[Jnomesh]

Hey good intentions. Did you happen to do any type of body work that helped you post mesh removal-like myofascial release or ART etc?

[Jnomesh]

I agree with good intentions-routine hernia repairs do not get a pain pump afterwards at least here in the states (I doubt elsewhere). That to me is a little susipicius. Get a hold of your operative report and review it.
also I’m am not saying this has happened to you but it happened to me and a quite a few others who had the Bard 3D (for me and the others it was the 3D maxx) but it has a tendency to fold over on itself. The mesh is designed to be concave so it can “better fit “ the inguinal region which is 3 dimensional but due to this has a tendency to clan shell on itself.
on one hand you are still early in your recovery and time may heal and the pain will go away on the other hand you still need to be proactive and try and find out all you can about your surgery.

[Jnomesh]

Research and consider a non mesh repair.

[Jnomesh]

Hi I just wanted to weigh in-i don’t have the pre hernia issues that you had and I am male but I did want you to know that I had the 3D maxx mesh used in my inguinal hernia surgery and it ended up folding over upon itself and after years folded up into a rock hard ball. If you google the 3D maxx mesh you will find a lot of issiues with it. It is concave in nature thus the “3D” and this makes it prone to folding over or clamshelling on itself. If you had a hematoma post surgery in the area of the mesh it could put added pressure on the mesh and possibly cause it to fold over. I have been in touch with Men and women who had this type of mesh removed and it was found to be folded over. It is very difficult to see the mesh on a cat scan Bc even though it’s folded over it can still appear to be in the proper place. After many surgeons and radiologists deemed everything to be fine with my mesh I sent the same CD scan to dr. Igor Belyanski in MD and he found that the mesh was bent and had slightly shifted. I was in immense pain and had it removed (not s easy or simple surgery) when he got in there the mesh was much worse then showed up in the CT scan. I believe mine folded very early after my initial operation.l and got worse over the years-I exercises too. for years I was in pain but it didn’t stop me from living life. Then 6 years later after my initial surgery I experienced pain like never before and then the frustrating search to see what was wrong with me. Finally after about a half a year I found dr. Belyanski and find iut the mesh was the issue.
I’m certainly not saying this is what is going on with you but anytime o come across someone having pain who had the 3D maxx her is mesh implanted I feel I have a obligation to share my story.

[Jnomesh]

Consider dr. William brown in San Fran. He also specializes in non mesh repairs. It is also possible it is a Seroma-which is swelling donto fluid collecting where the hernia once was. It’s is usually soft and can be similar in appearance to a hernia

[Jnomesh]

Don’t think it really matters as they both have the same concave design that make them susceptible to folding over. 7 people i am In touch with who have the 3D maxx have had this happen to them once the surgeon went into remove the mesh it was found folded over. Not saying this is what is happening to you but if tour symptoms should happen to not improve over time I just wanted to make you aware of this pheromonem

[Jnomesh]

This is by no means meant to scare you and I debated whether or not to chime in but I had the bard 3D maxx impnater inside me over 7 years ago-and it never felt right too and as time wen tin would flare up really bad. A year ago I them had really horrible experience with pain that was crippling. Long story short the mesh had folded over and crumpled up into a rock hard ball. I had to have the mesh wdplanted. During this whole ordeal I met and corresponded with a bunch of other guys who also had their 3D maxx mesh removed and it was found upon removal that the mesh had folded over inside of them too.
there is a design flaw in this product that they market as a advantage-it is concave meant to better fit the 3D inguinal canal but because of this concavity it has the tendency to fold over especially if it isn’t fixated which this type of mesh doesn’t need to be.
there are also a number of lawsuits out there for this type of mesh-you can google it.
i hope that as tome goes on you feel better but if you don’t keep this in mind.

[Jnomesh]

Thanks good intentions and I mirror what Chauncey said that your feedback iand thoughts are very welcomed and insightful. I’m on a FB mesh forum and there are a good number of men and woman who have had there mesh removed and so there is a lot of valuable information and I’m trying to collaborate with the moderator of that group how best to structure questions to get specifics of each story so information can be collected and categorized as to best offer people am I few of what to expect from mesh removal based on the specifics of their symptoms matched as best as possible to others who have had removal. As you know it is very hard Bc gender should probably be separated out due to different anatomy, open VS lapro, type of mesh, surgeon, how mesh was removed, how long mesh was in for, what were the pre mesh removal symptoms and onset, post removal symptoms, better worse etc. And the forum is primarily made up of women who had transvaginal mesh implanted and many removed so that is a whole separate issue.
i will post something in the near future here in this site

[Jnomesh]

