localCivilian
Forum Replies Created
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Sounds like a recurrence from the tissue repair. If so, most likely they will have to operate on you again and it would be best to use mesh this time around.
Unless it is because of a diastasis recti then they may still be able to do a tissue repair after they repair your diastasis recti but that doesn’t sound smart at all. If it’s a recurrence, the abdominal wall is already so weak especially from being sutured and coming undone.
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Had an umbilical hernia repaired myself, laparoscopically with mesh (seven months ago). Discomfort in the area is very normal. I had noticeable discomfort for about four to five months, but once six months it reduced drastically. I still feel it here and there but it’s only in certain instances or when I really think about it. At this point I find myself or getting I had it repaired.
Patience is key.
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Good thoughtful post. As you stated, we really are enslaved in this world of hernias once one develops a hernia. Once you develop one and even after you get it repaired, you really do have to watch over it for life and just hope that nothing goes wrong with the repair as far complications or a recurrence. Even if no complications arise, you still have to continually worry about a recurrence, even with mesh. That hole in your abdominal wall is there for life and any content can just pop right through again at any moment. Really does suck after thinking about it that way, but things happen I guess. The most we can do is watch over it and hope that more extensive research comes out in the hernia repair world. I always ask myself how a procedure so routine and straight forward is yet the one procedure that is hard to perfect.
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Coming from someone who had an umbilical hernia repaired, it’s not that bad, but this is just my experience and what I can tell you so far. I’m about eight months post-op, laparoscopic with mesh and absorbable fixation, and the only problems I’ve experienced were some tightness in my abdomen for the first two months. It was pretty rough tbh. All is well right now and I hope it’ll stay that way.
Keep in mind that most of the mesh complications are from inguinal hernia repairs, anatomically speaking, that’s a an area far from where the umbilicus is. You can barely compare the two types of repairs with mesh. It’s really rare to find mesh complications for a ventral hernia repair unless you have a mesh reaction or get an infection from it, which is possible. A lot of new techniques have been going around for ventral hernias and the latest one seems to be the TEP procedure and the other being a TAPP procedure. Those aren’t new for inguinal hernia repairs but they are for ventral repairs. They seem to have advantages compared to the traditional IPOM method, which the mesh is implanted against the peritoneum, but they are still pretty new techniques without very much evidence that they are superior than an IPOM repair. If you are going to go the mesh route, try to steer away from any kind of metal fixation. There is evidence that metal fixation does cause a lot of problems, so try to find someone who will be open to using absorbable fixation.
If you plan to get pregnant again, it’s best to go with the non-mesh route because once you are pregnant with mesh, you are pretty much bound to get a recurrence and that would involve removing the mesh most likely. If you don’t plan on that AND you really want to tackle the adhesions, then go the laparoscopic route, which will address both the hernia and your adhesions.
Remember, ventral hernias are different from inguinal hernias. Mesh complications differ between the two. I’m not saying that there are no complications at all with ventral mesh repairs, there are, but like I said, you can barely compare them to the ones experienced with an inguinal hernia repair. Most post-op pain for ventral hernias is due to the type of fixation which is its best to stay away from any kind of metal and permanent fixation, especially if you are thin.
In my opinion, it’s best to go with mesh since your hernia is 3 cm. That’s considered a medium sized hernia, according to most findings. Most experts, even the ones who remove mesh, suggest that hernias over 2 cm are best repaired with mesh. But please do find a surgeon who does hernias on the daily and is up to date with what’s going on in the field. Good luck to you!
Edit: Btw, I am active as well. I run and I bike quite often and like I said the only setbacks that I’ve had in my routine was when I was fresh in the recovery phase. But you will feel some tightness for some time in the area which will eventually go away.
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I think posts like this are important. Sometimes we can get caught up in a lot of negativity and it’s important to think positive. I’m glad all is well with you!
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[USER=”2844″]ssonic99[/USER] Shame on him. Thinking about this makes me question his results. Like how many others have been ignored who had post-operation problems? Does he just include successful operations in his findings? Not saying he’s bad surgeon, I’m sure many have had successful repairs done by him. But it’s worth questioning.
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[USER=”2791″]Meshpain[/USER] That’s really good to hear, I’m glad you got everything sorted out. Think positive and godspeed!
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[USER=”2963″]Kristine[/USER] How big is your hernia? I think I have read a comment on here made by Dr. Brown stating that a hernia, even big, can be repaired without mesh. Then again, to do so would take a highly skilled surgeon to perform the non-mesh surgery, especially for a big defect. That would most likely involve some traveling. If you’re thin, I would assume you could have a good outcome if you got a traditional suture repair due to the decreased risk of a recurrence. There is only resource that I have seen of someone claiming that mesh can create autoimmune diseases. It seems super unlikely as it really has not been seen.
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[USER=”2826″]patient[/USER] Keep in mind that chronic pain is mostly reported when mesh is implanted for an inguinal hernia, which he doesn’t have. Lots of nerves are located in the inguinal area that aren’t around for a ventral hernia. Mesh seems to be pretty essential for ventral hernias (unless you’re a female who plans to get pregnant) since recurrence rates seem to be much higher for ventral hernias, especially for an incisional hernia. Obviously, good results happen when done by someone who does hernia operations daily and is updated with the latest techniques for a ventral hernia repair.
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[USER=”2952″]TheWayBackUp[/USER] Of course. If you want to avoid another large scar and long recovery, then robotic AWR would be the superior option. I think it only involves four little incisions, three that are 5mm and one 12mm for the camera port. Like I said, the two surgeons I mentioned really have seemed to mastered and the studies they put out seem to be really promising. They’re both very vocal and well known in the hernia world. You can also see some testimonials from patients online too. Also if you do decide to go with either of them, good thing is that there aren’t far from you.
