I often get asked whether the Shouldice or the Bassini is the best method for repair of umbilical hernias. This represents a misunderstanding about hernia repairs. The Shouldice and the Bassini are methods to repair inguinal hernias but have no place in the repair of umbilical hernias. For umbilical hernia repair, there are two basic methods. The first is a pure tissue repair and the second is the use of mesh.
Pure tissue repair uses sutures to close the hole. This can be a primary closure or a layered closure such as pants over vest. The pure tissue repair has the best results for small hernias (less than 3 to 5cm) and in patients with a normal BMI.
Unfortunately, for large umbilical hernias mesh has to be used to get the defect closed. The mesh can be placed to cover the hernia or placed on the peritoneal side of the…
Trudy Lieberman recently published an article about the economics of the use of mesh in Harpers’ magazine. (I contributed to the article). She outlines the huge amount of money involved and the fact the mesh companies have paid hospitals and doctors to use mesh for hernia repairs despite the well know and documented problems of pain, shrinkage, sexual dysfunction, and nerve damage. I wish it was not true, but money does influence decision-making even if the patient suffers.
Download Article Here
Dr. Amir Jamali is a Board Certified Orthopedic Surgeon with offices in Walnut Creek and Sacramento.
He has specialized training in Sports Medicine. He will take good care of you. I highly recommend him.
Dr. Amir Jamali
100 N. Wiget Lane Suite 200
Walnut Creek, CA 94598
As you know, I have been against the use of mesh to repair hernias for 30 years. I am happy to report that the governments are starting to realize that mesh is a serious problem.
Australia is the first government to respond to complications and often debilitating complications related to the mesh.
In December, all surgical mesh – including hernia mesh – was reclassified from “medium risk” to “high risk” for potential adverse reactions.
All patients with surgical mesh operations must now be given a leaflet and implant card warning about the mesh’s potential risks.
I hope patients will use this information to push for more pure tissue repairs.
Contact me if you have any questions about your hernia.
Bill Brown, M.D.
Sports Hernia Patients and Classic Hernia Patients and Hernia Mesh Removal
Autoimmune diseases occur when the body’s defense system mistakenly attacks the normal cells of the body. This can result in chronic fatigue, myalgias, joint pain, irritable bowel, rashes, and more. It has been suggested that the inflammation caused by the implantation of mesh causes the body’s white body cells and foreign body cells to become overly active and thereby causing autoimmune disease. There are several studies that followed patients after mesh hernia repair. These surgical patients did not develop autoimmune disease at a rate any higher than the general population. This would suggest that mesh is not a cause of autoimmune disease. But the studies did report that if a patient has multiple allergies before surgery they are at increased risk to suffer autoimmune disease after mesh hernia repair. If you already have an autoimmune disease, then you should…
Last month I removed some interesting pieces of mesh
In Photo 1, the patient had had a laparoscopic hernia repair about 12 years ago. Lightweight prolene mesh was used. He started to have pain 8 months after the operation. He tolerated the pain until he fell with a twisting motion late last year and then the pain became debilitating. Rest, Steroid injections, and analgesics were not helpful. As you can see from the photo then flat mesh had scarred into a complicated three-dimensional mess. No wonder he was having so much trouble with that lump of mesh. So far he is doing well.
In Photo 2, the patient had a laparoscopic hernia repair 4 years ago. Six months after the operation he noticed a bulge and pain. Physical examination and ultrasound documented a recurrent inguinal hernia. At the time of surgery, the mesh did not completely cover the inguinal floor.…