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Mesh removal and repair

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  • Mesh removal and repair

    Hi Dr. Towfigh I recently had inguinal mesh removed and requested no new mesh to be put back in. It wa put in laparoscopically and removed the same way. I see in the operative report there was weakeness in the internal inguinal canal and the oblique muscle was brought down to the illiopubic tract and sutures with 2-0 v-loc absorbable sutures. I've read that these lose tensile strength pretty early.
    My question is I'm about 4 weeks out from surgery and am taking it very slow. How long does it usually take for this kind of suture to fully heal. As I really want to make sure I don't do anything to aggravate it. I've read that a hernia repair whether it is with mesh or tissue is usually 75% healed by the 6 month mark and fully healed by around a year. Would these be appropriate guidelines for the suture job I described above for me.
    again I really don't want to overdo it to soon and am totally willing to be diligent for 6 months if this is recommended.
    there seems to be very little advice and literature on how to heal and recovery for mesh removal.
    Some say no rettrictiins after 3 months some say let your body and how you feel dictate what you do. But my concern is since the sutures are absorbable and lose strength with time what is your advice in terms of how long should it take for this repair to fully heal to become strong again/healed.
    thank you

  • #2
    Good questions.

    Depends on the absorbable sutures used. Vicryl loses 50% of its strength at about 3 weeks. There are more slowly resorbable sutures.

    I do not use absorbable sutures because I feel the recurrence rate is too high. But Dr. Ramshaw, who I very very highly respect, uses that technique and has had excellent results.

    Ultimately, the best you can do is remain active, not gain weight, engage your abdominal muscles to keep them strong and supportive of the repair, prevent constipation, prevent coughing and clearing of your throat.
    #ItsNotJustAHernia
    www.BeverlyHillsHerniaCenter.com

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    • #3
      Thanks for the reply. So in your experience what is a general time frame you give to your patients who have had robotic assisted inguinal mesh removal? On average I've heard around 3 months to Heal from the surgery-does that sound right.

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      • #4
        I don't restrict, though I prefer they don't start gym type exercises until 2 weeks postoperatively.
        #ItsNotJustAHernia
        www.BeverlyHillsHerniaCenter.com

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        • #5
          Wow! Seems awful early-i definitely wouldn't of even been able to think about do any gym activities at two weeks out from my mesh removal.
          would this advice be any different if absorbable sutures were used? (I know you use permanent) since the sutures are losing strength or would you still feel if one is feeling up to it to be more active.

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          • #6
            Perhaps. Some of the absorbable suture are effectively no longer holding at 3 weeks.
            #ItsNotJustAHernia
            www.BeverlyHillsHerniaCenter.com

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