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I had a hernia in a similar location, mine was an umbilical hernia. Only two cm, but caused a lot of discomfort tbh. I can imagine how a five cm hernia feels. If it bothers you, it’s best to get it repaired with abdominal wall reconstruction since it’s starting to get in the “large” state as far as a size.
Good thing about today’s world is you can now get abdominal wall reconstruction done robotically, instead of having such a large incision done. Surgeons like Dr. Yuri Novitsky (NYC) and Dr. Igor Belyansky (Maryland) are two world renowned surgeons who have mastered the procedure using robotic surgery. Really is quite interesting. You can look up Dr. Belyansky’s robotic AWR videos on his YouTube page to get an idea of what it’s all about. Obviously, traveling for surgery isn’t easy. So if you can’t make it to them, it’s still important to find someone who’s close to you that is experienced with AWR.
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I would avoid the surgeon from Las Vegas, Nevada. Brian Jacob’s is a good option as well but he isn’t in network with any insurance so that’s a heavy literal price to pay. Dr. Novitsky would be your best bet. He does remove mesh robotically and is network with all the major insurance companies. He also often tweets a lot about removing mesh, if that gives you so peace of mind. Fortunately, after reading up a lot from other users here and general research, removing mesh for an umbilical hernia doesn’t seem to be as complicated as compared to removing inguinal mesh.
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Keep in mind that if you’re going to want a good solid tissue repair done, that it would be best to get it fixed ASAP since you say the new hernia is getting bigger than your first. If the defect becomes larger and larger then it might be hard to do a good tissue repair because of the high risk of a recurrence which means another surgery. Also, it’s important to find someone who’s skilled in a tissue repair which will more than likely mean traveling and possibly paying out of pocket (although it for sure wouldn’t be as expensive as a mesh repair) if they aren’t in your network. If you’re close to someone who is skilled in a tissue repair then that’s awesome.
If you’re only getting occasional twinges here and there and not any pain, then don’t let that be a reason from steering away from a mesh repair, especially if it’s only been nine months. You’re still gonna get those little twinges for quite some time. There are a lot of skilled surgeons who do excellent mesh repairs and if you do choose to go the mesh route, it’ll be good to find not just a general surgeon who does a few, but a hernia specialist who does hernia operations daily. Sometimes looking for a hernia specialist will mean some traveling too though, depending on where you live. But it’s understandable though if you do choose not to do mesh, it’s just a matter of weighing the risks and benefits, as with any type of hernia repair (mesh or no mesh). Look at both sides. Good luck to you!
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You might have pushed a little too hard too soon. Even though surgeons tell patients to give it six to eight weeks, a lot of healing is still taking place on the inside and that can be a while to fully heal. You may feel 100% on the outside but might not be there on the inside just yet. If you’re doing a lot of core exercises and if you started then within those eight weeks, that could probably be the reason for your soreness. I also read on here somewhere that crunches are the main core exercise that puts the most pressure on the abdomen. If it’s only been feeling like that for two days, give it time and see if it improves. If it prolongs, then it really is important to go to a hernia specialist to see what might be the problem.
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Do you know for sure if he implanted the mesh in IPOM (in contact with bowel) fashion? That’s pretty unusual for an inguinal hernia repair.
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For sure the two mentioned above. In your case though it would make more sense to go to Dr. Novitsky though since he’s a lot more familiar with abdominal wall reconstruction. Seems to be a master at it.
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[USER=”2795″]bmul100[/USER] is also right. I know Dr. Remus Repta in Scottsdale, Arizona removes umbilical hernia mesh only. He also states it on his website. But I believe he only does it openly. But I think it would be better to get all done by one surgeon just to make it easier financially and physically as well. Do you know any other plastic surgeons who remove mesh?
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[USER=”2042″]Jnomesh[/USER] You’re right about Dr. Peterson’s method of removing mesh. I believe he also makes the length of the incision the exact same length of the mesh most of the time which is crazy.
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I’m so sorry for what you’re going through. So I assume Dr. Belyansky is not in-network with your insurance? Or is he in your network but they’re just wanting you to go to someone who is local?
Out of your choices, I would leave out Dr. Peterson. I really have seen mixed reviews from him, to be honest. Dr. Brown seems to be a fantastic surgeon, but he does open removal. It would seem best to remove it laparoscopically or robotically.
Dr. Brian Jacob and Dr. Yuri Novitsky remove mesh laparoscopically and robotically routinely and they’re both in New York if you wouldn’t mind traveling again. But if they’re not in your network then it might just be a repeated cycle of what you went through with your insurance and Dr. Belyansky. It’s worth giving both of their offices a call and checking if they accept your insurance. From what I’ve looked up on my own, if you have a PPO plan with any major insurance company, Dr. Novitsky would most likely be in network.
Dr. Towfigh is in Los Angeles and she’s an out of network provider. So if you’re willing to pay out of pocket with Dr. Belyansky, it’s worth giving a shot going to Dr. Towfigh if you can’t find someone in your network who’s experienced in mesh removal. From all the studies I’ve read, mesh removal done laparoscopically or robotically have the best outcomes compared to open removal. I know Dr. Towfigh did a study recently where she had compared laparoscopic removal and robotic assisted removal and I believe she found that only one nerve injury was reported and not a single vessel or spermatic chord injury was reported in the robotic group. So if you can find anyone who can do it robotically, that would be good. But of course it also comes with skill so finding an experienced surgeon is crucial.
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Just looked him up and his clinic. Seems like a great place to start. Keep us updated on what they find to be the issue!