and does not take insurance.
From my visit with him although he is effortlessly a proponent of mesh he can do a pure tissue repair of requested.
i know you are seeing him for a first time repair and not mesh removal but it I thought I’d give yuh any feedback I know of
Concerning Yuri I have heard he is very good as well-he is anit plug and patch meshes but overall a proponent of mesh.
unlike Jacobs I have heard of people who have gone to see him about mesh issues and he usually doesn’t recognize it’s the mesh unless it’s a plug and patch repair.
i think this is important bc if something feels wrong with the mesh surgery you want your surgeon to be someone who st the very least can recognize it might be the mesh.
ask a lot of questions including what type of mesh they use-research it.
ask to speak to other patients to see how they are doing etc.
best of luck

[Jnomesh]

Great. Rest up and heal. Give yourself a good year before you do any major exercising and always be conscious of lifting heavy objects.
ive read slot of literature that says after hernia repair of any type it can take a good year for the area to completely heal. This doesn’t mean you have to live in fear but just a reminder to take it slow and easy in the early stages.

[Jnomesh]

@drbown
Correct me if I’m wrong dr. Brown-but I believe you mentioned you use absorbable sutures in your pure tissue repairs. It would be great if you can weigh in on dr. Towfigs comments regarding permanent sutures as the standard for pure tissue repairs. Thanks

[Jnomesh]

Arkj93. For me I had issues on and off for 5 years-my implanting surgeon only checked for recurrence when I’d see him in and off for the first year. As long as their was no recurrence he was insistent that he didn’t know why I was in pain and discomfort.
over the first 5 years I had cat scans and MRI’s that showed no recurrence and mesh placement was fine.
This is the unfortunate climate of the medical field as it relates to mesh issues. Except for a small handful of surgeons spread out of the United States they really only look st recurrence for cause of pain and some classic nerve issues.
Right up to 3 months before my removal tests, radiologists and surgeons (except when I eventually found dr. Igor Belyanski) we’re insisting that there was nothing wrong with my mesh, it was in the right place and even if there was something wrong with it, it couldn’t be removed.
And of course as I mentioned my mesh was completely balled up and shifted-but yet all was well???!!!
For 5 years I managed until 2017 when somehow else gave way/happened-and the “pain” I was feeling was 10x worse then previously. It stopped me from working, being a dad and a husband.
Thanfulky, my wife signed me up to a mesh Facebook forum and after a exhausting 6 month search I found dr. Belyanksk who diagnosed the problem. In this unfortunate experience I suppose I was somewhat fortunate that my situation was finally diagnosed even though if it wasn’t I was set in my mind to have laparoscopic exploratory surgery where I was sure they would find something. For many, mesh can be Erie king havoc even if it is technically placed properly and doing what it is supposed to do.
There is so much more information out there now then there was in 2011 and hope for people who are having problems post mesh implantation.
For 5 years I trusted the medical community that all was well with my mesh and my symptoms were something else but I often think back and feel things may have been worse if I’m the beginning someone else tried to remove my mesh-so I have to be thankful in the way my course played out-I guess.
Still as of today very frustrating.
I think you described earlier the feeling of sandpaper in your groin to describe some of your pain. That was one of my symptoms along with three others-a brick like feeling in my abdomen, something squeezing my anatomy, the feeling like my stomach would swell up as if I was 4 months pregnant if I lifted something heavy and didn’t support myself and later I’m 2017 a tearing squeezing sensations as well as a awful burning down my thigh and outside of my groin crease when I sat that was horrendous. I can say for me all of the symptoms are gone since mesh removal except for the burning down the leg when sitting but it is now manageable.
That sandpaper feeling is still sometimes preeent so I don’t know if that was a direct symptom of the mesh or nerve irritation or both.
Im pretty sure in my case the mesh did something to my lateral femoral cutaneous nerve that resulted in Merlagia parenthetical but at this point in my life I can live with it as it only comes about when I sit and I’m not looking for anymore surgery or even nerve blocks which I tried before mesh removal.
i believe mesh removal comes down to two simple tenets:
1) Having it removes successfully and not being worse off after removal
2) how one feels lost removal-is ones pain symptoms relieved
I personally believe there are a few surgeons out there that can take care of step one-getting the mesh out succwssfully witbkut makkng someone worse.
How one does after removal depends on so many variable related to ones situation.
As I mentioned a lot of people who have seen Belyanksk for removal are doing significantly better. If removed lapro from lapro implanted mesh I haven’t met one who had any hernias post removal-I less it was a open removal which often requires removal, repair and sometimes neurectomy -a much tougher and trickier recovery.
Feel free to reach out anytime-and I wish you the best on your personal journey I’m this mesh nightmare.

