Jnomesh
Forum Replies Created
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Good intentions-the other flaw in “supposed” follow up is I’ve come across many people who had similar experiences as mine in that when we went back to our original surgeons (and later different surgeons ) complaining of pain post surgery we were told the pain was not due to the mesh or the surgery. For me and many others the only “test” done was a physical exam to see if there was a occurrence followed by maybe a imaging test that showed no recurrence.
So how is pain even being recorded when so many patients are being told their pain has notjkng to do with their mesh or surgery???!!!
surely it isn’t being reported of the surgeon doesn’t believe or doesn’t want to believe their is any correlation.
in my case my mesh was balled up so tjere isn’t any confusion whether my pain was caused by the mesh or not but so many surgeons told me the mesh looked good on the scans and no recurrence so it had to be something else.
this is one of the travesty’s with the mesh epidemic-how many others are out there who are trusting their surgeons that their pain symptoms have nothing to do with their mesh surgeries.
if the pain isn’t destroying their lives many people just accept this from there surgeons and move on.
however for those in whose lives are forever altered they will continue on and spend every ounce of energy on not giving up. -
Hi iceflow. Sorry to hear about the recurrence.
the standard practice (although maybe not the best) is to put in more mesh but the opposite way that your original hernia was repaired. Ie if you had you mesh implanted openly then they would do a redo surgery but implant the mesh laparoscopically. And vice verbs I’d tkj had your mesh implanted laparoscopically.
Tjerr are a lot of people on this forum who have had major issues due to the implantation of mesh so having double mesh implanted maybe something that you want to look into doing or not doing .
also depending on how you originally had your mesh implanted will help you seek out the surgeon for a second surgery as some surgeons specialize in laparoscopic repair with our without robotic assistance and other specialize in open repairs.
personally I would be concerned if the mesh failed and a hernia recurred what is that mesh doing inside of your body? Did it migrated? Is the area the of the mesh where the hernia pushed through causing the mesh to fray and possibly damage nervy structures down the line?
i only bring this up because you may want the surgeon to first check out the status of the existing
mesh before just plopping a new one in the other way.
if the implanted laparoscopically the top surgeons can go in laparoscopically check out the existing mesh and either remove the old failed one and put in a new one or if the mesh is intact then go in openly and put in a new mesh.
most surgeons can’t do this but there are a few who can and are worth traveling for.
ofcourse the above suggestions are for if you want to have the repair with mesh.
there are options if you want the repair done without mesh but depends on some other factored
I’d say right now the best surgeons out there who can do it all-lapro, open, mesh, no mesh are
dr. Igor Belyanski in Annapolis MD, dr. Sherwin Towfigh in CA and dr. Bruce Ramshaw in TN ( he may have currently stopped doing surgery)
tjere are others out there too-this is just a shortlist of in my opinion the best of the best.
hope this helps. Whatever route you take just make sure you are seeing a hernia specialist and not a general surgeon because your case is more complex. -
Thanks Dr. Kang. Fascinating and kudos to be able to take a complex subject matter and brilliantly conveying it to the readers on this forum.
Some of the surgeons here in the US who do a non mesh repair used what they term a modified Bassini. I wonder if this is the authentic or corrupted version.
Thanks dr. Kang for your contribution! -
-To me that definitely doesn’t look typical -it’s most likely a Selena or a hematoma. Shocked that the surgeon would say everything looks A-ok. I’d get a second opinion.
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Not saying it is the mesh but rather suggesting not to rule mesh out as the problem because it has been 4 years of no issues. Many people have had issues where their mesh years down the road.
also mesh extends significantly past the hernia defect area both medially laterally as well as above and below. It extends over the upper front hip/thigh area laterally and medially over the lu if bone area.
meeh hardens and continued to contract over time
and can even move or migrate or bunch up. -
They are all groin nerves but have different course and therefor can cause pain or be felt in different areas in the groin/thigh.
