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  • Mesh Removal

    I wanted to give back to this site and share my experience with mesh removal. I found a lot of good information here when I was considering getting my own mesh out and hope that this contribution helps others struggling with their own mesh issues.

    I had bilateral inguinal hernia mesh placed 10 yrs prior to having any symptoms. The "keyhole" technique was used with an Atrium Prolite mesh. I was 32 at the time and quite active.
    Over the years I started to get a tightness in the groin, followed by dysejaculatory symptoms and a constant, dull, "pulling" pain. This began to affect my love life, social life and activity levels. I could still function and go to work etc, so did not have some of the terrible symptoms that so many mesh casualties have. It did not have a nerve entrapment. I had no signs of an allergic reaction to the mesh.

    I decided, after speaking to 3 different surgeons, to have the mesh removed. After hearing the horror stories on the internet about mesh removal, I proceeded with caution. I had the luxury of not being in excruciating pain and could take my time with this. I went to Seattle, LA and Las Vegas to visit with surgeons who would take out mesh. They all had varying degrees of experience with mesh removal. Some were more genuine than others and some made me leave their office and not look back.

    I had my mesh successfully removed 6 weeks ago. Bilateral mesh was completely taken out during the same surgery. The surgery was done laparoscopically and was robot assisted. It took 5.5 hours. The mesh removal was followed by a robotically assisted laparoscopic tissue repair (i.e non mesh repair). I was done with mesh.
    The first week of recovery was not fun, but I could walk around under my own power, climb stairs (very slowly) and able to take orals with BM's coming a few days after the surgery. Pain was controlled with Tramadol and Naproxen. No hard narcotics were needed. I had the surgery done in LA by Dr. Towfigh and was coming from out of town. I stayed a week in LA to have a one week post op check with Dr. Towfigh that went well. I recommend NOT getting on an airplane the next day after mesh removal as some surgeons recommend.

    I am back jogging now and barely notice the removal. I feel it occasionally if I put deep pressure on the site where the mesh was. I have some tightness in my abs when I do Up Dog in yoga, but this is loosening up nicely with time. Overall, I'm glad I had it done.

    Some final points:
    1. Mesh removal can be done safely.
    2. Find a surgeon with experience. I wouldn't have trusted this to just anyone. This is very specialized surgery in a very tricky and sensitive area. You want the best for this. Also, a large internet presence does not necessarily equate to being a good surgeon. Good surgeons don't need to aggressively market themselves.
    3. All other things being equal - laparoscopic is better than laparotomy (open) removal. You will heal faster with less tissue damage. I would also say that robotic assisted is also better than non robotic assisted. I have spoken to general and orthopedic surgeons who use a robot to assist in surgery and they all state that accuracy is increased with the robot. Anyone who says otherwise isn't trained in these procedures.
    4. It is common for the surgeon who put in the mesh that is causing pain to deny that it is the mesh. They are clearly biased. Don't fight too much with them. Go to a specialist who removes mesh. Since you are already on this site, half the battle is over.
    5. For anyone reading this who hasn't had mesh placed yet. If I could go back in time, I never would have had the mesh put in in the first place. Anyone with a mesh complication would say the same. Most of the time mesh placement goes fine. But when it goes bad, it goes really bad. There are lives ruined or almost ruined by this. A tissue repair recurrence dulls in comparison to a mesh complication and subsequent removal. If you are thinking of having a "simple" hernia mesh procedure, go see a specialist and discuss all options. See a surgeon who can offer you options - mesh vs non mesh. Putting in mesh is easy. Putting it in right or doing a tissue repair takes skill. A hernia repair is not just a hernia repair.

  • #2
    I'm pleased that you are better - but mesh overall is very safe as well as recommended
    http://mailchi.mp/23a275fbe343/j114lk1gnu

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    • #3
      vtjbrent,
      I sent you a personal message through the message center asking a few questions about mesh removal and your stay in CA. I look forward to your reply. Thanks!

      Comment


      • #4
        Originally posted by vtjbrent View Post
        I had my mesh successfully removed 6 weeks ago. Bilateral mesh was completely taken out during the same surgery..
        Thank you for sharing this. Your situation mirrors mine in many ways. I had Bard Soft Mesh implanted laparoscopically about 2 1/2 years ago. It never settled in like it was described that it would, I had to devise my own methods of getting my abdomen in to a condition that I could tolerate, and I wake up every day thinking about having it removed. I used to be very athletic - running, biking, and playing soccer. Now I focus on working out in the gym to just the right degree to allow me to be somewhat comfortable during normal activities like sitting at a desk or walking around. I'm too physically healthy to obviously need surgery, but the distraction degrades all other aspects of my life.

