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  • Types of mesh now being used?

    To clear up the confusion (mine, anyway) I keep seeing references to "Bard" mesh. Is that the usual mesh used for IH repair? The surgeon I am considering showed me a patch of mesh-it didn't occur to me to ask what type it was. Does it make a difference? thanks for any response.

  • #2
    Type of mesh does make a difference. But what, exactly, the long term effects are is unclear. Most of the literature provided by the device makers focuses on the immediate feel of the material before and/or during implantation, Soft or Flex or Grip, and various other qualities, many to make implantation easier. It's one of the great failings of the industry, that they have all of these different types of mesh, used on a regular basis, but there is no verifiable long-term data available to use for correlating problems or benefits to the mesh type. The new meshes are approved based on similarities to past meshes, meshes with, ironically, the very problems that the new mesh is supposed to improve.

    Many surgeons do not get to choose the mesh that they use either.

    Bard is a medical device maker. A brand. They have many different types of mesh products. Bard Mesh, Bard Soft Mesh, Bard 3D Max, etc. Here are three links, one showing how some surgeons just rely on their purchasing departments, another showing Bard's product portfolio, and an different device maker's products..

    Click "cancel" in the print window that shows up and you can read the article - https://www.generalsurgerynews.com/A...rticleID=34826

    Here is Bard's hernia repair portfolio - https://www.crbard.com/Davol/product...r+%26+fixation

    Here is another device maker's, Medtronic - http://www.medtronic.com/covidien/en...-products.html

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    • #3
      Thank you for this. I suppose at some point you h ave to assume the surgeon knows what he or she is doing.

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      • #4
        Originally posted by Dave Graham View Post
        I suppose at some point you h ave to assume the surgeon knows what he or she is doing.
        Put your effort in to verifying that what your surgeon is planning for you will actually work for you. Otherwise you're in the 1 of 6 category, generally. Like Russian roulette. 10 - 16% chance of chronic pain.

        Many surgeons are expert at getting the mesh implanted. It's the long-term results that are undefined. My surgeon had the best of credentials. But lost track of his patients after he was done so, as I found out later when I had problems, he could not say if past patients were doing well or poorly. Only that the surgery went well.

        Ask your surgeon if they know, based on communication with past patients, that their methods work for your planned activities. If they don't, then the risk is higher for you.

        Good luck.

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        • #5
          Good Intentions: Thank you for this. I believe you said your procedure was done laparoscopically? Do you suppose that made a difference in your case? From all I've heard, that is a complex procedure, with more chances of things going wrong than with "open". I am planning on open surgery, with only local anesthesia-keeping things as basic as possible..

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          • #6
            I really don't know. There is so much variation within each technique that,without tracking long-term results, nobody can say. There is TEP versus TAPP, the surgeon can use a small piece or a large piece of mesh, a 3D material or flat, lightweight versus normal weight, they can leave it unfixed or they can go crazy with tacks, they can place the mesh high or low or to the sides.

            Many of the same issues are present in open repair. Different types of mesh, device designs, placement, fixation, etc. That's why I think that it's best to make the surgeon verify that what they do is proven. Otherwise you're just their latest effort to get it right.

            Without high quality oversight from regulatory agencies or good guidance from professional organizations, it's just a crowd of individuals working on separate puzzles with a huge selection of puzzle pieces. You can't trust just a material or a method. Find a person who had a successful repair and get that exact repair from the same surgeon. Or find a surgeon who has known history of good repairs. But I wouldn't simplify it down to open versus lap, or assume that certain medical device will always give good results.

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            • #7
              Also lapracooic hernia repairs place the mesh behind the muscle while this in theory has some benefits it placed the mesh closer to one’s intestines (only the peritoneum is between the mesh and ones intestine. IAlso usually a bigger piece of mesh is used for a lapro repair so the mesh covers a bigger area, while this has some advantages like reinforcing the femoral area and indirect and direct hernia areas with one piece of mesh (open mesh only reinforces direct and indirect spaces) the mesh has more opportunity to mess with other structures.
              ooen repair also has its pluses and minuses-local anesthesi vs General for one.
              also consider non mesh repair no foreign plastic mesh being inserted-.
              And most of all whatever you do goto a specialist.
              for example some meshes seem to be better or worse for thin people etc. don’t seek out a general surgeon seek at a hernia specialist even if it may mean traveling etc. the worst thing that can happen is a surgeon messes up and now you have to pay the price with a piece of mesh in you causing pain.

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              • #8
                Originally posted by Good intentions View Post
                Without high quality oversight from regulatory agencies or good guidance from professional organizations, it's just a crowd of individuals working on separate puzzles with a huge selection of puzzle pieces. You can't trust just a material or a method. Find a person who had a successful repair and get that exact repair from the same surgeon. Or find a surgeon who has known history of good repairs. But I wouldn't simplify it down to open versus lap, or assume that certain medical device will always give good results.
                I would agree with the point that Good intentions is making here. Try to focus on finding an expert with a history of patient success.

                Good luck and keep us updated on your case and decision making.

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                • #9
                  Jnomesh, can u please elaborate on the pluses and minuses of open repair

                  Comment

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