A simple google search will illustrate the pathways and course of each nerve. There is a 4th groin nerve called the lateral femoral cutaneous nerve that can also sometimes be affected in laparoscopic places mesh but this nerve causes more issues in the front and outer thigh. -
Good intentions I found the video clip on one of the 4 Facebook mesh forums I belong to-so fortunately to some degree it is being spread albeit to a limited group of people.
Ans Chaunce 1234 yes I believe athletes see her and dr. Koch which both may or may not be part of bio hernia center which advertise/promote non mesh repairs.
Another interesting thing I came across on one of the FB mesh forums is a guy used a surgeon who is a plastic surgeon in Scottsdale Arizona a dr. Repta who amongst other things specializes in tummy tucks.
The surgekn was able to remove his open mesh and do a natural repair . And so far he is doing well. At first I was hesitant about the fact that he used a plastic surgeon to remove his mesh but he did interview with a bunch of surgeons including some of the more well known removal surgeons but really felt that this doctor had the specialty needed to do the job so I thought I’d include the surgeon. Not sure of his first name . -
My apologies to good intentions who posted this story earlier. Did not see it
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Hi all. If you go into Facebook and search (type in) the hernia forums names they will pop up.
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I also think it is really inaccurate for studies to compare mesh vs non mesh repairs outside of recurrence. When you compare pain between the two t’s impossible to know what the source of one pains is with mesh is and the severity of causes , as mesh can harden, migrate, fold up, encase nerves, become infected, attached to one’s bladder, intestines and other things like autoimmune disorders which I think in time Will come to light as a possible side affect of mesh as well as one being allergic to mesh.
It’s s fine to analyze different types of pure tissue repairs but analyzing “pain” from one method using one’s own tissue and some sutures and another method that uses large piece of plastic inserted into someone’s abdomen meant to be permanent just seems really not to smart.
so i ask people this (and I’m directing this around I inguinal hernias ) if pain is relatively similar between mesh and non mesh repairs (which I personally don’t believe) and let’s even say recurrence rates are a tad lower with mesh (although a specialty hospital like the shouldice clinics data blow away mesh results in regards to both pain and recurrence) then why is it that mesh repairs are the gold standard and dominate the industry? Why is it that one has to search high and far to find a surgeon who has expertise in pure tissue repairs? Why arent peoe offered a choice? Why has one method so dominated the other? Anyone who says big pharma doesn’t heavily answer my question is just fooling themselves. Statistically speaking pure tissues repairs in this country are practically extinct-instead people are left with no choice but to be implanted with permanent mesh or travel to another country to get a non mesh one.
On top of that mesh companies are frequently coming out with “new and better” meshes. Why?
why are meshes recalled? Why is mesh in other countries for women with pelvic problems being banned? Why is there not even a registry for mesh that is used and patients complajts documented and tracked. Why is mesh pushed through a unregulated 510k process that does not require clinical trials. Why is there no protocol to deal with issues that maybe and are probably mesh related? Why are there practically no surgeons (except for a few compared to thousands who do the implanting surgery ) who are trained specialists on removing mesh? And dealing with long term pain issues from the surgery. Why is there no back up plan when things go bad with mesh?
something is just very fishy.
Hey I’m not saying mesh is evil and I’m not saying get rid of mesh but what I am asking for is a choice and not just a choice but a real choice as in surgeons being trained in both procedures equally-not 2 or 3 who specialize in non mesh orepairs in the United States. I’m asking for patients to be educated by surgeons they see regarding the draw backs and dangers of mesh even if the surgeon believes they are small or “never happens “ to their patients. Let people k ow that they are permanent and they can’t be removed. Surgeons let your patients know if something does go wrong with the mesh that you can’t remove it and let your patient k or they are screwed for life.
its time for the plahjnf field to be evened out-I think rationale people can agree to this.
