Jnomesh
Forum Replies Created
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Be prepared to travel and potentially pay out of pocket to seek the top (very few) surgeons who specialize in mesh complications and mesh removal. Since you were implanted lapro the bed t way to remove mesh of indicates is by the same method it was put in so you will want to find a surgeon who specializes in lapro removal
there are threads on this site that list removal surgeons .
There is dr. Towfigh CA
dr. Igor Belyanski in MD
dr. Brian Jacobs in NYC
and others
I had my mesh removed by dr. Igor Belyanski and and am doing very well. Recover can be slow and non linear and you can notice improvements at intervals all the way into the year and year and half marks. I can also Dr. Belyanski is doing many removals these days and as someone who has been in touch with many of his patients I personally haven’tt met anyone who is worse off after removal of that was what was decided on.
Some are 100% some 90% and so on. You are welcome to PM me if you have any specific questions and I am happy to put you in touch with other people who have had their mesh removed.
it is a big decision and not one to take likely and I always rx people consult with at least 2-3 removal surgeons get as much info as you can and make the best decision.
Dr. Towfigh this forum is great and your personal professional opinions are great. One point I would disagree on from personal experience and from speaking to so many other people is that mesh issues can occur way down the line without having any major initial issues in the first year.
For me personally my major issues started 6 1/3 year after implantation and became quite debilitating.
All tests normal (cat scans multiple MRI’s of groin back and hip-GI doctor, Urologist etc all “normal” findings.
After a exhaustive 5 month search I found dr. Jacobs whose best educational guess after seeing some weird abnormalities on one of MRI’s was that it was something wrong with the mesh and he would perform diagnostic lapro explorato
ry surgery. I wanted a second opinion and sent my CT scan to dr. Belyansk as that is what he specializes in reading and he saw that the mesh was bent and shifted.
I ended up having removal with Belyansk and traveled to Maryland. It was a 3 hour surgery and he found my mesh was completely balled up and rock hard and attached to all sorts of structures it shouldn’t of been.
We know ourselves the best. The majority of the medical community is clueless when it comes to mesh issues. If you are having issues in the area where the mean was inserted and have had test after rest doctor aftter doctor tell you that you are fine then there is a good chance that your issue is due to the mesh or related to the mesh repair.
seek out the best surgeons and make the best decision you can!
bedt wishes -
Sorry I was hoping the full article would show-I did have to register to see the whole article. It took a few seconds and then I had access. Worth doing.
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Hi. I believe New Zealand was the first country to ban female pelvic mesh and either Australia has or has out it on hold to investigate.
i should mention that it seems here in the US only one type of pelvic mesh has been halted and roger mesh for say urinary incontinence is still allowed as well as other meshes for soffeeent female issues.
So even a smaller step then I anticipated.
apparently they reclassified this type of mesh the one that was banned as a class 3 which has to meet stricter standards. I imagine hernia mesh is only a class 2. So I guess until real change happens it might have to be reclassified for any real reform to happen. -
I think it is always wise to get a second opinion and with a hernia specialist would be best.
Sometimes this means traveling and or going out if your network. Some who are not in the same state as yours may be able to review your documents, scans etc and offer advice.
There is dr. Towfigh on the west coas and also Dr. Igor Belyanski on the east coast in Annapolis MD.
You maybwsnt to research these two surgeons or see if they know of or can rx someone in your state/city who can offer a second opinion. -
Tj37067
i was hesitant to reply but would feel remissed if I didn’t as I would of greatly appreciated if someone had done the same for me.
