Announcement

Collapse
No announcement yet.

Paper: "Why we remove [hernia] mesh" by Dr Shirin Towfigh

Collapse

Top of page, responsive

Collapse
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • Paper: "Why we remove [hernia] mesh" by Dr Shirin Towfigh

    Another new paper by drtowfigh and colleagues has been published on yet another important topic; hernia mesh removal.

    The paper is titled "Why we remove mesh"

    https://link.springer.com/article/10...029-018-1839-4

    The particular research paper covers 105 removed mesh implants and is certainly interesting discussing the 'why' of hernia mesh removal. Unfortunately there isn't any patient outcome data provided (visible in the free abstract anyway) but hopefully a follow-up paper would include that, or perhaps Dr Towfigh could provide some insight on her own if possible.

    Anyway, apologies for flooding the forum with several new topics on various papers, but I find this information valuable and therefor worthy to share.

  • #2
    Itís been a busy month or so...

    Correct, this paper was not intended to be paper about postoperative outcomes, rather of preoperative workup and indications for mesh removal. One goal was to share our experience with the relative incidences of the various indications for mesh removal, with insight into whether specific types of repairs, mesh, techniques, or other clinical factors stand out among them. Also, in doing so, we were shocked to see a trend toward more patients requiring mesh removal after laparoscopic repairs and also more patients showing up with systemic mesh reactions.

    We will followup wirh an outcomes paper soon.
    #ItsNotJustAHernia
    www.BeverlyHillsHerniaCenter.com

    Comment


    • #3
      drtowfigh

      Thanks, I will share this paper with the surgeon who removed my mesh recently, who in fact is a devotee of Dra Towfigh.

      Another contribution of my surgeon Dr Prof Moreno Egea about a case of autoimmune disease and scleroderma due mesh reaction, with removal, who also quotes Dra Towfigh. Spanish, English (abstracts):

      http://www.sohah.org/wp-content/uplo...nia_Moreno.pdf

      Comment


      • #4
        Yes. I wrote a Chapter in our book that specifically addresses autoimmune diseases and mesh use.

        The book is the SAGES Manual of Groin Pain. You can click on its link on our homepage to buy online.
        #ItsNotJustAHernia
        www.BeverlyHillsHerniaCenter.com

        Comment


        • #5
          Originally posted by drtowfigh View Post
          Itís been a busy month or so...

          Correct, this paper was not intended to be paper about postoperative outcomes, rather of preoperative workup and indications for mesh removal. One goal was to share our experience with the relative incidences of the various indications for mesh removal, with insight into whether specific types of repairs, mesh, techniques, or other clinical factors stand out among them. Also, in doing so, we were shocked to see a trend toward more patients requiring mesh removal after laparoscopic repairs and also more patients showing up with systemic mesh reactions.

          We will followup wirh an outcomes paper soon.
          Thank you dear dr drtowfigh for coming the right side of the battle..Would you consider to start petition to stop using mesh in the hernia repair..we all will support you! ..Myself i have a thousands followers :} Get media attention .....

          Comment


          • #6
            Thanks for the message. I like to deal with issues scientifically and with an open mind.

            I do not support abstinence from mesh repair at this time. Thatís technically not possible. We do need better technology and some companies have a mission to develop them.
            #ItsNotJustAHernia
            www.BeverlyHillsHerniaCenter.com

            Comment


            • #7
              Originally posted by drtowfigh View Post
              Thanks for the message. I like to deal with issues scientifically and with an open mind.

              I do not support abstinence from mesh repair at this time. Thatís technically not possible. We do need better technology and some companies have a mission to develop them.
              Dear
              drtowfigh ... Just wondering how technically was it possible before mesh was invented ? ..Term." groin pain " complication after hernia repair has become almost common from the time of that great invention...
              Last edited by dog; 1 week ago.

