where every meal is exactly the same, no matter where you go.
It's important to maintain a historical perspective. The reason we
moved to mesh repair for hernias in the first place is that patients
who underwent open tissue repair were having chronic pain, slow
recoveries, nerve injuries and high recurrence rates. The idea was that
patching the hernias, as opposed to sewing them closed, would pre-
vent the need to cut muscle or suture tissue tighter than usual.
There are risks for mesh-related complications, yes, but non-mesh
repair has its own share of risks, with similar chronic pain complica-
tions. Offering non-mesh inguinal hernia repair may be a good thing
for some patients, but not for most. Choose the least invasive opera-
tion with the lowest risk of complications, as tailored for each patient.
Sometimes, that means using a mesh product. Sometimes, that means
offering a tissue repair.
The blame game
The legal system is very interested in creating class-action lawsuits
based on mesh-related issues. The TV solicitations by law firms are
ubiquitous. A large proportion of my patients have sought legal counsel
before seeing me for their complications. My office manager spends
much of her time making copies of records for these firms. The reality
is that all these class-action suits are good for the lawyers, but don't
really benefit patients.
OSM
8 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 8
Dr. Towfigh (drtowfigh@beverlyhillsherniacenter.com) is the director and
owner of the Beverly Hills (Calif.) Hernia Center.
