"I recently got a call from Sam, a friend in Florida. He asked, “I have a small hernia. What should I do?”
I told him, as I always do, I’m not a doctor but you can do your homework and that includes understanding what are the various different alternatives to mesh? You should investigate all alternatives and see which are the most appropriate for you, individually.
That may be a tissue repair using suture.
If you have a small primary hernia you may want to talk to a specialist who can take care of that with a pure tissue repair and those options are Shouldice, Bassini, McVay, and Desarda - the four well known types - and you may find a surgeon in your area who does one or you may want to travel.
One place is the Shouldice Clinic in Toronto the Gold Standard where Ralph Nader went, the consummate consumer advocate, so you may want to consult with these alternatives before you settle on the mesh.
Mesh is the standard of care but that doesn’t mean it’s for everybody.
Near you there is a surgeon you might consult in Fort Lauderdale, Jonathan Levine, MD, a general surgeon at Holy Cross Hospital in Fort Lauderdale who has done Shouldice repairs and Dr. Kevin Petersen in Las Vegas, he’s got five stars on Health Grades.
Sam said his was a workers’ compensation case and he was given a referral to a guy who does mesh. That doctor told him they don’t use the recalled products anymore they have a new product and it’s a new type of patch, not a mesh.
I explained to him it’s still a mesh and he’s not doing anything wrong in the sense that he’s lying to you, he’s trying to diminish the anxiety you may feel because mesh is the standard of care and it has a higher positive efficacy. We have to be honest about that. According to the FDA and manufacturers, there is at least a 70% success rate in the short-run, but at the same time he should be telling you about alternatives and giving you the choice to make an educated decision.
I explained to Sam that the doctor is not being forthcoming. I’m not saying that he’s doing that just to get your business, but the doctor should be giving you the choice of what to do. And if that means avoiding a foreign body implant that can ultimately hurt you, you should be making that choice not him. I told Sam to find out what product the doctor planned to use.
When Sam called back he said it was a 3D Max (made by Bard Davol) and the doctor told him it was made out of polypropylene.
I told Sam it’s not new. Polypropylene has been used since the 1980's and that’s the main culprit in the majority of injuries. Sam said the doctor said the mesh is permanent, it can’t come out, but it remains soft, comfortable, and you won’t feel it. It stays that way.
I told Sam that’s not true! Polypropylene mesh is proven to degrade, migrate, wrinkle, stiffen, and turn into a meshoma you will feel for the rest of your life so I highly recommend you go for the consult (with Dr Levine).
Sam told me he couldn’t take off time from work. I repeated 3D Max has a lot of complications reported to the FDA. It’s a commonly complained about product. You can look it up on the FDA’s MAUDE database.
Do I feel he wasted my time?
No. I understand because I went through it the same thing. I saw over 40 surgeons who all insisted on mesh and also refused to acknowledge the original mesh surgery was the cause of my pain or injuries when in the end it was proven it was.
So, for me, I wasted two years, putting up with that denial, visiting doctors who are in denial, or who otherwise enjoy the profession of putting in foreign bodies in that can potentially harm someone without informing of the potential side effects.
There is something unprofessional about that. That is not responsible medicine to do that. If the individual comes back after being educated, that’s their choice, it’s not the doctors’ fault if the person is educated.
That’s why in lawsuits you hear the question - When did you first hear mesh might be your problem? Did you do any internet searching before your repair so you might have seen this could happen, so you were informed? People don’t realize that so they ruin their own case.
So this doctor did not provide adequate informed consent in my opinion.
By his explanation - he tried to explain it away by saying I detected you were anxious about this and I wanted to diminish your anxiety, I placated you because I didn’t want you to run scared.
But that’s not his choice to make that decision. That’s the patient’s choice whether or not they want to run scared. This person has a small primary inguinal hernia so he may able to be stitched up. And if it doesn’t work out he can always get a mesh the second time." ###
Bassini repair technique (here)
Shouldice Hernia Hospital (here)
Desarda Repair (here)
McVay hernia repair (here)
Dr. Jonathan Levine, Holy Cross Hospital, Fort Lauderdale surgeon
MDL Bard mesh, Southern District of Ohio, 2:18-md-2846 Davol, Inc./ C.R. Bard, Inc. Polypropylene Hernia Mesh Products Liability Litigation (here)
There is also a consolidated State Court ,C.R. Bard / Davol Inc., lawsuit pending in Providence, RI Superior Court. The Rhode Island 3dMax hernia mesh lawsuit allows those victims who have missed a mesh deadline (statute of limitations) an opportunity for an extended 3dmax mesh statute of limitations.
Hollis Law on 3D Max Mesh
Mesh News Desk, April 16, 2019, Hernia Mesh Secrets: Bruce Rosenberg Answers Hernia Patient Questions After Complications
Mesh News Desk, January 14, 2019, Sen. Rand Paul Chooses Shouldice Clinic for Hernia Repair
MND, Dr. Bendavid tells Parliament adverse events are under-reported, October 2017 (here)
MND, Hernia Mesh: The Debate and the History, October 2014 (here)
MND, Women May Not Always be Candidates for Surgical Mesh, April 2013 (here)