[Jnomesh]

Yes please make a informed decision and do as much research as possible.. One problem with find an alternative to mesh repair is finding someone who is a expert at doing it the old fashion way. Make sure your surgeons has experience and confidence in doing a pure tissue repair.
i have heard that the pro grip mesh is a very difficult to remove if it ever had to.
There is the shouldice hospital in Toronto that specials in pure tissue repair and Dr. Tomas in Florida who does a pure tissue repair called the desarda technique and dr. William Brown in CA who specializes in non mesh repairs

[Jnomesh]

Worth contacting as he specializes in nerve issues and groin pain.

[Jnomesh]

I can’t personally help in the sense that I haven’t had any bit I do know that there seems to be a debate from the textbook literature on the groin nerves and real life experiences.
There are people out there that have had long term issues with neurectomies as they pertain to sexuall dysfunction and abdomen muscle atrophy/weakness. It seems they may not only be sensory nerves but motor as well.
if you google the Dellon institute he has a wealth of information on this subject matter and maybe someone with

[Jnomesh]

Hi Arkj93
not sure if you have seen any of my posts about my removal surgery. I had my lapro mesh removed by dr. Igor Belyanki a little over a year and a half ago.
my mesh was in my for about 5 years before being removed.
if you would Like to PM me feel free. I am also in touch with a good amount of people who have had their mesh removed by Belyanksk and if you would like could see if I can put in you touch with them to hear their stories and to see how they are doing.
i can tell you that he is one of the best if not the top removal surgeon out there especially when it come to removing mesh laparoscopically.
That being said this is a very serious operation and my letdown so advice is to put in the time and effort to treat it as one and that in my opinion not only means interviewing/consulting with at least 2 or 3 removal surgeons so you can make the best decision even if this means traveling or having to come up with the money somehow.
There is a saying out there when it comes to mesh removal that you really only get one chance to get this right. You can be made worse by removal if you don’t pick someone highly skilled with plenty of removal experience. If this means traveling or spending some $$ to get it done right then do it -your health is worth it.
I traveled from Ny to Md to get the operation done.
He did not accept my insurance and I was prepared to pay out of pocket-his rate was more than fair (much cheaper then some of the other surgeons quoted). However, I was pleasantly surprised that my out of network benefits pains for everything. So look into if you have out of network insurance benefits.
I can tell you that out of everyone I’ve spoken to who have had their mesh removed by Belyanksk no one is worse off after there surgery. This is huge bc there are people out there who have had their mesh removed and are doing worse.
i can tell you most of the people I am in touch with are significantly better: some 100% some 90% and some 80%.
You should have realistic expectations about mesh removal surgery. Everyone’s case and situation is different.
If mesh has adhered to structures that pose a removal risk
Belyanski will get as much out but may leave small amounts on the spermatic cord or iliac vein and artery. So in some cases 90-95% of the mesh may be removed. Better this then say losing a testicle or bleeding out during surgery.
Be aware that recovery from removal is different for everyone but for many like myself can take a good among of time in which small but noticeable improvement d can be noted.
On one hand for me I went back to work around 6 weeks lost removal but still had some burning issues when I sat and some soreness in a area where a believe my mesh was folded and balled up for a good amount of time. At the year mark and the 19 month mark I noticed little improvements that keep gettting me closer to the 100% mark. I think Good intentions can attest to this.
I did not have to have any of my groin nerves cut by Belyankski and this is another reason I chose him as he does not believe in cutting the nerves unless warranted.
insersatnd that there are some surgeons who believe mesh removal and neirdctomies go hand in hand.
From my research and talking to others I believe that lapro removal is a less traumatic surgery then open removal-with easier recovery times-so this could be a plus in your case.
Another thing ive noticed is that with lapro removal of lapro implanted mesh is that when the mesh is removed there are no hernias present (if the mesh had been in for a while ) so the stress of trying to figure out want to do once the mesh is removed if there is a hernia present but there are usually no hernias present as scar tissue fills in the defect. Bieber you should have a game plan of what to do in case there is one .
I highly rx Belyanksk. Still get a couple of opinions.
Dont let travel or $$! get in the way of seeing the best of the best .
Hope this helps.

