Okay, more questions from me. If you decide you don't like the mesh systems and want to go with a single layer of mesh, which kind seems to be the best. I'm reading about so many of them shrinking. Good Lord, of course that's going to cause pain. I don't like the idea of Gortex being implanted inside the body but is there one that works better than another or are there problems with all of them. I'm still thinking the old fashioned way is the best. My father had a repair done 50 years ago and never had another problem with it. He had a small one done just a few years ago with mesh and continued having pain. I was seriously considering talking to my son about going to Toronto for the surgery then realized, we don't have our passports.
Anyway, if you have to go with mesh, which type of single layer mesh seems to work the best without shrinkage? Honestly, the more I read the more frustrated I become. I can't thank the people on here enough for sharing their experiences and knowledge.
there are still surgeons here in the U.S. that don't use mesh, look back in previous posts here on this site. I would look into Dr. William Meyers In Philadelphia or Dr. Kevin Peterson in Las Vegas.
I think you should weigh ALL of your options. Doctors enjoy pushing their types of mesh because they are either spokespersons for the mesh manufacturer or don't know how to do a pure tissue repair correctly. I have had both and the mesh needed to come out while the pure tissue repair is holding some 30 years after it was done.
Tuesday 06/16/09, 4:09 c-time. Hi Anonymous, This is Lin, Question for you??? What did you do for 30 years to keep you from getting a recurrence of an another hernia?? I had my first Ventral Hernia with entrapment in 2003 after two c-sectionals in 82 and 87. Any one else or doctor ; Here I would like information, Reading the forums daily, I haven't seen or come across any other posting like this, here goes I have an outie navel,it's been that way ever since a child, got worst with pregencies, then when the first v-hernia was so called repaired the navel was never fixed. So now I have a incission from under breast bone to the navel then from under the navel to pubic for the c- sections, and in between the bellie button or navel sticks out Is their no fixing the navel it self, after or with open ventral hernias??? Next question how much gas or air do surgeons pump into the void when enlarging the area of surgery??? How much fluid does one obtain with a hernia?? I have become obese, from this second recurrent hernia,because of fluid retension, told not to do alot of begin on the feet activitices. so weight gain..to much. How does a surgeon know how much mesh patch to use when the area has been filled with gas,and the person has gained weight more then what they normally would of weighted??? here I want know after surgery if person been over weight and looses all the weight they had put on during the hernia will the lose of weight change the tension of the mesh and stiches..Does weight lose and gain stretch on the mesh as it desolves and knits the tissue back together?? How does surgeon know how much tension to use or put on tissue with these factors??? Last question when the open tension technique was used on myself Mayo vest over pants. Why I don't know ???? When I had the other two prior surgeries.... which I know the surgeon had too had known that I was in the high recurrence field doing the surgery this way..as in his patient consultation he said he was going to use Gore tex product... I had a co worker that had same surgery I don't know if the same surgeon but he had the defective Devoul mesh put in him with the wire breakage in him.He had surgery 6 monthes before me.and he was waiting for county red tape to get indigent help to get it taken out....but in the county where this happen in Florida you cann't owe any kind money to the county or have any kind record with the county....this is no crap..... So now being frustrated /confused the mesh supposed to been the answer for the high recurrence of open tension surgery. Now even the mesh being rejected by bodies,,,, how is one not to become confusing over it all, and it seems like our government is not doing anything to protect us.... So now what is the best mesh or technique to be used in a recurrence of ventral hernia being this will be 4th surgery, second hernia repair.... also does Adrenal Fatigue stress have any play on the muscle tissue weakness???? I has seen something over the past weekend on the topic of adrenal fatiguel stress,and how it can monkey up your system. Do all meshes get stitched down??? I read that some dual systems, that one part just gets placed in and muscle tissue holds it in place. If this is true,what keeps it from wrinkling and bunching all up?? Need answers before going under the knive, I cann't afford to keep going through this every five years. I belive in my own self that my hernia was coming apart in the first year but was lied to about it, because the county didn't want to repair what their own county Surgeon messed up to begin with....
it is well known that pure tissue repairs of the past had a 20% failure rate. This means that 80% of patients didn't get a recurrence. Your father is in this group. This rate however, is MUCH too high. 1 to 2 % is the reported rate of recurrence for mesh repairs of inguinal hernias. Also, the non mesh repairs are associated with a higher level of post op pain because of the tension created with a suture repair. So let me ask you, do you want a 20 % recurrence rate with a non mesh repair or a 1 to 2 % rate with a properly performed mesh repair? The answer is easy for the majority of hernia patients in the USA, they select a mesh repair. I don't know what your pain is from. It may be from bad technique with your hernia operation rather than the mesh. I think your son should have a mesh repair.