First of all you are still early on in your recovery and I hope you will continue to heal and the symptoms you are feeling will reside.
i like you had my hernia repaired from a hernia surgeon (private) on the upper east side and he used the Bard 3D maxx back in 2011
i didn’t feel right throughout my recovery and had to see him 3 or 4 times in the first year-he said there was no recurrence and a follow up MRI confirmed that-he said give it time.. I accepted that. The pain and discomfort I was going through for the most part did not stop me from living my life-but about two or thre times a year tje area would flare up and knock me out for 2 or 3 days-bed rest and Tylenol. My lower abdomen would feel heavy like I was 4 months pregnant and there was a lot of burning in the groin. It would for the most part resolve with rest but I always had a feeling like something was kind of stuck in there.
long story short 5 years later (2 years ago) severe pain was brought on and it turned out that my mesh had folded over and balled up after a lengthy and painful search to what was causing me these symptoms
There seems to be a “non admitted “ design flaw in the 3D maxx that since it is concave it in certain cases can fold over on itself. On my mesh removal journey I have spoken with about 6 or seven other man who ended up having mesh removal and it was discovered that their bard 3D maxx mesh has also folded over or clam shelled on itself causing pain.
if you google this type of mesh you can learn more about it.
My original Sutrgeon was only concerned with hernia recurrence when I went back to him over the first year. Subsequent surgeons and imaging tests also did not show anything- no help.
Finally after a exhausting journey I found a mesh specialist who saw on the same cat scan that other surgeons said was normal that my mesh has bent and shifted. Only after removal was it found to be even worse-balled up.
My removal surgeons said the 3D maxx isn’t a good mesh for thin people-I don’t know if this is true or not but I am thin.
like you I was active-sports and weight lifting etc .
My advice would be to take it easy while you heal and avoid weight lifting and other sports while you heal-maybe for at least 3-6 months. Avoid lifting anything to heavy without support. Walking and stretching and other movement shookd be ok.
If however, your symptoms do not resolve in time or shookd get worse you may want to look into the mesh itself. -
Can you clarify a little bit in the relationship between the pain and the bowel movements.
Does the pain act up before a bowel movement , during, or come about and persist after a bowel movement and was this similar to what you experienced before you had the surgery?
Also always a good idea to get the operative report to see if there was anything unusable about what was found during surgery.
Since you job includes lifting and bending what did dr. Tomas say about how much time would you need to recover and get back to the demands of your job? -
As you know Good Intentions, I totally agree.
Ive been trying to nail home this point for a while.
pain sucks and I never try to minimize different types of pain. However, I believe that there is pain as it pertains to the human body itself and then after going through what I went through with my mesh ordeal-there is pain that is caused by implant materials.
i kept telling docs, friends and family that what I was feeling was so unnatural. I remember telling people I felt like I had a alien inside of me that was killing me. And In reality I did-a plastic piece of mesh, balling up and taking with it muscles, nerves and tissue.
i think surgeons think in terms of typical natural pain-I think they are cluelsss as it regards to mesh pain.
i guarantee if they could feel what I was going through, even for a few mins they would highly rethink the over usuage of mesh implantation..
i still wonder to myself would these surgeon who are seeing and helping mesh victims- would they use mesh on their children or loved ones?
Highly doubt it. -
Hi. Dr. Brown. I tried the CBD oil post hernia mesh removal and unfortunately it did not help me. Like the previous responder I have heard that the CBD oil from hemp can help with anxiety.
i have heard from other people that medical mirijuana can dramatically help with pain including nerve pain. I believe this has the THC component too which the Hemp CBD oil doesn’t.
seems the THC might be a big factor in pain relief -
I also second that the topic of pain from mesh and that of pure tissue repair is really a apples to oranges comparison. And that is not to de-emphasize pain from a non mesh repair but rather to highlight that mesh is a permanent medical device is large in size and has the propensity to cause pain and damage to so many other structures not to mention the ordeal it causes if it needs to or it is decided that it needs to or should be explanted.
peoles lives are being ruined by mesh related problems: perforated bowels, twisting of tissues and muscles, migration, attached to bladder just to name a few. A suture repair just can’t come close to the wide array of damage mesh potentially can.Dr. Towfigh I’m just curious if the two non mesh repairs that you are repairing-were they from nkkn mesb repairs you did or are the patients coming to see you had the pure tissue repairs from other surgeons.