It doesn’t really matter what the pain post mesh implantation percentages are, for the people who have them their lives they once knew are changed forever and they face a medical community all to willing to look them in the eye and say it has nothing to do with the mesh-I’ve lived through it and ultimately had to have it removed Bc guess what my mesh it turned out had rolled up into a rock hard ball and attached itself to many organs and structure that it shouldn’t have. But guess what from the outside it all looked fine and 6 months of being passed to surgeon to surgeon test to test doctor to doctor all said there is nothing wrong with me and the mesh looked fine and even if something was wrong it couldn’t be removed because it would kill me. Nothing worse to be in sickening pain and not to believed by the medical community. However this part of my journey/story is what every single person who has had mesh pain has gone through. How heartbreaking and how shameful that the medical community turns a blind eye when someone who didn’t have the pain before being implanted with mesh is dismissed and passed off.
That being said many thanks to the few surgeons out there like dr. Towfigh, Belyanski, Ramshaw, Billings, Jacobs who at least can offer people some hope who have issues with mesh even though they all overwhelmingly support the use of mesh as the gold monopolistic standard for hernia repair.
My hope is non mesh repairs can make their way back and surgeons can specialize in doing them tans doing them often-not to replace mesh not to be a suitable alternative. And simultaneously my hope that the guidelines for mesh become stricter-which included clinical trials in humans (sorry animals can’t tell you if they are in severe pain ) as well as a registry to track every implant and track patients complaints. -
Hey Bure96.
i would definitely seek another opinion in addition to chen’s. I’m not a doctor but I’m almost positive the shouldice hospital would refute what he has told you.
chen is very pro mesh and anti mesh and I’m sure inside he was gleaming that a pure tissue repair isn’t satisfactory to some one. Your comment that he said the problem with the shouldice repair is that “when” corrected to “if” kind of said it all.
i would definitely get a third opinion from dr. Brown. Something doesn’t seem right with Chen’s assession that you have bulging Bc you ab muscle are weak as a result of the shouldice technique.
i had a mesh repair go bad and the mesh had to be removed, you had a pure tissue repair and seems something is off-what I have learned from my ordeal is that when it comes to surgery and probably a lot of other things we just can take a surgeons word and have to really do our due-diligence: get a second or third or 4th opinion. Until you feel good about the surgeon and what they are telling you and also do some research on your own.
unfortunately the drawback of going to the shouldice hospital is that should you need to see them again it means that you have to travel.
because the repair is so specialized it may benefit you to return for a follow up.
i understand the worry that maybe they will push you off and not explore further.
final thought is that if you haven’t you should really get your operative report from the shouldice hospital as there may be some clues in the report-sometimes they may note some unusual things that can give insight to what may be bothering you .
hope this helps-if you can id try my best to see dr. Brown especially if the pain lingers. -
I’d mesh was implanted laparoscopically and has to be removed the same way the robotic da Vinci has some major advantages in experienced hands for mesh removal
1) 3D camera giving the surgeon superior visibility of all the structures which is extremely important when removing mesh
2)the robotic arms can rotate 360 degrees giving the surgeon the ability to perform certain tasks the human wrists just can’t do
3) prevents fatigue on the hands in long surgeries which mesh removal can be
I had my mesh removed with the robotic assisted lapro-by dr. Igor belhansky in MD as he specializes in this type of instrument and surgery.
most lapro surgeons are now turning to the da Vince for mesh removal (of it was implanted laparoscopically ) -
Great post good intentions.
tje thing that drives me nuts is that the shouldice hospital reports a less than 1% recurrence rate and a less then 1% chronic pain. So the evidence is out there that a speciality hospital can achieve amazing results using a non mesh repair. Yes I know that the shouldice hospital uses certain criteria to turn away certain people so they may be technically ensuring a better result but still.
what these people are really saying by this study is that outside of a speciality place like the shouldice hospital there are compatible pain results between the two methods which again is silly.
and obviously the other thing that isn’t Apples to Apples are all the other things mesh can do-infections, autoimmune disorders, adherence to bowel and bowel obstruction, meshoma, migration., adherence to the bladde and other nerves.
its just not about equalness of the pain % but the type of pain and the fact that if it is a problem with the mesh the fact that mesh removal is a whole other nightmare of the equation. You just don’t have to worry about all of these other problems with a pure tissue repair.