              Comment


              • #8
                I think the future should be something like taylor made mesh with autologous stem cells culture in a cell matrix, stimulating the right type of fibers (through CRISPR or whatever). But it sounds like Sci-Fi.

                But the nerve entrapment will remain a problem.

                Comment


                • #9
                  Honestly, it seems like skilled surgeons performing anatomical reconstruction does the job a lot better than any mesh will...

                  Comment


                  • #10
                    paco great idea. Now have to make it so itís cost effective. After breast surgery, hernia surgery is the poorest reimbursed field in general surgery.
                    #ItsNotJustAHernia
                    www.BeverlyHillsHerniaCenter.com

                    Comment


                    • #11
                      dog it wasnít possible technically possible before synthetic mesh so most lived with their hernias, no matter how disabling, and could not be offered a repair. People were maimed by other techniques and complications of open tissue hernia repair. Use of the darning technique caused fistula and erosions and chronically draining wounds. Surgeons were harvesting fascia from the thigh to treat abdominal wall hernias. This worked about half the time for the hernia, and the fascia harvesting left a disabling set of complications to the leg, including nerve injury. Deformity was more common. Testicle loss was more common. Scars were enormous.

                      It wasnít a rosey picture before mesh.
                      #ItsNotJustAHernia
                      www.BeverlyHillsHerniaCenter.com

                      Comment


                      • #12
                        Originally posted by drtowfigh View Post
                        dog it wasnít possible technically possible before synthetic mesh so most lived with their hernias, no matter how disabling, and could not be offered a repair. People were maimed by other techniques and complications of open tissue hernia repair. Use of the darning technique caused fistula and erosions and chronically draining wounds. Surgeons were harvesting fascia from the thigh to treat abdominal wall hernias. This worked about half the time for the hernia, and the fascia harvesting left a disabling set of complications to the leg, including nerve injury. Deformity was more common. Testicle loss was more common. Scars were enormous.

                        It wasnít a rosey picture before mesh.
                        Not to mention, from a purely practical standpoint, it could easily be a decade or more before there could be a sufficient number of surgeons trained in tissue repairs. First, the small number of surgeons proficient in such techniques would have to train other teaching surgeons. Then, those surgeons would have to begin training fellows and residents, who could then begin training the next batch of fellows and residents. Overall, it would require a significant lead time, no?

                        Comment


                        • #13
                          Originally posted by drtowfigh View Post
                          Also, in doing so, we were shocked to see a trend toward more patients requiring mesh removal after laparoscopic repairs and also more patients showing up with systemic mesh reactions.

                          We will followup wirh an outcomes paper soon.
                          Does this have to do with the laparoscopic technique in and of itself, and how such meshes are implanted/affixed, or the fact that the mesh is placed inside the abdominal wall, as opposed to outside of it?

                          Comment


                          • #14
                            Dr towfigh... also as more meshes were removed to systemic reactions as time went on was there any underlying Common ground as why those pts developed these reactions

                            Comment


                            • #15
                              Originally posted by drtowfigh View Post
                              dog it wasnít possible technically possible before synthetic mesh so most lived with their hernias, no matter how disabling, and could not be offered a repair. People were maimed by other techniques and complications of open tissue hernia repair. Use of the darning technique caused fistula and erosions and chronically draining wounds. Surgeons were harvesting fascia from the thigh to treat abdominal wall hernias. This worked about half the time for the hernia, and the fascia harvesting left a disabling set of complications to the leg, including nerve injury. Deformity was more common. Testicle loss was more common. Scars were enormous.

                              It wasnít a rosey picture before mesh.
                              These are medical emergencies, rare complications. Mesh, however, is now used for every garden variety hernia. There are surgeons now who will use mesh as an absolutely last resort. Those are the ones I would suggest going to.

                              Comment

                              Right rail skyscraper

                              Collapse

                              Bottom of Page

                              Collapse

                              Sages Manual Banner

                              Collapse
                              Working...
                              X