The patient may never know if they had a recurrence due to the tissue repair not being a good fit for their circumstances or because the surgeon who did the repair does not specialize in or do many non mesh repairs.
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Well summarized pinto. From these talking points some common sense possible policies can be undertaken. A national registry seems to be one of the first steps to make sense although the talk does point out that it is questionable whether surgeons would report these complaints but making it easy for the patient to do so (in a APP) would be a great step regardless.
one other thing I’d add to your takeaways is the mention by dr. Garvey that he is also seeing more and more people who have autoimmune disorders that he believes is a cause and effect from their mesh I implantation, whether it’s a worsening of pre-existing conditions or completely new issues.
We as a country have become so conscious of plastic and the harm it can do right down to not using it for the bottles we use to feed babies but yet we Implant it permanently into people to repair hernias-without a blink of the eye.
Seems at the very least before implanting polypropylene mesh into patients there should he a questionnaire filled out by patients regarding any autoimmune disorders that may have for candidacy (along with a host of other proposals )
A test to see if people- no matter how rare-are allergic to plastic would be a no brained too.
Imagine being allergic to plastic and being implanted with a permanent piece of plastic inside you. Insane-but happening. -
Thanks dr. Brown!
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I’d also be interested if you know if it was mentioned of if you can find out if the Shouldice Hospital admitted that their repair failed and did they repair the recurrence with mesh (in a small number of cases they use mesh) or was it a different surgeon that diagnosed the failure and repaired with mesh.
Good intentions is right that you should find out as much as possible to help you make a educated decision :
Some additional questions: was the hernia a direct hernia or a indirect hernia, large or small, was his mesh implanted openly or laparoscopically and how far out is this person from his or her repair with mesh (ie months, years etc) -
I can’t personally vouch for dr. Tomas but I’ve heard from a few peope who have had their hernias repaired by him with happy results. As you know he uses the Desarda repair and specializes in this pure tissue repair.
i know Dr. Brown tailors his approach based on what he finds is going on when he gets inside there-where the desarda approach and shouldice approach are subscribed to methods that are used no matter what is going on inside (whether it is a direct or indirect hernia ).
I remember dr. Kang a Korean surgeon who periodically weighs in on this forum and who does a non mesh repair mention that he feels the desarda repair is more appropriate for a direct hernia then it is for a indirect hernia.
There is a gentleman who had his hernia mesh removed and hernia repaired with no mesh/pure tissue repair by a dr. Repta (drrepta.com) in AZ. He couldn’t say enough positive things about this surgeon who is actually a plastic surgeon. He mentioned that people should look into plastic surgeons for pure tissue repairs Bc they can be very knowledgeable in this area. -
Colon, and a fibrosis reaction.
All this from one piece of mesh and believe me I can associate pain symptoms and complications from I believe the compromised integrity of the mesh And how it affected all the above mentioned structures.
Thats why it is so important in my opinion for “pain “ symptoms to be defined to when taking about complications from mesh
I’ve had 3 surgeries in my life, broken bones , torn ligaments, strained muscles, TMJ and the “pain” I experienced form my mesh ordeal was like noting I ever experienced.
it was as abnormal as abnormal can be and I believe this not only had to do with the mesh but how it was implanted-laparoscopically! -
Great post Good intentions. I believe it’s both .
incesse in chronic pain due to the usage of mesh and a more expensive list of pain symptoms and complaints about large pieces of mesh implanted laparoscopically in which more structured can be affected by the mesh. It was quite amazing to learn that my single piece of mesh had attached to my bladder, spermatic cord, illiac vein and illiac artery, meshoma, mesh hard as a rock and pressed into my c -
Pinto you are right that mesh has a place in the repair for certain types of hernias. And non mesh surgeons in specific cases use mesh when needed.