Thank you Dr. Kang. Your insight is very helpful. And I think a lot of us appreciate the detail you provide Bc there are a lot of us who are interested and probably spend a good amount of time familiarizing ourselves of this complex anatomy to help understand our own particular situations. Most surgeons don’t do this and make a strong line in the sand in surgeon/patient relationship.
toj probably have answered this before somewhere but do you use absorbable sutures for your realized or permanent.
id also like to asks your thoughts on a couple of things
1) classic non mesh hernia repairs and what seems to happen to a lot of people who have laparoscopic mesh repairs and then when they have the mesh removed there are no hernias found as the mesh has promoted scarring and scar tissue that close up the defect. Would this be as strong as a classic non mesh hernia repair? Or weaker because muscle isn’t initially being brought together and stitched. Just curious on your thoughts Bc my self included I’ve come across a good number of people who after lapro mesh is removed don’t hsve any hernias and I’m wonderknf what the prognosis is Fein the line is ther more chance of a recurrence compared to a classic non mesh repair?
2) this leads me to another question regarding this concept that mesh seems to be a process where the defect is closed up upon removal of mesh and a relatively new mesh called absorbable mesh. Could absorbable mesh be a middle ground between mesh and non mesh relairs? For example a lot of people after having mesh removal do not want mesh out back in their bodies but a lot of surgeons rx putting mesh back in because the area may be weakened even if there are no hernias. I’m wondering if absorbable mesh may make sense as a compromise in this situation (and some surgeons are offering this)-the two brands are tiger and phased absorbable mesh that don’t start to break down and absorb/dissolve until 18-24 months and by this time the hernia is repaired through scar tissue formation.
this absorbable mesh could also be a option due to so few surgeons who offer non mesh repairs and the fact that even some that do aren’t experts at it. I’m wondering if the absorbable mesh is a option. Case in point my sisters husband has a hernia ( not sure if direct or indirect ) and wen to see a local surgeon. He expressed concern about permanent mesh and was interested in a non mesh repair. The surgeon told him she doesn’t do non mesh relairs but offered him a absorbable mesh as a compromise. He doesn’t have a lot of money to travel to Canada to the shouldice Hospital and pay out of pocket so he is considering this option.
Woukd be very interested to hear your thoughts on the above questions-and again thanks so much for providing a much needed service as a alternative to mesh and taking the time to answer questions on this forum.

[Jnomesh]

Hi good intentions as someone who had his mesh removed 2 summers ago In which it was found to have curled up k to a rock hard ball I think knit would also be interesting to find people who have had successful mesh removal and more to the point successful recovery of symptoms prior to mesh removal.
through my own research I have only met one person (a female) who recovered 100% (that being feeling back to 100% of her ore mesh stmptoms. Everyone else seems to still have lingering issues but most are happy they got the mesh out and generally feel better.
anyways I’m regards to your post I know two people who have had hernia repairs and have had no issues. My sisters husband who had open mesh repair 17 years ago when he was 20. He is in the process of getting his operative report Bc he now has a hernia on the other side and after hearing my ordeal is doing a lot of research so he can make an informed decision. Although personally I think he should consider the shouldice Hospital I also told him if does decide on hernia repair with mesh for him to get his operative report and try and replicate it as much as possible since the other side was successful with mesh-in other words seek out the same type of mesh and possibly if still In practice the same surgeon.
When he gets his operative report I will be able to tell you the type of mesh
the other guy is my best friends dad-who had lapro repair around 15 years ago but I know he won’t get his operative report.
another interesting note and I k or I’m all over the place with this post but my sisters husband went to a surgeon where he lives in Massachusetts and folded her he was thinking of getting s non mesh repair and she told him she didn’t have the expertise in that but if he wanted that the shouldice Hospital would be great but she did offer him a open repair with fully absorbable mesh which disappears around 18-24 months after implantation but is in long enough for the hernia defect to heal through the scar formation the mesh indices. I know dr. Bruce Ramshaw uses this type of mesh (he uses tiger mesh) for patients who when he removed mesh and the area isn’t strong enough for a pure tissue repair this type of mesh is a good compromise for patients that don’t want more mesh put in post mesh removal. Now it seems as it may also be a solution for those that don’t want mesh and can’t find a surgeon who specializes in pure tissue repairs (a real problem )
anyways there is a lot to be skeptical about but this seems like a topic worth exploring more

[Jnomesh]

Not a surgeon-but everything I’ve researched says it’s best to remove the mesh the way it was inserted. I had my mesh implanted lapro and removed lapro by dr. Igor Belyanski who has significant experience in removing mesh. I am also in touch with another guy who had a plug and patch (placed openly) and removed by dr. Belyanski openly. Belyanski then repaired the defect with a combination of permanent and absorbable sutures Bc the guy did not want more mesh. Hope this helps.

