[Jnomesh]

Thank you that would be great if allowed by Dog.

[Jnomesh]

Totally understand and totally agree. And what makes it even more frustrating is that I’ve seen her name pop up form other people who have had their mesh removed by her which means she knows first hand what this stuff can do to some people. I have a feeling she mostly removed o it infected mesh as that is known th be easier to remove and can be used as a excuse of why mesh needs to be removed when there are so many other reasons.
The Salt on the wound is that she is basically also saying that she doesn’t really do non mesh repairs Bc she doesn’t really doesnt do many non mesh repairs and because of this it’s ok to tell the patient no if you don’t feel comfortable doing one.
Just so frustrating and pre-k logic.

[Jnomesh]

I would absolutely go back to your surgeon to hear what he or she says but be prepared to probably be not satisfied. There is a good chance he or she will say give it more time. This isn’t entirely inappropriate advice as a lot of people’s bodies heal over time. There is always a chance your surgeon will have some helpful insight but
be prepared to be pushed away for now. A urologist would be helpful to maybe rule out a hydrocele on the testicle. A MRI OR CAT SCAN can hopefully shed light on what that other bump is.
If you still have have pain down the line and don’t get better Your surgeon will probably order a cat scan or MRI anyways to rule out a hernia recurrence but most likely it will come back normal.
The next step will be that the surgeon will either say the pain has nothing to do with the repair or he or she will try some nerve blocks and if that doesn’t work it’s off to pain management.
What I would do is try on focusing on resting and getting better-at the same time I would request my operative report (this can be done through the surgeon or definitely through the hospital)
if you aren’t significantly better by 3-6 months I would see exactly what type of mesh was used and do some research on it as well as study the operstive report and see if there were any unusual circumstances regarding your surgery
i would also if not better by the 3-6 month mark see out one do the top hernia specialists who have experience with mesh issues.
Be prepared to travel to see one of them in that there are very few. There is a list of them in this forum. There have been very good reports by patients on dr. Igor Belyanski, dr. Sherwin Towfigh, dr. Billings and others.
if you are in significant pain after 3-6 months with no gradual improvement and no answer in what that other bump is you will need to take action.
Note: I am not a doctor. Maybe some of the other surgeons will respond.

[Jnomesh]

Yes I’d be curious to know whether the mesh was implanted laprocpically or open and how it is being removed.
id also be curious if you could mention the name of your removal surgeon.
i had my mesh removed (implanted lapro and removed the same way) and have been in touch with a good amount of people who have had mesh removed by the same surgeon and I haven’t come across anyone in this group that have had to have multiple surgeries to remove the mesh by this surgeon. We have all had our mesh removed in one surgery-some have had 10O% of their mesh removed and some have had some chards of the mesh left on arteries or structures deemed to dangerous to completely remove -but in any case it was done in one surgery.
Your case could be a unique one but I’m also interested in if you sought out one of the few top mesh removal surgeons.
i have come across others who haven’t had as successful removals as they have gone with surgeons with less experience-usually because they couldn’t or wouldn’t travel to see them or due to lack of insurance etc.
If you feel you need a second or third opinion there is dr. Igor Belyanski, dr. Sherwin Towfigh, dr. Billings, and a few others who people are having good results with their mesh removal.There is a more extensive list of removal surgeons on this list.

[Jnomesh]

I think k it’s a great question. As seeker said this is what they used to do for incontinence issues instead of mesh.
one would also think with the development of stem cell therapy that this can play a huge role in hernia surgery going forward.

[Jnomesh]

Chaunce123,
agree. With mesh removal seemingly being done more often focus needs to be on products and ways to deal with the unfortunate event should the mesh need to be explanted.
BTW the surgeon I was speaking of who made the statement of removing TEP implanated meh was dr. Belyanski. The takeaway wasn’t that TEP placed mesh can’t be removed but that in his opinion or statement it is much more challenging to do so..

[Jnomesh]

Kevin B. Make sure if possible that you have someone you can trust (a family member is best) to be a public advocate for you.
This is very important as when we are in pain and in combination with the many doctors and tests one sees and has in the ER can be overwhelming.