        Please post back with the results of the healing from the surgery, if you can. It looks like it's been nine weeks since you had the surgery. It would be fantastic if Dr. Towfigh could describe what she found, although from what I've learned, there was probably nothing unusual. Your mesh was probably exactly as it was intended to be, for recurrence avoidance purposes. But not quality of life.


        To the Herniator - your reply almost perfectly exemplified the problem with the mesh implantation industry. A focus on avoiding recurrence, and a safe procedure. vtjbrent's point was all about a degraded quality of life, but you replied with an answer about safety.

        Anybody considering mesh implantation to fix a hernia should make the surgeon prove that they have satisfied and happy patients. There is no reason at all that the surgeons shouldn't know by now what works and what doesn't, for quality of life after the implantation. But nobody seems to be trying to determine that. The mesh companies are all selling their weave patterns and materials and shapes but with no quality of life correlations. After thousands, or hundreds of thousands of implantations, those comparisons should be possible. Many surgeons and organizations seem to be captured by the mesh company they work with though, and are making financial decisions first, with the patient second I think.

        Comment


        • #5
          Good Intentions,

          Just to clarify: surgeons do not implant mesh for material gains. There is no gain in implanting mesh. Surgeons don't get paid extra to place mesh in patients. Institutions/facilities lose money each time a mesh is implanted in a patient, as there is no extra payment for that procedure.

          There are a lot of quality of life studies performed on patients with and without mesh implantation. It is a fallacy to believe that non-mesh patients in general, as a population, have significantly improved quality of life. That has never been proven.

          However, population studies and trials are different than individual experience. For sure there are individual patients that have complications after hernia repair with mesh. Of that population, some of the complications may be directly related to the mesh itself. We are struggling to determine the mesh-related risk on an individual basis before it is implanted in a patient. There are a few studies looking into it.
          #ItsNotJustAHernia
          www.BeverlyHillsHerniaCenter.com

          Comment


          • #6
            Thank you for the reply. I did not mean material gains. I meant contracts with the mesh companies. It might not even be the surgeon who has the contract.

            I have heard the statement about losing money on mesh implantation. It doesn't make sense. That's not how businesses are run, costs are adjusted to break even at least, in a non-profit organization.

            I really appreciate your contributions, but your comments are the general platitudes, with no useful detail, that leave everyone wondering. No offense intended. For example, why are there so many different types of mesh, from so many different companies? If the procedure is as easy and as safe as suggested, what purpose would be there be to have all of these different products? Somebody is making money here. A person could argue that there must be flaws in the materials and methods because medical device companies see a need for new products. There must be, they don't do research for fun. How do we patients get the information behind the reason for the new products.

            We all go in to the specialist's office expecting that they will be up to speed on the state-of-the-art. Then we're supposed to tell them what we want. But we don't have the information we need to make an informed decision.

            "There are a lot of quality of life studies performed on patients with and without mesh implantation". Where are the quality of life studies comparing the different materiasl and methods of implantation? "With and without mesh" is not really the question, it's "what is the best mesh and method to give the best quality of life".

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            • #7
              There are many studies comparing different mesh products and techniques. There is no best mesh. There is no ideal mesh. Whereas one patient may do very well with one type of mesh, another would not. For example, perhaps an obese patient will do better with a heavier weight mesh, a thin patient may do better with a lighter weight mesh or no mesh, a patient with a wide-based hernia may do better with a sandwich type designed mesh. A direct hernia may be best treated with a heavier weight mesh, but what if you are thin and have a direct hernia or a wide-based hernia? The permutations are plenty. There is no formula to plug in to tell you which patient will have the best outcome with which technique. Each surgeon has a different outcome with each technique and each patient has a different outcome with the same technique. That is where the art comes from.

              Many mesh companies profit nicely from selling implants, especially since mesh repair is considered gold standard in the US. Surgeons don't have contracts with mesh companies. In fact, in many situations, the type of mesh carried is an economic decision.

              Medicine, as you may have figured out by now, is not a profits-first business. Patient needs supersede profit margins. Unlike most businesses, patients' lives come first. So, e.g., if the patient requires a certain treatment, implant, procedure, etc., and they can't pay for it, or their insurance doesn't cover it, or the insurance pays too little to make the procedure profitable, that is often not a reason to prevent the patient from having a life-saving, life-altering, or to withhold health care. It is part of the reason why the US healthcare is bankrupt: improvements in technology and availability of new technology precludes the doctors to take advantage of the new technology and provide the best care to their patient, even though it is often at higher cost. Same with pharmaceuticals. The real winners are the industries that provide this technology. For sure, it is not the doctor. They intend to provide the best care for their patient.

