Did you have an inguinal hernia repair using a mesh?

Pretty much all hernia operations are done with mesh nowadays, especially for recurrence

@Caravanfan I just found a doctor in Florida that does mesh free hernia repair. Dr. Thomoas He only does mesh-free hernia repair and he’s done over 2000 of them with just local anesthesia. I hate to be knocked out completely.

I live in Tacoma, WA and don’t mind doing a little traveling if I can’t find a surgeon around Tacoma that will give me good treatment. And I don’t care if my two health insurance companies refuse to pay.

A hernia is when an organ departs from its normal position. Nutritionists say that is caused by a deficiency of B vitamins. Doctors have no training in nutrition so they don’t know that.

I often get challenged by some doctor who claims to be a registered dietitian. Doctors don’t even know the difference between a nutritionist and a dietitian.

Well I just read about the technique and it’s not one I would recommend especially for a bilateral recurrence but good luck!

The hernia repair without mesh looks good to me.

When my family practice doctor confirmed thatI have two inguinal hernias, I told him that I don’t want a mesh put in me. Then he informed me, “The surgeon will make that decision”. I said to myself, “No I will make that decision”.

20% of the patients who’s hernia repair was made using a mesh have problems (pain, infections, internal bleeding and surgery to remove the mesh.

Of course no surgery is without risk. Looks like the risk are less without the mesh. No problem if my insurance companies refuse to pay. I’m in charge of my health. Not the doctors. Not the insurance companies.

As I said good luck to you. I am just trying to give you the benefit of my experience (which happens to be substantial in this particular subject). You did, after all, ask the question. I’m sorry if you don’t like my answer.

@gondwanalon: Where did you get the statistic about 20% problem rate? That sounds unusually high and I always wonder if statistics come from a source that is not reliable (like attorneys offices compiled them).

@Caravanfan I like your answer (I hit the great answer button for you). I’m interested in the getting all the information that I can on this. Thank you for that.

@jca2 There is a lot of information on the internet about the negative aspects of plastic mesh. Med Truth says that studies have shown that more than one third of hernia mesh surgeries may result in complications. Some are serious (chronic infections, difficulty urinating, internal bleeding, chronic pain and erectile dysfunction).

@gondwanalon: If you look at the site (the link you provided, MedTruth), they are pushing attorneys. Therefore, to me, they’re looking for a problem so they can profit off it. I’d trust statistics that come from a more reliable source.

@jca2 Good idea.
I’ll keep reading more about mesh hernia repair. I hope to get my repair done this November. I’m making a list of the positive, negative and uncertain aspects of mesh vs non-mesh surgeries. I want to be in control and make the decisions. However if my hernia suddenly gets worse and I wind up in the ED, then I’ll take whatever methods the surgeon is comfortable with.

I’ll try one last time. Would you trust a hernia repair technique that is not peer reviewed, that only a few people appear to do, there is no data, and the guy who “invented it”? can’t even spell? And he needs a shitty website to try to push it? The technique is similar to ones that have been done for 50 years and have been largely abandoned in favor of more advanced techniques

http://www.desarda.com/

If it’s such a great technique, why aren’t more surgeons doing it? It’s not even particularly innovative.

I’m sure there are other mesh-free ones besides the one in your link, @Caravanfan. It’s not something I’ve ever researched but both with mesh and without are very common, so the man in your link is far from the only person doing any technique.

@jca2 The one in my link is specifically the technique the OP originally posted before the details of the question were edited.

@Caravanfan You make valid points worthy of consideration. You may wonder why I’m so nervous about this.

5½ years ago my longtime cardiologist in Seattle had given up my heart’s chances of ever beating normally again after a failed ablation and drug therapies. He wanted to ablate my heart’s AV and SA pacemakers and give me a man made pacemaker and keep me on drugs for life. I told him about a heart expert in Indianapolis who designed his own method of curing my heart’s arrhythmias and he had a 70 to 90% success rate. My cardiologist said, “Well you know what they say, if ir sounds too good to be true”. I did my research and went to Indianapolis for treatment. My heart has been beating normally without drugs ever since.

What do you see that is wrong with Dr. Thomas hernia repair procedure (link above). It is different from the two non-mesh procedures that I’ve had done in the past and is likely very unique as it uses the patient’s own muscle in the repair.

Thank you for your time and thoughts.

Okay, here is a list of what I think is wrong with it.

1) It’s an open technique so more painful, and you’re doing bilateral, so ouch.
2) You have a recurrence so your anatomy is going to be all screwy inside
3) His claims of mesh complications are wildly overblown
4) All he has as “proof” on his site are testimonials which are worthless (where are the testimonials of the ones gone bad?)
5) Your prior non-mesh hernia operations also used your own tissue and they failed.
6) Your experience with your arrhythmia is interesting, but has absolutely nothing to do with your hernia.