[Jnomesh]

Amongst other things it would be a great step if surgeons would also consider mesh “type” and procedure “TAAP” vs TEP in regards to how easy or difficult it is to be removed/explanted.
i too have heard that a TEP procedure of implanted mesh is much harder to remove as one top removal surgeon said it would be much more difficult and like “filleting” the patient open.
The same removal surgeon also told someone the type of mesh he had was a kind that was berry difficult to remove.
Since we are dealing with a device that is meant to be permanent it seems logical that the only criteria shouldn’t be how well theoretically the mesh can fix the hernia but god forbid if the mesh needs to be removed how easily can it be.

[Jnomesh]

Let us know what the surgeon says.
FYI mesh repairs in general are considered “tension free” repairs but most surgeons keep the mesh in place by either suturing, using a tacs or staples and any of these can puncture the LFCM nerve so definitely find out from you surgeons and operative report what-if anything was used to fixate the mesh in place. Hoping the issue resolves.

[Jnomesh]

The area you are describing especially the outer part of your thigh sounds like the lateral femoral cutaneous nerve which can be damaged during lapro placed mesh for hernia repair. Find out what type of mesh you had implanted and if staples, race or sutures were used to fixate the mesh.
it has been mentioned in the literature that the LFCN can be damaged by a tax or staple.
If you look up Meralgia Paresthetica you will find the official terminology to numbness, tingling or burning pain to the anterolateral portion of the thigh. The nerve runs different variations in different people and could also explain the burning in the crease.
if it persists there is a nerve block that can be performed of this nerve to see if it helps and then additional things that can be done including certain types of nerve pain (gabapentin etc).
Does the numbness flare up when you are sleeping in your affected side ?
For me many years later after lapro placed mesh I went through and am going through similar issues except my outer thigh doesn’t get numb but burns pretty bad as well as a feeling of burning I’m tjr outer crease however for me it only happens when sitting and not when walking.
some of the literature says it comes about for some when waking and relieved by sitting and others comes about when sitting and is removed when waking-go figure.
Of the pain is being caused by a tac or staple
pain can be relieved by removing the fixture although this means another surgery.
For me years later it was found that my mesh had folded over and balled up. It was removed and a lot of my pains symptoms disappeared except the burning in my front and outer tbiggt and ground crease is still there but only when sitting.
fortjnstely I can mange it

[Jnomesh]

Two things. When researching surgeons for mesh removal I had spoken to people who had mesh removed by Ramshaw and they all said before mesh removal the did have to take/complete some cognitive behavioral program. What was expressed to me was the program was meant to help with the recovery process after removal. I have no idea what the content was all I knew from my end was there was already a long with to get get a consultation with Ramshaw (this was almost 2 years ago) and I couldn’t imagine with the pain I was going through that I’d have to finish a program after waiting so long to get a appointment .
Which leads me to a point that I think reinforced what good intentions was saying. The word pain can mean different things to different people and I think most people associate the word pain with what they have experienced during their lifetime.
i think I’d describe this as “normal pain”. Not that it isn’t and can’t be debilitating but it’s what we experience with a pulled back, strained neck, stomach virus, broken bone or strained ligaments.
From my Personal experience and form others I speak too the “pain” I had from mesh was like nothing I had ever experienced. And it was so GM is k and effected a lot of things. Because the mesh is so large and in laparoscopic procedures can infiltrate so many anatomical areas : the bladder, the colon, spermatic cord, nerves etc the potential for systematic complications are great. That being said the “pain” was so different and awful. It was a gross pain. And when you consider the area in which the mesh is inserted for inguinal hernias the male private area can be awfully affected.
For me the onset of symptoms felt like I was being operated on but I was awake. It felt mine I was being ripped apart inside. This then turned into a sever burning in the groin and thigh-like I was being burned alive. When I told this to one friend he said come on if you were being burned alive you’d be in the emergency room. But this is what it felt like especially when sitting.
I also had a feeling like a brick was stuck in my abdomen-don’t think many people ever felt that kind of pain, I also had a feeling that something was tightening or clamping down on a area near my genetalia
i had to urinate often and it would take a while for the pee to come out, the urine stream was weak and would stop and start. My private always felt like they were under pressure-like one was being immersed in a cold tank of water but this lasted all day and night.
low labido.
Difficulty deficating
My lower stomach would feel swollen for days if I lifted something somewhat heavy.
All these crazy symptoms and I didn’t even experience a lot of the traditional “pain symptoms “ from mesh like a stabbing pain or infection
So when I hear a surgeon say traditional non mesh repairs have “pain” symptoms too I’m like no way can a puré tissue repair cause this global
“pain” that mesh can cause.
it can be truly devastating. You literally don’t feel normal anyway-the anatomy itself feel grossly different in a disgusting way.
I would tell people all the time I don’t feel whole.
It was in essence kind of inexplainable. If a hernia surgeon had these “pain “ symptoms after having mesh inonanted in them I think they would understand so much more.