              Perhaps this is too much information.
              #ItsNotJustAHernia
              www.BeverlyHillsHerniaCenter.com

              Comment


              • #8
                I feel this testimonial is very timely and important. There is a lot of ‘gloom and doom’ out there surrounding hernia complications. A small group of very talented surgeons have been pioneering efforts to remediate these and their published data seems to suggest that the majority “get better.” But what does that really mean? There is so little information available to patients that a positive outcome from one particular doctor or procedure is actually a huge data point. The procedure you had (minimally invasive primary tissue repair) is somewhat new. Jogging after six weeks also sounds miraculous.

                Granted every case is different and peoples individual mileage will vary. I can echo many of your observations regarding traveling the country looking for the right doctor. Each has an approach that is very different. Some of these doctors are even booked over 6 months out.

                Your case stands out.

                Just like surgeons share these cases with each other at meetings all over the world it would be great if we as patients had a better resource to share our experiences. Many of the old support sites/groups are now defunct as their creators moved on with their lives. I suspect many patients with good outcomes return to a normal life so we don't hear from what I hope is the happy majority.

                If you can, continuing to share how your recovery goes would be really helpful.

                It sounds like you may be able to return to a full active life which is really quite inspiring.

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                • #9
                  I would like to echo everything vtjbrent said in his post. I recently had my mesh removed. It had folded and curled into a ball and was rock hard.
                  i too had it removed robotic assisted laparoscopically by dr. Igor Belyanski who saw in a CT scan what so many others had missed that the mesh had folded. It was much worse when he actually got inside there. I am about 4 weeks out.
                  i am encouraged to see you are doing so well 6 weeks out.
                  And yes if I could do all over again I would of researched the best way and place to get a pure tissue repair. Unfortunately there aren't many choices out there as mesh has become the gold standard. Whether you argue for or against mesh the real take away is when it goes bad it really goes bad. 99% of the implanting surgeons do not k is how to remove the mesh and to me this is a fundamental problem in using mesh. 99% of surgeons and radiologist do not know how to read an MRI or CT scan to identify mesh issues-and that is a problem! So you get passed on from test to test to doctor to doctor and they all say everything is fine with the mesh. It's a long and brutal journey, not to mention you will have to most likely travel to another state to find a removal surgeon.
                  i don't think the surgeons understand this point.
                  The physical, emotional and psychological effect this has on someone.
                  there has to be a better way-then sticking something in someone that statistically speaking can't come out of you and almost a zero chance to see something is wrong on tests-unless you find the 4 or 5 surgeons in the United States out of thousands who can help you.
                  this is the fundamental problem with mesh.
                  sorry for the rant-it's been a long journey for me.

                  Comment


                  • #10
                    Originally posted by Jnomesh View Post
                    Unfortunately there aren't many choices out there as mesh has become the gold standard. Whether you argue for or against mesh the real take away is when it goes bad it really goes bad. 99% of the implanting surgeons do not k is how to remove the mesh and to me this is a fundamental problem in using mesh. 99% of surgeons and radiologist do not know how to read an MRI or CT scan to identify mesh issues-and that is a problem! So you get passed on from test to test to doctor to doctor and they all say everything is fine with the mesh. It's a long and brutal journey, not to mention you will have to most likely travel to another state to find a removal surgeon.
                    i don't think the surgeons understand this point.
                    The physical, emotional and psychological effect this has on someone.
                    there has to be a better way-then sticking something in someone that statistically speaking can't come out of you and almost a zero chance to see something is wrong on tests-unless you find the 4 or 5 surgeons in the United States out of thousands who can help you.
                    this is the fundamental problem with mesh.
                    sorry for the rant-it's been a long journey for me.
                    Good luck, and thanks for posting. And thanks for another name to add to the surgeons who will remove mesh.

                    Your summary matches the conclusions I've come to almost exactly. Especially the part about "really bad". The surgeons who implant the mesh have no recourse if it doesn't work. They don't know what to look for, And they don't know how to respond. In addition, there is no specific "code" for mesh removal, in the insurance industry, so it's not tracked, directly anyway.. Most doctors today are part of the standardized health care industry. It's very bureaucratic. I've developed much appreciation,and sympathy, for my surgeon, after seeing how his actions are all second-guessed and graded, for proper fit to the system. As far as the insurance companies are concerned, mesh problems don't exist as a thing. Which makes it very difficult for the surgeons who implant mesh, to keep up with problems.

                    I think that if a person went to a doctor with just the symptoms, and didn't mention the mesh, they might get farther along to a solution.

                    Again, good luck. And keep posting. I've learned most of what I know from forums like this one.

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                    • #11
                      Good Intentions:

                      That was a fascinating response. Rings very true. It is an uphill battle for us surgeons to treat our patients and have the insurance companies agree there is a problem that needs treatment.
                      #ItsNotJustAHernia
                      www.BeverlyHillsHerniaCenter.com

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