[johnmac]

Alternatives to mesh

To Dr Pszotek and his comment “In addition I am looking at combined products that have both biologic and synthetic products in a single mesh.”
Can I ask what combined products are you looking at, and have you used any combined products in inguinal hernia repairs? Any results/thoughts on combined mesh products?
Thanks in advance

[johnmac]

Alternatives to mesh

Hi Dr Towfigh
In your experience is there a significant difference in reoccurrence rates between the likes of SurgiMend,and the later types such as Tigre/Phasix/Bio A meshes? The manufactures of Tigre, Phasic and Bio A all claim their products “remodel”, i.e. generate new collagen, as they dissolve away, which can take up to three years. Any thoughts?
regards
John

[johnmac]

Alternatives to mesh

Thank you Connier, I appreciate your thoughts & insights. I do relate to your choice to live with your hernia & not risk surgery. I wish you well,
best regards
John

[johnmac]

Alternatives to mesh

Hi Connier
Thanks for your advice.
Unfortunately the bit – “You should be in proximity to one of these” is a bit off target.
I live in New Zealand, east coast USA is 12/14 hours flight one way, Asia ditto, India 16 or more, East Canada 16 and Europe 25 at least.
Given the relative NZD v USD the cost of flying & accomodation is an issue, but much worse is the fact I’d be on my own afterwards. I have checked this – no NZ surgeon will want to know about an overseas operation that has gone wrong & neither would my insurance company.
Hard calls either way.

[johnmac]

Alternatives to mesh

Hi Connier
Thanks for your comments. I have extensively researched Desarda & Shouldice techniques, less so the Guarneri. The difficulty for me is the travel distance – to have any of those techniques done by experienced surgeons mean somewhere around 18 to 25 hours flying time each way. And I’m on my own if it goes wrong once back home. Not attractive, but of course compared to mesh issues (if they go wrong) a small price to pay.
Still in the watchful waiting & research mode, hoping someone will invent the perfect operation :unsure:

[johnmac]

Alternatives to mesh

Hi DrBachman
Many thanks of your information & ideas.
I haven’t had too many foreign body implants, however after a small operation to remove a BCC my body tried to reject the internal stitches. Also, over the past two decades I have worked hard to rid myself of toxins such mercury fillings, lead (from paint) & other toxins from my youth. I certainly feel fitter and better for that detoxifying processes. Implanting polypropylene seems a retrograde step in that regard. Like one of the other comments, I do tend to feel anything going on in my body, I would hate to feel a wad of scare tissue & mesh in my core (Pilates) muscles.
Your comments about biosynthetic mesh were really interesting and informative. The Tigr people have competed a three year study on using Tigr mesh for inguinal hernias (open technique), which seems to work well on indirect hernias, less well on direct ones. They have just started another three year study on Tigr mesh (laprascopic technique), but as its just started its way to soon to tell anything. However in theory biosynthetic mesh sounds great – mesh to allow the body to heal itself, gradually dissolve away and all gone after three years.
Regarding your other suggestion, I have been using a hernia support for 18 months now. It was great to start with but its less effective now. I am resigned to some form of surgery, the missing part of the equation is what type.

[johnmac]

Alternatives to mesh

It’s been really interesting seeing the various replies to my post and I am grateful to people making the time to respond.
I have four further queries;
1. I was especially interested in Dr Towfigh writing “As a 60-year old, and an athlete, I would not recommend a tissue repair unless you have true contraindications to mesh implantation.”
Can you please elaborate on your reasons for giving this answer?

2. Also I was very keen on the Desarda technique. However Dr Towfigh writes elsewhere on the forum that;
“The Desarda technique is a revival of an old technique that was abandoned in the 1950’s and 1960’s because the recurrence rate was too high.”
Could you please elaborate on this statement?

3. Another option I have been investigating is the use of biosynthetic mesh such as Phasic, and Tigr. Reportedly these act as standard mesh for some months, while stimulating the body to rebuild natural tissue, before disclosing away completely within 18 months to three years? Has Dr Towfigh had any experience with these meshes?

4. Another mesh option is the TiMesh, which as I understand it is standard polypropylene coated with titanium, which apparently causes less of a foreign body reaction. Has Dr Towfigh had any experience with this mesh? And if so what doe she think off it?

As always, answers and posts are very interesting and much appreciated.