[LD50]

Both of my seromas were very painful which is why I (ill-advisedly) sought out relief for the 2nd one using manual therapy and acupuncture. I think acupuncture would have been helpful if I insisted that there was no needlework on my abdomen (open incisional hernia tissue repair). The first seroma I had (after C-sect) was very painful until it ruptured.
I am scheduled for a robotic mesh repair of my recurrent ventral hernia on March 3 and I anticipate a seroma. I’m anticipating that there will be a lot of pain until the seroma resolves. I have a high pain tolerance and I don’t want to use narcotics (or really much of any pharmaceuticals) for pain relief, but I’m keeping an open mind. I do plan to receive acupuncture to facilitate healing/ reduce pain and my current acupuncturist and I are on the same page re:no abdominal needlework. I’m hopeful that this will be my final hernia repair, so I plan to follow my surgeon’s instructions and I’ll be glad when this entire episode is in the past.

[LD50]

While I believe there are remnants of my seroma on US, I don’t notice anything that I can point to that indicates whether or not I currently have a seroma.

I do have a very different situation than you do. I have loose skin from weight loss. I have a large ventral hernia and a rectus diastasis, so everything looks abnormal, but I don’t think it looks abnormal from the seroma.

I think that if you follow your surgeon’s instructions (i.e. don’t be a non-compliant idiot like I was), your seroma will resolve uneventfully. I know it’s difficult to wait and see, but I don’t know of an alternative.

[LD50]

ajm222 In 2019 I had an open tissue repair of a very large incisional hernia. A seroma formed soon after the surgery and became very large. Though I never met with the surgeon again in person, I sent photos of the area while I was laying supine and he thought it was softball sized, but I think it was closer to soccer ball- really huge. I had US imaging done several times since to follow it. US showed that it transformed into a hematoma and back again (no indication of black/blue on my skin when it was a hematoma, since the seroma itself is deeper than skin level).

The surgeon didn’t want to drain it because apparently draining increases the risk of infection and most seromas resolve on their own within a couple weeks/months. Also, I became much less motivated to travel to the surgeon or go to a local doctor or hospital for treatment due to the pandemic lockdown which started a few months after my surgery. My seroma may have lingered as long as it has (the imaging center where I have had all of the imaging done on the seroma says the remainders of the seroma are still present) because shortly post-op, I did manual therapy on my abdomen to relieve the pain and I received a session of acupuncture on my abdomen specifically in the area of the seroma. US showed that the seroma transformed into a hematoma shortly after I started a Chinese herbal formula (Jin Gu Die Da) that is supposed to mend bruises by bringing blood to the bruised area. US showed the hematoma transformed back to a seroma over a couple months after I stopped taking that formula.

Incidentally, prior to the operation, the surgeon had advised against post-op abdominal massage and acupuncture. We can learn from this that being a non-compliant patient has real risks, don’t do manual therapy or have acupuncture on the seroma area itself and that from a Traditional Chinese Medicine perspective, seromas aren’t bruises.

Also, many years ago I had a small seroma from a previous abdominal surgery which ruptured about a week post-op. The doctor gave me a couple rounds of antibiotics to treat any infection and the area healed rapidly. Apparently some people are prone to seromas, so now that you know your body forms seromas, make certain to inform any other surgeon you may need in the future that you had a seroma.

[LD50]

Thank you.

[LD50]

Does anyone know of any updates re:hybrid meshes (e.g. Ovitex, Synecor, etc) with regard to hernia recurrence, QOL, etc.

Due to the recent innovation of these hybrid meshes, published data is scarce (link to a 2021 Synecor study below, with a paywall), but promising. Comments from hernia surgeons are appreciated as well.

I’m facing a recurrent ventral hernia repair, but hybrid mesh performance in other populations would also be appreciated.

Early Clinical and Patient-Reported Outcomes of a New Hybrid Mesh for Incisional Hernia Repair https://doi.org/10.1016/j.jss.2021.03.030

[LD50]

@Dr.Towfigh I wasn’t able to tune in to your HerniaTalk Live Q&A on Mesh Implant Illness (MII). I would appreciate it if it could be posted on your youtube page so that I can listen to it.

[LD50]

Kudos on the impressive article, Dr. Towfigh!

j. of abdom. wall surg., 30 January 2023
https://doi.org/10.3389/jaws.2023.10983
Patients With Systemic Reaction to Their Hernia Mesh: An Introduction to Mesh Implant Illness
http://www.frontiersin.orgNegin Fadaee1, http://www.frontiersin.orgDesmond Huynh2, http://www.frontiersin.orgZayan Khanmohammed3, http://www.frontiersin.orgLaura Mazer4, http://www.frontiersin.orgIsabel Capati5 and http://www.frontiersin.orgShirin Towfigh5*

https://www.frontierspartnerships.org/articles/10.3389/jaws.2023.10983/full?fbclid=IwAR0pLHIzTAIlaTc7xOIvv6b1pn4L9IvT64qkEM4mzxnOucfIbGFlmsr8Dj4

[LD50]

Thank you.