I, too, read the research to say that mesh produces lower pain complication rates as well as lower recurrence rates. I also read the research to strongly suggest that laparoscopic surgery produces lower chronic pain rates in types of hernia surgery where it's deemed appropriate (which includes most typical inguinal hernias). This interpretation of the research is, no doubt, arguable, but I'm basing at least some of my thinking on a 2007 review of 12 large-scale studies done since 2000.
Yes, pain complication rates, sadly, remain as high as 34% in some studies, and at the low end 10% -- neither of which is good enough. Yippee, we've lowered recurrence rates, but now, due to the fact that way too many "local" surgeons are doing hernia surgery and due at least in part to the methods we've used to lower recurrence rates, we've increased the difficulty of addressing the damage created when poorly designed and installed synthetics have problems. Removing a plug and patch or a hernia system, for example, if there are problems, is complicated and damaging. Thus, I would vote for mesh-only done laparascopically by a very experienced and well respected surgeon (i.e., recommended by many).
And, just for the record, The Shouldice Hospital's recurrence and pain complication rates are very low. The problem overall is a lack of skill and current knowledge on the part of too many local surgeons.
So, the challenge is to find a very experienced and reputable surgeon. Tell your son it's worth traveling to get the job done right. I would consult with various surgeons by phone to get their view of which mesh the prefer and why. Some people like the lightweight meshes, while others feel they wrinkle too easily. There is also solid research about shrinkage rates. Given where you live, I would consult docs at the Hernia Centers at Columbia and the Univ. of Maryland, among others.
Jeff - Given the issues with shrinkage, etc. is there a particular type or brand of single layer mesh you would go with? Let me ask you this also. If you have a mesh-only repair and have problems, can you then go to a tissue repair as done at Shouldice or is it too late then? Is Shouldice not an option for you at this point?
Okay, so if he decided to go with a mesh and has also decided he doesn't like the dual layer mesh systems, which type of single layer mesh would you use/recommend? Honestly this new Ethicon system seems a little too much like the plug and patch to me and he feels more comfortable going with a light weight, single layer mesh. However, in reading about shrinkage, etc. it sounds as though there are problems with so many of the meshes out there. I realize this is a small percentage of the people who have problems. However, that is no comfort when YOU are one of the ones in that small percentage. I know because I'm a small percentage of the population who's had lifelong problems related to another issue and the fact that MOST people never had problems doesn't make me feel any better. I would like better options than that for my son.
I just tried to post a reply and the system ate it. It was too long to redo, so here's the gist...
Lightweight has lower shrinkage. Other than that I don't have specifics for you. Hernia MD has written about a specific lightweight mesh he likes based on shrinkage research.
As for your question about pursuing the Shouldice method after use of mesh. Yes, it's possible. GDSM and Nixa Man, posters on these boards, have had this done by Bill Meyers and Bruce Ramshaw, respectively, due to negative reactions to mesh. The Shouldice hospital definitely won't deal with you after what I've been through, because there's now too much tissue and other damage to allow for the suture-only method to work.
Hi, In researching about repairs, I have read on doctors / surgeons reports, that recurrence on open or tension repairs are alot higher then what you stated, Has this dropped over the years??? Also are most of the mesh patch problems related to one type hernia then on any other type hernia???? I just don't want go through what others have with mesh system....
Seth,
There is NO evidence that parietex shrinks less than UltraPro in humans. It is documented that parietex is the only mesh on the market where adhesions have been shown to increase over time.
First off, you need to show respect to people on this board. Secondly, it has been well documented that polyester meshes have adhesions that increase over time. This mainly relates to meshes placed in the abdomen for ventral hernias. All of the other meshes do not form additional adhesions after about 2 weeks post op. Surgeons today will use polyester meshes in the abdomen with an adhesive barrier. These barriers are not perfect and go away after about a month. Parietex is not a bad mesh, but it is far from perfect. You should check on some of the research done at the Carolinas Medical Center by Dr. Todd Heniford's group. They have produced the most data on mesh and the newer lightweight mesh. I have spent some time there as well studying under Dr. Heniford. I stick with only what I know on this board.