[Jnomesh]

Yes I second that In that as of now dr. Ramshaw has suspended seeing patients and performing surgeries. Hopefully it is temporary.

[Jnomesh]

Hi momf4. Were you able to resolve the burning pain in your thigh that was believed to be the damage to the lateral femoral cutaneous nerve?
dod you have this nerve removed or respected and if so has it helped ?
ylu can private message me if you wish. Thanks

[Jnomesh]

Need a mandatory national registry for every mesh that gets implanted. It is the only hope of tracking these devices and the complaints and removals. Otherwise it will just be swept under the rug like it is currently being done.
need every surgeon who implants mesh to be just as qualified In removing mesh otherwise they shouldn’t be implanting mesh.
need surgeons currently in school to be trained on pure tissue repairs just as much as mesh repairs.
mesh companies need to put further research into is there a way to repair hernias and have a mechanism that allows the mesh to be easier and safer to be removed should it require doing.
Surgeons need to be trained on how to reward a MRI and cat scan as it pertains to shifted or folded mesh-there are a few out there that can do this-all should be able to or have a place where they can resource scans out that specialize in reading them as it pertains to mean. No reason someone should be in pain for years and he told all is well when after removal they are told the mesh was folded or balled up.
finally need a mesh protocol for patients in pain and for a place surgeons can resource patients to who need further investigations. One surgeons shortcomings shouldn’t prevent a patient from receiving adequate care.
The playing field absolutely needs to be leveled when it comes to mesh repairs and non mesh repairs.
to say it is lopsided now is a understatement

[Jnomesh]

Wishing you a uneventful and successful surgery and a speedy recovery. Dr. Brown is one of the best you are in good hands.

[Jnomesh]

Thanks Dr. Towfigh. I will pass this on to my explantknf surgeon and it is a start but obviously a lot of data will be missing because it is not only voluntary but a lot of people don’t know about it unless they visit this forum.
Still seems logical that surgeons should be mandated to report patients complaints and mesh removals otherwise true outcome measures can not be measured.

[Jnomesh]

Good point Chaunce 123. One of the reasons I posted this question is when I was consulting/interviewing surgeons for my mesh removal the three I visited all said if there were hernias present after removal and I didn’t want mesh they all said the would and could do a pure tissue repair but I knew that this isnt something they routinely did-they were all laparoscopic skilled surgeons and robotic experts as well. They all also quoted me a higher recurrence rate that seemed a little a high to me-not crazy high-maybe 10-12% and I just kind of feel instinctively that this % rate had built into it the fact that they just don’t have expertise in this type of repair.
so as a patient I feel like the absorbable mesh in addition to a pure tissue repair by a skilled surgeon but not one of the top non mesh repairs surgeons or hospital could be not only a solution but make the patient feel a little more confident in the repair too.
another point is that although the mesh disappears the main healing and scarification is promoted by the mesh in the first year. That is his mesh mainly works in repairing hernias-it promotes scarring to close the defect and the strengthening the surrounding areas.
its one reason a lot of people like myself who have had lapascoocslly places mesh and later had it removed (the same way) have no hernias upon removal-because the area filled in it closed up by scar tissue caused by the inflammatory reaction caused by the mesh.
Im certainly not saying because of this absorbable meshes are better than permanent meshes but I do see a combination of the non mesh repair and the absorbable mesh for people who don’t want mesh and can’t travel to the few surgeons and hospitals that do non mesh repairs can maybe have a better outcome by the combination of both and surgeons who maybe have the skill to do a non mesh repair but don’t do many can have more confidence in the outcome if both approaches are combined.
What I’m also interested in form the surgeon on this forum is are there any contraindications to using absorbable mesh in addition to a pure tissue repair-ie can the absorbable mesh interfere with the healing or have any adverse affects to the pure tissue repair ?
And I’m specifically referring to inguinal hernias