[Jnomesh]

Dr. William brown CA.

[Jnomesh]

Whichever way you go make sure you see a surgeon who has expertise in mesh removal just in case there is a issue with the mesh itself. For example, if you decide to have exploratory surgery or to have the tacs removed and it turns out the mesh is bent or migrated or impinging in merbes you want someone who has done many removals otherwise you can come out worse. Brown and Meyers are very reputable but have more expertise in my research with removing mesh openly which is great if you had your mesh put in openly. If it was implanted laparoscopically dr. Igor Belyanski in Annapolis MD, Bruce Ramshaw, and Shirwin Towfigh May be the best way to go.
for my own two cents I think it borders on criminal/negligence to implant someone with a huge piece of plastic mesh when no hernias were found.
if this wasn’t discussed with you before your surgery id seriously consider legal action.

[Jnomesh]

I was always under the impression that the mesh is easier to remove the less time it’s been in the body. If you do opt for removal seek out one of the best surgeons even if it means traveling-there are only a few. But you are early on in the recovery stage and maybe the above suggestion of just removing the tacks May be the best way to go. A cat scan can show the rack placement

[Jnomesh]

At some point may be best to get a MRI as ultrasounds are very administrator specific .
not to say MRI aren’t radiologist specific too but you could send the MRI results to dr. Towfigh who has expertise in not only reading MRI’s but finding and treating occult hernias.

[Jnomesh]

The bard 3D maxx mesh is concave in nature and has a tendency to fold over-especially if there wasn’t any reinforcement to hold it in place. This can happen immediately of over time.
if the pain doesn’t go away I would-because if this type of mesh-get a MRI or cat scan or both and send it to either dr. Towfigh or another surgeon who specializes in mesh issues like dr. igor Belyanski and have them review it to rule out any shifting or bending/folding of the mesh.
i myself have had this type of mesh ball up inside me and have corresponded with 5 other people who have had to have there mesh removed and in all of these cases it was found that the mesh had folded over.

[Jnomesh]

Thanks Dr. kang. It’s just a shame that here in the United States there are so few surgeons who specialize in tissue repairs. Thus The patient is pushed into a repair using mesh. If the patient requests a non mesh repair the surgeon either says they aren’t proficient enough in this type of repair or quotes a high recurrence rate that I believe is used to cover up the fact that they just aren’t comfortable doing them. So if a hernia returns the surgeon can then say I told you that was a higher risk.
We need more specialists like you here in the US.
it is very unfortunate that a patient had to most likely revel out of state or out of country to avoid mesh.

[Jnomesh]

Hi. I can’t offer a whole lot except that I was strongly considering dr. Brown to remove a defected hernia mesh and repair the hernia without mesh. He is one of only a few surgeons in the US that not only has major concern with mesh but who has the expertise to repair hernias the old fashion way. Like you I spoke to him and he even gave me his cell phone to call him anytime great bed side manner.
i think the only place I’d put ahead of him is the shouldice hospital in Canada. There stats show a less than 1% recurrence rate and less than 1% chronic pain not sure how you can go wrong with those stats except that it is in a different country.
there is dr. Kevin Peterson in Las Vegas and if you are on the east coast there is a surgeon in LI dr. Samer Sbayi at Stoney brook who studie at the shouldice hospital and touts over 650 of these shouldice repairs.
but dr. Brown seems like a great choice. I’m glad you are avoiding mesh-my mesh ended up folding up and causing debilitating pain.

[Jnomesh]

Thanks for sharing Chaunce. Super important. Glad that Concerns regarding mesh seems to be making its way to the forefront. Hoping that in the near future surgeons will be equally trained in mesh and non mesh repairs so that not only can the patient be presented with a choice but receive expert care in either procedure.
the thing that I always come back to that is quite remarkable is the “mis-truths” that surgeons and the industry seem to spread regarding the inferiority of non mesh repairs-that they carry a higher recurrence rate than mesh-I’ve even heard this quoted by some surgeons on this forum-yet the shouldice Hospital (non mesh repairs) has data showing less than 1% recurrence rates and less than 1% chronic pain. There it is in black and white-if a surgeon has a expertise in doing non mesh repairs these repairs blow out and are far superior in regards to both the recurrent rate and chronic pain rate of mesh repairs.
so when you hear a surgeon say that mesh is superior to non mesh repair it is really code speak for either the use of mesh or for the fact that they don’t have the expertise , confidence because they just don’t do enough of these type of non mesh repairs-which is a huge problem and disservice to patients. It’s a shame that one has to travel to another country for a non mesh repair or at the very least travel out of state to see one of the few surgeons left who specialize in non mesh repairs. Sad.

[Jnomesh]

Best wishes on this most unfortunate journey