[Jnomesh]

One thing they also mention as a positive for lapro surgery in addition to “faster” recovery is that for inguinal hernias the mesh covers all 3 possible defects in one shot : indirect hernia, direct hernia and femoral hernia.
But I agree placing the mesh (which often is a bigger piece when doing lapro surgery compared to open is that it is placed closer to the intestines. I believe the only thing separating the two is the Peritonium and maybe the omentum.
As someone who had lapro mesh implanted and eventually removed the same way I can say the procedure itself I believe caused my stomach/abdomen to never be the same besides the mesh implantation. I feel like the stomach being inflated during this type of surgery permanently changed my anatomy.
I had mesh openly placed years before on my opposite side so I do feel like I am someone who can comment on both type of surgeries .
However for some people they seem to do very well with lapro surgery.

[Jnomesh]

I found dr. Igor Beyanksi in Annapolis MD. He looked at the same cat scan that many read as normal and saw the mesh had bent and shifted. I had surgery to remove the mesh and it was found that the mesh was way worse-balled up and rock hard. I have come across a lot of people who had there mesh removed who had bard 3D maxx and the mesh was again found to be folded over or clamshelled on itself.

I bring this up becomes I wonder if this is what may have happened with you and this that is how the recurrence happened.

So so it may be best to do your best to rule out that the mesh has maybe folded over. I only say this because you may not want to leave a defective piece of mesh inside of you (if this is indeed what happened ) as although it isn’t causing any problems now it can possibly cause problems down the line.
Dr. Belynaksi specializes in reading cat scans and although it can be challenging even for him to see on scans if the mesh has folded over (for me I think bc mine turned out to be severely balled up it was easier to see on the scan) others he said the scan looked fine even though after removing other peoples 3D maxx it was found to be folded over during surgery .

you can google 3D maxx and see some of the design flaws and issues with it.

it may be worth a consult with dr. Belyanski to help figure out why the recurrence occurred and whether it be beneficial to remove the mesh and either put a replacement mesh in, leave the mesh in and just fix the hernia openly without mesh, or leave the mesh in and repair openly without mesh.

Dr. Belyankski is one of the top hernia specialists in the country

[Jnomesh]

RKS89
whenever I see the Bard 3D maxx mesh mentioned-I feel I should chime in. The 3 D maxx is concave in design and has a tendency to fold over on itself. This happened to me and the mesh continued to ball up into a rock hard. All CT scans and MRI’s were read as normal by radiologists and surgeons

Eventuallg severe pain settled in 5 years after implantation and again all tests and scans came back normal.

After finally coming across some mesh forums

[Jnomesh]

The shouldice hospital reports chronic pain at their hospital is less then 1%. Mesh pain rates is now being recognized to be 10-20% range with some reports saying as hi as 30%.
Also understand that the world pain has a huge umbrella range to it.
Pure tissue repairs use your own muscle and tissues to repair the defect. Mesh is a large sheet of plastic that can cause a whole slew of pain problems then pure tissue repairs-mesh can fold and ball up and take your muscles, tissue and nerves with them, mesh can attaché to your bladder, your spermatic cord and nerves.
mesh can become infected, mesh can migrated and come in contact with other organs, mesh can erode into the intestines and cause fistilas especially with lapascooic relairs. Mesh can cause auto immune issues, digestive issues and more.
so I think it is about time the medical community stop clumping “pain “ into one neat category when it comes to mesh pain Vs pure tissue pain.
pain sucks but their is a huge difference in my opinion between “natural” pain from your own. Body and unnatural pain caused from a lice of plastic being implanted into a sensitive area of the human body.
For a good amount of people it appears mesh “works” but when it goes wrong look out.
You will have a piece of plastic that is meant to be permanent and very difficult to remove. You will almost certainly be gaslighted by the majority of the medical field in which they will find nothing wrong with you.
Only until you on your own find the few surgeons who are often in different states than you will you have a chance. And ofcourse you will probably have to pay out of pocket to have the permanent device removed with no guarantee of success of your pain issues.
So short answer is no: the published data shows pain from mesh to be significantly higher then the shouldice hospital.