so yeah it seems this study is nonsense and looks to neatly sweep the mesh problems under the rug by simply saying mesh is neither worse or better than non mesh repairs-not thst simple. -
I’m addition look into non mesh repairs-they will be harder to find but they are out there.
understand that with mesh they put in a pretty big piece which is standard-bigger for laparoscopic Repairs (5”x7”) which seems out of whack for a small hernia like yours but is standard procedure.
also understand that mesh is permanent and not meant to come out-there is no “do-over”. Another thing to think about if you should have post op pain you will never know for sure if it is do to the mesh itself or Bc you had preoperative.
so research the hell out of both procedures and ideally meet with a Couple of surgeons for both mesh (open/lapro) and non mesh repairs whichever route you decide to take make sure the surgeon is a hernia specialist-this means probably looking outside of a general surgeon. -
I know when they use robotic surgery and maybe even lapro surgery there is a camera that automatically takes video and pictures.
i think for open repairs it would have to be requested. -
I think that was a very thorough and well thought out response Good intentions. I also think one of the issues is the reporting of chronic pain.
In the real world outside of these studies people who have chronic pain and go back to their implanting surgeon in most cases are eventually dismissed by there surgeon as there is nothing else they can do for them and it’s off to pain management. I seriously doubt that any of these chronic pain cases are being reported by the actual implanting surgeons and on top of that manny people are being told by their surgeons and other professionals that the pain they are experiencing int due to to the surgery so people leave and go off on other ventures, their back, hip, GI etc. it’s really a shame-there absolutely needs to be a registry and Surgeons by law need to document pain issues so we can get true numbers
reagsrdi pain with mesh-especiallgy when you take into consideration mesh is meant to be a permanent implant. The fact that there isn’t even a protocol to make sure someone isn’t allergic to plastic is rediculous even it is most likely a small amount of people-we are taking about a permanent piece of plastic.
i also believe for some people the mesh causes or exasperated autoimmune issues. I’m not drawing straws out of thin air-I talk to many people these days who are having autoimmune issues after being implanted with mesh. Some cases are immediate some show up years later.
when these issues arise the mesh is never suspected instead they go down the typical route of being passed off to the GI specialist etc.
bottom line is there needs to be new protocols when it comes to mesh. Mesh should at this point not be the gold standard it should be a option, and a option that most patients should have the choice about and also be able to choose a pure tissue repair. And as a result we need Surgeons to be trained on becoming experts at pure tissues repairs otherwise what’s the point. Every surgeon need to be trained on meeh removal and how to spot mesh issues. People can’t be used as guinea pigs.
im currently speaking to someone whose husband had laparoscopic mesh inserted for a inguinal hernia and the husband is in pain lots of burning and inflammation and it’s beem almost 5 months post impantation. He is a formal shell of his self before surgery. Sorry but this isn’t normal. He has tried nerve blocks and been put on gabapentin which have not helped The surgeon had passed him off to a surgeon who deals with mesh issues-not a name on the list on some of these posts.
this new surgeon has rx ibuprofen for 2 months and to come back in 2 months.
If I were a betting man you can see where this is going. The pain will continue-maybe it will be numbed by the Ibuprofen but once that is discontinued it will still be there at which time in 2 months and then the surgeon will say he still doesn’t think it’s the mesh etc.
really a sad state of affairs.
one of the most common things I see when I speak to people who have severe pain/issues after hernia repair with mesh is that they get passed off from the implanting surgeon as the mesh surgery isn’t the cause. However it’s real simple if the pain wasn’t present before the surgery then it is due to the surgery!!!!
if mesh is going to be used then at the very least we need a responsible system to help people and to recognized the it’s either due to the mesh itself or caused by the mesh secondarily ie nerves trapped by mesh etc.
