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Dr. Bendavid Answers Hernia Questions

Dr. Robert Bendavid, Shouldice Clinic, Toronto

Mesh Medical Device News Desk, May 23, 2017 ~  Dr. Robert Bendavid is a leading hernia surgeon with Shouldice Clinic in Toronto, Canada. He also believes in non-mesh repairs for hernia whenever possible and Shouldice does not use mesh in its hernia repairs.  

Shouldice Clinic in Thornhill, Ontario, is the only licensed hospital in the world dedicated to tension-free and natural tissue technique for hernia repair. 

Please ask your question and we will attempt to have them answered here. This should not be construed as medical device and please always consult with a hernia mesh expert. 

Hello Mesh News Desk, Thank you for any information.

I had a left unguinal hernia surgery w. mesh 6 months ago. about 3 months after i did incur a sharp “ripping” pain when i did a heavy awkward lift. surgeon days he doesn’t feel any re-herniation. i have pain only sometimes, hard/heavy work related usually. the area of the hernia feels very different than prior to incident, prior to incident, i felt ‘great’. is there any actual test (ct, x-ray, ?? than can actual know for sure, or even if probable damaged ?? or, did i just “temporarily strain myself” ?? thanks… bill

Dr. Bendavid Replies: 

It always helps to  know what was exactly done in a way of mesh repair and whether the previous surgery was done through an open procedure or laparoscopically. Certainly, following mesh or mesh free repairs, after three months, there should be no limitation of activity. The onset of pain can and does occur on occasions, perhaps associated with heavy activity and may also take place whether mesh was used or not. Nothing is more accurate than a physical examination to confirm absence/presence of a recurrence. An ultra-sound may reveal a recurrence but they can be fraught with false positive/negative results. It would be wise to simply treat conservatively with heat, massage, anti-inflammatory medication for two-three weeks and avoid the activities which you know give pain. Often, the pain is due to adductor pain or lower rectus insertion strain. More and more, pain is being reported following mesh repairs and may contribute to a “chronic post-herniorrahphy pain syndrome”. Proper assessment should be made by a hernia specialist. RB.


Hello Dr. Bendavid,

Do you remove mesh from women? I have had a total of 3 inguinal hernia repairs, two on my left side (one laparoscopic and one open). I’m in chronic pain and the Dr’s really don’t care, and the ones that do can’t help you. I also had purple plastic found during my second left surgery. The Dr claimed that material could not have been from her. I had Dr Shirin Towfigh review my records (I live in Seattle) and she said that material has to be from the secure straps (or tacs?) used in my first left sided inguinal hernia repair. I believe that and the mesh are causing wierd problems. About a month after each surgery I had weird things happen. For example, I stared having panniculites in my inner thighs. I want to have the mesh removed, but I’m scared to make things even worse. Most Dr’s say mesh causes no problems.


Hi Jane (for your patient):

Mesh definitely causes problems. Not in everyone, granted, but when it does it can be quite the challenge. Since you live in Seattle, if you do not know anyone near you who has removed meshes (make sure they do not insert a new one after removing the old one… which often happens and doctors may convince you that the new meshes are lighter and cause no problem. They will if you have had issues with polypropylene) you could consult Dr Kevin Petersen in Las Vegas who removes quite a few and in fact has supplied me with many explants to study. 

It is difficult in Canada to do surgery on US patients as the system (State medicine) will not protect surgeons against any suits brought on by US patients. Also, in some states, patients can sue Canadian surgeons and hospitals from their hometowns! It is a conundrum. Your US insurers generally will not cover you for surgery outside the US unless that type of surgery is not done in the US! It would also have to be approved beforehand. Good luck. R. Bendavid MD.

Robert Bendavid
6:37 AM (2 hours ago)

 

Dr. Bendavid,

I am a 36 year old woman and was told yesterday in the ER that I have a small inguinal hernia. I was referred to a surgeon because the hernia gives me pain when I carry anything over 5 lbs. I was wondering which type of repair you think someone in my situation should receive?

I am worried because I have a three-year-old who needs her mother and also I very delicate skin. I react with rashes to many creams, wools, and some non gold jewelry. I was told this type of hernia is rare in women, mostly men set it. So, I would like to find an experienced surgeon who has repaired these on Women.

Do you recommend anyone in the Chicago area or in Illinois? I would prefer to just get sutured with no mesh, but I am worried it will. It hold. It so close to my uterus that I am really worried because I had always hoped for one more child. of coarse, I am more worried about my long term health and trying to avoid the horror stories related to mesh.

Please help. Thank you and God Bless you.

 

Dear Reader,

It is possible that you have a femoral hernia and that is present in 16% of women. The majority of female patients however have an indirect inguinal hernia (70%) which do not need mesh or a direct hernia as in 14% of women. If a femoral or a direct hernia is/are present, they may require mesh but there are safe ways to do it. Laparoscopic surgery does not represent a safe way to do it as it lays indiscriminately mesh against femoral vessels and bladder. An open technique would directly and accurately cover the defect only.

I do not know anyone in the Chicago area in particular. I do in New York. Many US patients consider that surgery in Toronto, when all is said and done, turns out to be cheaper than in the US. You may contact Ms Nancy Law at at nlaw@shouldice.com.

If you decide on New York, you may contact Dr Samer Sbayi at samersbayi@gmail.com. He did train with us and can be recommended.

Good luck. R. Bendavid MD, FACS.

 

 

4 Comments

  1. Denise S says:

    I would like a true answer to a question I have asked many drs…. should physiomesh hernia mesh have been used over a aortobifemoral bypass?? on a patient that never had a hernia, didn’t feel or look like I had hernia, over a 8yr old incisional hernia + uncharted umbilical hernia added to make 15×20″ ? Would just like an answer, should it have been done?

  2. Sue t says:

    I have had two umbilical hernia repairs. The first one via midline laparotomy with Atrium pro lite then when that failed a larger composite piece of parietex polyester mesh. I have severe right sided pain. I had a nerve block yesterday and the ultrasound showed tight scar tissue. The Dr has now said it’s either nerve of mesh pain. I want the mesh out as I also have translational mesh and I know the harm this is doing to my body. I had no pain pre
    hernia mesh inserted. WHat are the complications to remove apart from the usual surgical possible complications and what can it be fixed with after removal apart from porcine or any other mesh types. thankyou

  3. Jane Akre says:

    Dear Reader,

    Too many details are lacking to analyze what was done or why. What was the surgery for, exactly, when the Physiomesh was used? Was it a ventral, incisional hernia or even perhaps groin hernias? When was the surgery done since Physiomesh® has been recalled since last year?
    R. Bendavid

  4. Martin says:

    I had an inguinal hernia repair in 1999 whilst in my third and final year of a degree. I was given the option of a keyhole surgery with mesh. I opted for this over an open surgery due to the reduced recovery time. I lived an uneventful life until 6 years ago when my body started to do strange things. I began to suffer terribly with abdominal pain and my bowels were all over the place. There are days when I cant even put my own underwear on. I also feel as though I’ve been poisoned. All of my glands are up and I get major kidney pain. My mesh ID is missing from my records, as is the surgical report. I want my mesh out! it’s 15 x 12cm of degrading plastic that is reported to hold bacteria… How is it possible to verify whether it is the mesh thats doing this?

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