However, instead of using mesh in certain situations it has become the golden standard and 99% of surgeons use mesh whether it is indicated for special situations or just a typical repair. This is wrong and reduced patient choice and care.
When the majority of surgeons say that don’t do non mesh repairs or aren’t confident in sold them because they just don’t do them often-it is a severe problem. The playing field is not balanced it is extremely tilted towards the use of mesh forbjer is repair -
Thanks for posting Chaunce and Good Intentions thanks for all your input. You both are great contributors to this site. Just want you to know although I don’t respond to all of your posts indonread them all as I’m sure many do.
Although I am not anti mesh (it has its place ) I am totally against the way the current climate regarding hernia repair and the overuse of mesh, it’s comlicstins, lack of oversight, and lack of patient choice and care post surgery that gets me very inflamed.
we know that mesh is the standard practice used for hernia repairs.
we know that at the very best the majority of med students are not sufficiently trained on pure tissue repairs or not trained at all.
we know that mesh is either the sole cause or pmaysba role in many patients who have pain issues post mesh surgery. And these % are growing as more problems are coming to light.
we know most surgeons out there do not know how to do a pure tissue repair and many of the surgeons who feel they can do a pure tissue repairs as a matter of practice don t do many leading to a reduce quality of care to the patient.
Many surgeons refer to the inguinal region as one of the most complex anatomies of the human body-so I’m not sure how a conference can really help surgeons to learn more about pure tissue repairs. It’s trsining, supervised surgeries, and plenty of practice that leads to expertises.
so the field is interwoven and set up to use and promote mesh.Howeber, I want to shed light on another area of this topic that is totally unacceptable especially when mesh is the gold standard and being used 99% of the time in the US: Patient care post mesh surgery.
since my mesh nightmare I have vowed to be there to help people who have had surgery with mesh and are struggling with pain issues. I probably hear from and speak to on average 4 new people a month who are having issues post mesh surgery.
A common theme I find in all these people stories that echoed mine to the T is that all these people went back to their original implanting surgeon either weee dismisses right away or over time by their implanting surgeon.
like my situation and theirs-it usually goes something like this:
return to surgeon to complain of pain
surgeons says give it time
after some time return to surgeon
surgeon does a physical exam, days no hernia recurrence and either rx more time or a making test (MRI, CT, or ultrasound )
imaging comes back no hernia recurrence and mesh is placed appropriately
if pain symptoms suggest nerve entrapment
nerve block is rx or its off to pain manegemt and our is rx to see other specialists:hip, back, Gzi etc.
By this time patient gives up in going back to original surgeon and lives with pain symptoms or explores other options with different surgeons .
Implanting surgeon has a clean record no issues of pain due to the mesh.
To me this is a tragedy but is common practice form my experience and the majority of others I speak to.
The implanting surgeon either doesn’t want to hear it Bc they know they can’t do anything since mesh is made to be permanent or they are truly untrained in mesh complications.
mesh complications aren’t only obvious infection or nerve related. As we now know we see patients with migration of the mesh, folding of the mesh, balling up of the mesh, attaching to and or perforating the bowels, latching on to many unwanted structures-bladder, neves, arteries, spermatic coed, autoimmune disorder, fibrosis, Sheila ge of the mesh and many more.
Mall these symptoms can mirror other issues so the patient goes through a carousel of doctors often ignoring the root cause-the mesh.
This to me is the final cherry on the proverbial sundae: predominately using mesh, not offering adequate alternatives, not warning of all the complications mesh can cause and then of the patient comes back with pain issues they are dismissed and hands are wiped clean.if mesh is going to continue to be the gold standard which for the near term it looks like it will be then there has to be a suitable humane protocol for people who are experiencing problems post mesh implantation with impnatkng surgeons as requirements to be extensively trained on mesh removal and trained in mesh issues and trained on how to read a imaging test as it pertains to mesh. To me that’s a start.