mesh has now been discontinued:banned in some countries (australia and Scotland) used for pelvic problems in women. These women lives have been ruined and revision surgery for many has not worked-if they can even find a surgeon willing to remove the mesh and believe the pain is caused by the mesh-sound familiar.-they are still left in debilitating pain Bc iof the widespread damage mesh can do. It’s only a matter of time before the attention turns to mesh for hernia repairs. Human lives have to be put ahead of big pharma profits. -
No problem. If the mesh isn’t killing you best to take your time and gather as much info so you can make the best choice for your situation.
i often think to myself how someone’s condition prior to removal effects outcome. I’m other words if someone is in immense pain from the mesh will removal cure that pain or is something so established already that it won’t be a cure all. And of course if someone isn’t in immense pain does that hold better as a indicator that removal will help. My gut reaction is if the mesh isn’t crippling you then hold off on removal. But as a first hand witness I know that things can get worse and in my case I wish I explored more what was causing my pain Bc it did get a whole lot worse 6 years later and I now feel if I would of known it was the mesh earlier and had it removed before the it rally got bad maybe some of my lingering issues would of never happened. Of course it is much complicated then that but I will leave you with one thought:
i was speaking to a man overseas and he was telling me that he really wanted to have his mesh removed (implanted openly ) Bc after he swims and bikes the pain comes on strong in his groin and testicle. Outside of exercising he didn’t experience any pain. I have to admit as he was telling me this I was privately thinking is he nuts? To risk mesh removal and possible permanent all the time pain in the hope that he can exercise without pain? And his mesh had been in quite sometime 10 plus years
Anyways long story short he had his mesh removed by dr. Andreas Kock in germany and after about 3 or 4 months of recovery is now according to him 100% pain free and is swimming again pain free.
this led me to think maybe just maybe you don’t have to have debilitating pain to take the gamble if getting mesh removal. Maybe in fact the less pain and damage the mesh has done maybe the better the outcome. Ofcourse you need a top notch surgeon etc. -
Sure. I’m at the year mark since removal and doing much better. I hate to put % on things of this nature but if I had to I’d say I’m about 95% better.
there were about 3 different things the mesh was doing to me and 2 of those are gone post removal.. one issue that remains is I had severe burning pain when sitting but since removal it is now more uncomfortable than painful with no more burning. It’s something I can live with and this summer while wearing comfy shorts i didn’t feel anything and did driving trips if 6 plus hours.
one of the reasons I chose dr. Belyanski was Bc I spoke to some other people who he removed their mesh and he got 100% of it out but to me more importantly preserved the groin nerves.
For me there were no hernias present upon removal-which seems to be quite common if mesh was implanted laparoscopically and in for some time and no nerves had to be cut
I should note the preservation of the groin nerves seems to be more common with lapro removals of lapro implanted mesh. Open removals seem to have the likelihood of at least one nerve being cut.
I always think it is a good idea to meet with at least 2 or 3 of the top surgeons regarding mesh issues and removals and be prepared to travel
someone once told me if you’ve tried everything , seen every dr had every test and everything comes back normal it’s the mesh causing the pain and symptoms.
Fortunately there are now a small subset of surgeons who can in my opinion remove the mesh safely but unfortunately we are still in the unknown of how people will do post mesh removal when it comes to resolving ones pain issues.
and unfortunately there is still very little recognition from most of these surgeons that mesh itself causes pain and other symptoms which is a real shame.
Tjere is a great documametsry called the bleeding edge on Netflix which highlights issues of pelvic mesh and it’s dangers as well as other medical implants. -
Best surgeons for mesh removal: dr. Igor Belyanski MA (removed my mesh), dr. Bruce Ramshaw TN, dr. Sherwin Towfigh CA, there are more. It’s best to interview and correspond at least three surgeons and then go with your gut feeling.
i know this hard to do eseliciag when you are in pain and have to travel. I traveled out of state to see Igor for a consultation and the traveler a second time for surgery. -
There are a number surgeons listed in this site that specialize in mesh removal. Dr. Bruce Ramshaw, TN, dr. Igor Belyanski (Maryland-and who removed my mesh), dr. Sherwin Towfigh CA.
there are others but those are the tips in my opinion.