Hernia Mesh -?

The Garage
#1

G’day,

How’s things?

So, I’ve debated posing this Q on here for a while, and - well - here goes.

I have a small hernia that requires some repair work. Due to plenty of negative press over the past 1-2 years regarding hernia mesh implants (leaving patients with blocked bowels, and chronic pain), and the fact that it is incredibly difficult to remove once installed, I’ve been researching the topic pretty thoroughly.

From studies performed in both Europe and the USA for hernias of a similar type to my own (umbilical, less than 1cm), mesh does improve outcomes (around 5-7% less chance of recurrence than using sutures alone), however it also carries around a 5% likelihood of complications as noted above.

In my mind - it’s a no-brainer - the benefit does not outweigh the risk.

When I raised this issue during my surgical consult, whilst the resident (?) seemed understanding to my concerns, especially when I revealed I wasn’t basing my opinion solely on A Current Affair, but backed up with actual studies, the surgeon himself was quite submissive of the issue. I didn’t want to be “that patient”, so at that point said I was happy to defer to his experience, however my preference was no mesh. The surgeon then wrote up my “surgical plan” - and stated he would use mesh and suture. The intern actually commented on this, and made a side-note about mesh only to be used if required.

That left me very much feeling like the surgeon has no intention of respecting my wishes.

My surgery is meant to happen sometime in the next 2 months. I have the day off work, and am now awaiting calls from Vic Health’s “patient rights” person, as well as the actual hospital’s patient liaison officer. I simply want to verify that I do have the right to say - NO MESH - and be heard and respected.

Yes, perhaps there’s a degree of paranoia around this issue. I know that hernia repair is one of the most common procedures performed by surgeons, but I’m the type of person that these things happen to…

cheers

cosmic

#2

You absolutely have that right. It’s your body. But you may not get to say that if they start the procedure and then decide they need it.

I’m working on the assumption it’s a public procedure not private insurance (i.e. choose your own surgeon who will respect your preferences)?

It may be a case of the only way to guarantee it doesn’t happen under the public health sector is to not have the surgery.

#3

Yes, public system…

#4

I just recovered from hernia surgery here in NZ. No mesh was used, in fact the surgeon was dead set against it from the start. This was for a stomach hernia (double - rolling / sliding). You should have options to have the repair done without mesh, but you’ll need to get through the registrar to the actual surgeon to have a meaningful conversation about it.

#5

I ended up talking to the hospital’s “Patient Liaison”, who flagged it with the surgeon. Had an appointment with him today, armed with two 10,000+ patient studies that indicated that mesh in small umbilical hernia repairs only marginally improved outcomes, plus added risk of complications (albeit small %).

After checking the hernia again, he has agreed to perform a suture only repair - no mesh - and agreeing that in my case, mesh would only provide a small benefit. If down the track the hernia does require further repair, then mesh would be a given.

Great relief on my part…

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