But my main issue with this is just that they’re basing their entire practice on fear. They are stoking your fears of standard hernia techniques so they can make more money. To me, that’s just appalling.

Edit: I did a pubmed search for “Desarda” and there are some small studies, but no RCT. They either demonstrate equivalence to Lichenstein techniques or slight improvement. I see no studies comparing with mesh technique.
https://www.ncbi.nlm.nih.gov/pubmed/?term=desarda

I still wouldn’t trust it, though.

I would go to three surgeons that you choose, and have a discussion with each one. Always get a second opinion, in this case, a third opinion. Talk about the pluses and minuses of each thing they suggest – the length of recovery time, the chance of recurrence, your personal issues and how they may go with each method (i.e. smoking, weight, muscle issues, etc.). Then you are armed with as much information as possible and can make your decision.

^^yup.

@Caravanfan and @jca2 Thanks you two! Very helpful. Good health!

Your surgeries lasted for a long time! I’m so happy for you that you were without hernias for so many years.

I did a quick literature search and it seems that mesh is the clear standard of care and does not have statistically different outcomes (infection, quality of life, etc.), other than recurrence. The inguinal hernia recurrence rate in one study was 7% without mesh and 1% with mesh. That was from surgeries in the late 1990s and I’ll bet the rates have slightly improved since then. There are many meta-analysis studies that show no difference in outcomes other than recurrence.

I think a very valuable conversation (with a surgeon) to have here is about the different types of mesh used and how surgical approaches have changed over time. There are certainly benefits of only having local anesthesia… so that’s another useful thing to discuss. I would be a bit wary of a surgeon who ONLY does surgeries without mesh, because that is contrary to the standard of care. In an of itself, that is probably not a huge deal. But what other practices do they not follow that are standard? Do they scrub in for the surgery? Use an antibiotic wash? Etc. I believe fully in clinical decision-making (instead of a robot-like adherence to clinical guidelines/best practices)... but not EVER using mesh does not appear to be clinical decision-making, but rather an unwillingness to follow clinical best-practices, which is concerning to me.

I am a public health researcher (focusing on provider implementation of clinical guidelines) and would be happy to provide you with some studies or help you to interpret findings or the patient population to see what may be most relevant to you… just let me know if that would be helpful.

Good luck! From my very brief lit search, I think that the complication rate may be blown a bit out of proportion in the media/lawyers. But in full disclosure, my husband had 2 mesh surgeries in his abdomen and he’s done great (it’s probably been 7 years).

Thanks for the helpful information that indicate mesh hernia repair is actually not so horrible as claimed by some sources. @Caravanfan above has given me a few studies that show the effectiveness of mesh vs non-mesh hernia repair. Form what I’ve read, I understand that there is isn’t a significant amount of difference in the two with successful outcomes.

I would like to see more mesh vs non-mesh hernia studies.

I included my experience with my cardiologist above not because there is any relationship between my heart problem and an inguinal hernias but because it shows that experts in healthcare with all the tools at their fingertips can make poor decisions. If I trusted the cardiologists at Swedish Cardiology in Seattle to give me the best care then I would be permanently physically crippled and prone to having strokes. But I found a doctor out of State who had the skills and desire to cure my heart arrhythmia not just manage it. Now I’m a very active 68 year old who competes year round in outrigger canoe races. And I feel terrific! I’ll be competing in the World Sprints in Hawaii next year (and many long distance races all up and down the PNW and Hawaii this year).

Also no one here has said anything about how effective wearing a hernia brace is. I’ve looked a few and I like This one best. It’s made for athletes and works well when it gets wet. The inventor even claims that it cured his inguinal hernia. Worth a try for under $80.

@gondwanalon No, I absolutely didn’t write that. I gave you a couple of studies comparing different non-mesh techniques. I specifically said that there are no studies comparing this technique with mesh.

What @Cupcake wrote is absolutely correct. Mesh is standard of care because the recurrence rates are much lower, pain is better, and time to work is faster. Hernis braces do not cure hernias.

@Caravanfan The link that you gave me contains a few studies that absolutely do compare mesh vs non-mesh hernia repairs. I try to understand what you are telling me but you offer me conflicting information. Thank you for your efforts though.

Oops, you’re right. My mistake. They’re still open techniques, though and not modern laparoscopic techniques which have far less recovery time.

@Caravanfan You really have been very helpful. Can’t thank you enough.

I’m going to try hernia brace. Couldnn’t hurt and may help when I’m canoe paddling, I’m constantly hinging and twisting at the waist. Toward the end of my workouts I sometimes get a slight cramping feeling in my left inguinal area. If I stop paddling and massage the area the cramping goes away (for a while). Nothing ventured nothing gained.