[9NEWS] 'Major catastrophe': Sydney surgeon calls for hernia mesh ban

[9NEWS] 호주. '대재앙': 시드니 외과의사의 '탈장수술 시 인공망 사용 금지' 요청.

By Emily McPherson Senior Journalist 12:11pm Dec 3, 2020

A leading Sydney groin surgeon has called for the use of mesh in hernia operations to be banned because of the long-term complications it can cause.
Mesh has been commonly used to surgically repair hernias since the late 1980s in Australia and is generally considered to be low risk. His comments come as more men and women continue to share post-hernia surgery horror stories.

READ MORE: Men speak out about hernia mesh injuries

Mesh has been commonly used to surgically repair hernias since the late 1980s in Australia and is generally considered to be low risk.

Doctors at the Holroyd Private Hospital in 1997 carry out the mesh repair of a hernia in the groin. (Steven Siewert)

However, revelations in recent years about the number of women's lives destroyed by pelvic mesh - which led to a damning 2018 Senate inquiry and a massive class action against medical giant Johnson & Johnson ? meant patients with hernia mesh were now questioning their symptoms, Dr Garvey said.

"I think the pelvic mesh drama might have been the catalyst for questions about inguinal (groin) mesh," he said.

"People were getting all sorts of strange symptoms but it only just clicked after the pelvic mesh situation came to light that they could be related to inguinal mesh."

Dr Garvey said the most common complication he saw in patients with hernia mesh was chronic groin pain stemming from nerve damage.

A much smaller number of patients also appeared to have developed autoimmune conditions, he said.

Dr John Garvey has called for a ban on hernia mesh. (Supplied)

Dr Garvey, who also specialises in surgically removing mesh, said he had seen "lives turned upside down and destroyed" because of it.

"It's certainly a big issue and I think it's underestimated," he said.

"A lot of patients end up going through severe financial and personal hardship just for having a simple hernia repair.

"The mind boggles. Decades ago, before mesh was invented, it was just a standard thing, a small operation that could be done under local anaesthetic.

"Now it's turned into this major catastrophe."

As a bare minimum, patients should be given the option of a mesh-free repair and warned about the potential complications of mesh, he said.

Ultimately, Dr Garvey said he would like to see a complete ban on the products. 

"I would like to see mesh totally withdrawn from the market, except for use in exceptional cases where a mesh-free repair isn't possible."

However, Dr Garvey said the rest of the Australian medical profession would likely disagree with him.
"I would have a lot of trouble convincing other surgeons of that view, I am in the 0.1 per cent minority."

Mesh has been used to surgically repair hernias in Australia since the 1980s. (Supplied)

Every year, there are about 100,000 Australians hospitalised for hernias, according to the Royal Australasian College of Surgeons (RACS).

It is not known how many of those people go on to have their hernias repaired with mesh or what the rate of complications are.

A UK study published in the British Medical Journal in 2018 cited leading surgeons as saying the rate of complications from hernia mesh could range from 12-30 per cent.

Associate Professor Kellee Slater, a former national chairwoman of the Royal Australasian College of Surgeons' Board in General Surgery, has previously estimated the figure to be about five percent.

Dr Slater said the complications of hernia mesh could not be compared to the now well-known issues surrounding pelvic mesh.

Hernia mesh was generally very safe but patients needed to be informed of the risks, Dr Slater said.

"Mesh used properly with the right technique and with the right patient preparation is very safe and lowers the risk of hernia recurrence, but ... like all medical devices, there are can be complications associated with it and every patient considering having mesh inserted needs to be aware of these risks so they can make an informed choice."

Victorian man wins hernia mesh payout

Victorian man Alan Adams was given a seven-figure payout after

a hernia operation in 2013. (Supplied: Alan Adams)

In the US, manufacturers have so far settled more than 50,000 hernia mesh lawsuits worth more than US$1 billion.

While no Australian law firms are yet to take on a class action for hernia mesh, as has been done with pelvic mesh, there have been individual law suits settled against surgeons and doctors.

Former lawyer Alan Adams says his life was destroyed when a surgeon operated and put mesh in his groin for a "hernia" that turned out to be non-existent in 2013. 

His claim was settled for a confidential amount in July this year after he initiated legal proceedings against his Victorian surgeon and hospital.

"The moment I settled the case, I had joy for about two hours and then I fell into this big dark hole," he said. 

"The realisation for me was the reality that my body was wrecked for life. No amount of money was going to pay for that."

Mr Adams said he had since had three surgeries to correct the problems caused by his initial mesh surgery which included severe pain caused by nerve damage, bowel and bladder incontinence and sexual dysfunction.

"It's been an absolutely horrendous seven-year journey. I've always been a very fit person, I was an A-grade footballer and A-grade squash player. I used to go jogging, I used to have a normal relationship with my partner, and now I feel like I'm 100 years old."

Australia among the first to act, TGA says

A spokesperson for the Therapeutic Goods Administration (TGA) said Australia was one of the first countries to respond to reports of adverse events relating to mesh.

In December 2018 all surgical mesh ? including hernia mesh - was reclassified from "medium risk" to "high
All patients having surgical mesh operations must now be given a leaflet and implant card warning about potential risks of the device, the spokesperson said.

Since 2006, the Therapeutic Goods Administration (TGA) has received 903 event reports for mesh devices -  713 adverse event reports in relation to pelvic mesh and 190 adverse event reports for all other surgical mesh ? including hernia mesh.

'It's a generational thing'

Dr Garvey said he was concerned many surgeons weren't being trained properly in doing mesh-free hernia repairs, which involve only sutures. 

"I think perhaps surgeons have lost the skills to do non-mesh repairs," he said, adding that after mesh was introduced onto the market in the late 1980s "everyone was using it".

"A lot of people consider it to be the gold standard for hernia repair.

"There is a generation behind me that have never done a mesh-free repair."

Contact reporter Emily McPherson at emcpherson@nine.com.au.