[Jnomesh]

Hi dr. Towfigh. What about the idea of a combination of pure tissue repair to close the defect (which from what I understand isn’t done in mesh repairs) and a absorbable mesh in the same surgery (for inguinal hernias) for extra reinforcement and possible strengthening of the area.
i understand experts on both sides of the pendulum (pure tissue experts and mesh experts) may think this unnecessary.
But there is a huge middle ground especially with people searching for surgeons who do none mesh repairs. Often having to travel out of state and country to get a non mesh repair.
i spoken to many who say their kicks surgeons either say they don’t do mesh repairs, don’t do many, or don’t think there is a high probability the non mesh repair won’t hold.
However, what if the local surgeon does a non mesh repair supporter further with a absorbable mesh.
Seems like a possible solution that should be studied further?

[Jnomesh]

Thanks uhoh. I think your post illustrated my initial post. Those who are experts at non mesh repairs like dr. Kang would most likely think and say absorbable mesh is not necessary to use along with a pure tissue repair Bc they are experts in this type of surgery and deem it uneccessary. Surgeons who are experts at mesh repairs would most likely say absorbable mesh is inadequate and permanent mesh should be the gold standard.
The problem lies in that there are very very very few surgeons in the US that do non mesh repairs and on top of that are expertise in pure tissue repairs- meaning people wanting a natural repair will have to either travel out of state or out of country for what back in the day would be a routine non mesh repair. Many people won’t do this endeavor either because of travel or cost or both.
on top of that most surgeons except for a few (I count maybe 5 surgeons in the US who only do non mesh repairs) day they will do a pure tissue repair but that there will be a high recurrence chance-I believe they say this Bc they just aren’t confident that there repair will hold Bc they just don’t do many if any of this type of repairz
Thats why I think a pure tissue repair with absorbable mesh may be the great compromise for s large number of people who don’t want mesh but also can’t travel to one of the few surgeons who do non mesh repairs.
For the surgeon who says I can do a pure tissue repair but there will be a high recurrence rate maybe this rate will come down greatly if a absorbable mesh is used in addition to the natural repair.
This may also be a option for people who have had their mesh removed like me, who even though there were no hernias upon removal the area is surely weakened and if I ever re-herniate and don’t want mesh but a natural repair may not hold Bc of the weakened tissue maybe a absorbable mesh on top of the non mesh repair may be an answer.
Could be the great compromise!
ofcourse more data needs to come in on absorbable mesh (for me would be more if a chronic pain question then recurrence rates)
but im more curious if there are contraindications to a absorbable mesh on top of a pure tissue repair?

[Jnomesh]

Hi Dog. Seems pain rate is significantly less with absorbable mesh. They still worry about recurrence with absorbable mesh that’s why I think it would be interesting to examine a pure tissue repair to close the hole and then a absorbable mesh to further reinforce the area to help it heal fully during the first year of healing ( a time period researchers note is imperative as the area gets stronger and this is the time period a lot of recurrences happen-within the first year) then by the end of that year the mesh will be fully or hopefully fully absorbed or disintegrate fully.
would love to hear some of the surgeons weigh in.