Althougg helpful and beneficial I don’t think a few conferences are going to touch the problem.
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Dr. Brown I was also wondering since you have worked with many athletes for hernias and sports hernia if you can address exercise specifically weight lifting and running as they pertain tojernkas and the hernia areas.
Dr. Towfigh has mentioned that most exercises Ethan weights are ok and to AVOID excercises that increase intra-abdominal pressure like squats for example. Can you weigh in on this topic?
As I mentioned I had my mesh removed (no hernias present upon removal) after a year of rest I have slowly begun to moderately exercise with weights again. I use a comfortable weight md don’t strain-no squats. Just enough to keep in shape.
Anything I should be doing or NOT doing.
i don’t have any pain after working out. -
Thank you for your response dr. Brown you answers all my questions and your answers were invaluable.
like good intentions I too had my mesh removed-the mesh was implanted laparoscopically for a direct and indirect hernia and removed the same way robotic assisted.
My mesh was found to be balled up into a rock hard ball.
i had it in for 5 years. After removal there were no hernias found as scar tissue brought on ny the mesh scarred in the defects.
Surgeon noted there was some weakeness in the internal ring but he reinforced this while in there laparoscopically by bringing down the internal oblique muscle and seeing it to some other structure. He also found weakeness in the femoral area but said he coold not reinforce laparoscopically Bc this area as it was to vascular.
He said I was st risk in the future of a femoral hernia which is somewhat concerning to me as I had painfully hernias that did not present with a bulge.
like good intentions always in the back of my mind is the possibility of re-herniating in the future even though I am so much better after meh removal and the ordeal it presented.
Since if possible I never want mesh again in the future it’s good to know that open exploratory surgery in the right hands can be done and whatever needs to be repaired (true hernia or weakeness ) can be done so without mesh.
thanks again dr. Brown. -
Wow. I would like to echo the others and say thank you for sharing this and breaking it down in layman terms-ofcoirse l too have some follow up questions:
1) if I’m understanding you right this is the first time I’ve heard that a indirect hernia can potentially lead to a direct hernia as you stated since dog had his indirect hernia for some time it had compromised the muscles causing weakeness in the direct space (although no official hernia).
let me know if I have this right that a indirect hernia could potentially cause a direct hernia and is the opposite true too-that is a direct hernia could weaken the muscles of the area in the indirect hernia space? I have a feeling the second may not be true as a direct hernia is a weakening of the muscles and the indirect hernia has to do with a opening that is there from child birth.
2) is the term weakeness as it pertains to inguinal hernias therefore more associated with the muscles of a direct hernias and maybe a femoral area (hernias ) or would it also include indirect hernias (areas)-in other words all hernia areas
3) from your experience what are some of the most common symptoms someone with weakeness in the direct space be experiencing if there isn’t a hernia if any? Would it be pressure feeling, pain, burning, issues with sitting as the abdominal pressure increases with sitting, or most likely nothing as a hernia hasn’t formed yet
3) would the weakeness of the direct space be synonymous with a sports hernia or is the entirely something different and a different area?
4) it sounds like (but I may be mistaken ) that you did 2 repairs. One for the indirect hernia and the other to strengthen the direct area? Or did suturing the transvasalis Facia to the inguinal ligament take care of both objectives?
does the shouldice and or desarda repairs fix and strengthen both direct and indirect areas in one operation? In other words if one has a indirect hernia and has the shouldice or desarda technique to repair will the direct space automatically become reinforced and stronger even if there is no hernia? And vice versa? Will a direct hernia repair using the shouldice or desarda approach strengthen the indirect area?
5) and lastly can open groin exploratory surgery be done without weakening the indirect and direct spaces risking future hernias if nothing is found upon open exploration?Thank you so much for your earlier replay and thanks in advance for any insight you can shed to any of these other questions I have. Much appreciated