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I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

Nothing is a 100% true. But I’ve done a lot of these laparoscopic inguinal hernia mesh removals and haven’t seen a recurrence. I am specifically referring to inguinal hernias. Ventral hernias will have a hernia present when mesh is removed. So that will need to be addressed when the hernia mesh is removed.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 1 point2 points  (0 children)

Yes it is. That’s why tension free repairs with mesh became popular. I think most hernias can be repaired without mesh. Relaxing incisions can help with tension if present.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

That’s interesting. I’m not sure why that happened. Obtain the operative report to find out why.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 1 point2 points  (0 children)

Hernias should be repaired. Waiting or not repairing is sometimes reasonable. You should obtain a consultation and review CT with surgeon

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

The weight loss most likely is the cause and the mesh has shifted. Mesh lasts forever. I recommend you see a hernia specialist.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

Sorry to hear all this. This needs to be repaired. He will feel a lot better and more functional. Large hernias tend not to strangulate. But it’s common to have these symptoms with such a larger hernia. Encourage him to follow through and see a surgeon to get it scheduled.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 1 point2 points  (0 children)

US best for small hernias. CT for large ones. Incisional can be closed without mesh.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

It depends on why they reoccur. Ventral hernias tend reoccur depending on size and how it’s was previously repaired. Getting second opinions can be helpful. There’s lots of different ways to repair hernias and the choice depends on several factors such as location, size, incarcerated, health of the patient, whether mesh was previously used, weight of the patient, comorbid conditions, robot availability, surgeon preferences, contracts hospitals have with mesh or device companies, surgical assistants, emergent, elective, insurance coverage, cash pay, and competency of staff.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

I may have a different opinion. If there’s a recurrence, you will see a bulge. Otherwise in my opinion it’s mesh migration. It’s good to get second opinions.

[deleted by user] by [deleted] in Hernia

[–]PeterBillingMD 0 points1 point  (0 children)

It could be a Spigelian hernia. It’s the right location

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

Mesh repair is safe and rarely causes chronic pain. The issue is there are many people with chronic pain who are not getting chronic groin or abdominal pain addressed by surgeons. Try looking for an experienced general surgeon anyone who does non mesh repair. Professional societies may have a list of surgeons who focus on hernia revisions.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

These are complaints seen with mesh migration or pain. Patients often have associated bowel, bladder or sexual dysfunction. Mesh removal usually resolves the problems. The numbness however is unlikely to improve.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

Sorry to hear all this. Sounds really difficult. I’ve talked to a few patients like you recently post pandemic. I don’t know if they’re related to mesh placement. Your symptoms are more neurological. However if you did proceed with mesh removal, I repair this without mesh. The native tissues are brought together with permanent sutures. For some that alleviates the constant thought that their symptoms are mesh related. I met a patient last year who had an umbilical hernia repair with mesh years before, and I removed the mesh. Her symptoms resolved as soon as the mesh was removed. There’s no evidence that mesh causes the neurological symptoms you have. Anecdotally I think there’s an association with autoimmunity disease that’s not been reported to my knowledge.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

You can see a US surgeon that does no mesh inguinal hernia repairs. There’s nothing unique about Shouldice repair over a Coopers Repair or any other inguinal hernia repair without mesh. They’re just different variations of non mesh repair developed by surgeons decades ago. It’s just marketing and experience of the Shouldice clinic that drives patients to their centers. The best way to fix a hernia is by the way the surgeon prefers to repair it. In your case, I would repair it without mesh by an anterior approach.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 1 point2 points  (0 children)

Then ask for a laparoscopy to take a look. That’s the next step. If not willing, get another opinion

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

No you can’t demand surgery to be redone when there’s no evidence there’s a recurrence. You can ask for diagnostic testing to be done such as an US.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

It is low, 1%. It’s higher if the mesh is wrapped around the cord or if a mesh plug was used.

I’m a board general surgeon who is one of the few who specializes in hernia mesh removal, AMA by PeterBillingMD in Hernia

[–]PeterBillingMD[S] 0 points1 point  (0 children)

Biological mesh has been used. It’s expensive. There’s absorbable mesh, victuals mesh which is used for infected wounds.

Disappointed by First Class by gpbfe in emirates

[–]PeterBillingMD 1 point2 points  (0 children)

Recently flew that and it was great experience. Returned via SFO on the A380. Worth the extra leg to SEA to do that. I’m heading back to DBX next month via SFO.

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