Hernia mesh complications are rising in 2025. In this podcast with The Medical Legal Guys, Dr. Greg Vigna, M.D., J.D., and nationally recognized attorney Ben C. Martin explains mesh failures, chronic pain, and legal rights for patients needing revision surgery and dealing with the harsh complications hernia mesh can cause.
You’ll learn about:
• Why hernia mesh devices fail
• Mesh erosion, adhesion, nerve pain
• The latest mesh updates
•When you may qualify for a lawsuit
• What a revision surgeon looks for
• Alternative mesh for patients (P4HB)
📞 Contact Dr. Vigna for a FREE case review: vignalawgroup.com | 817-809-9023
📞 Contant Ben Martin for a FREE case review: bencmartin.com | 214-761-6614
TRANSCRIPT:
B: I'm Ben C.
V: And I'm Doctor V.
The Medical Legal Guys.
V: I'm Doctor Vigna I'm a physician lawyer. I sue pharmaceutical companies, doctors, hospitals and nursing homes and represent people with catastrophic injuries. And Ben Martin. He's been sueing pharmaceutical companies for 50 years now.
B: 30. 35, 40. Okay, quit saying thirty!
V: So today's topic is about hernia mesh. Hernia mesh has been around for 50 years. What we're referring to as mesh is the plastic material. Poly propylene. And this topic is about a safer alternative design called P4 HB. It's cultured from E.coli and natural occurring bacteria. And some pharmaceutical companies now have the ability to make this material into mesh. The outcomes show are that it works just as good.
B: Just as good.
V: But complications long term are negligible because the device's been removed naturally. So it's not getting infected.
B: You don't want a hernia mesh infection. Can you imagine?
V: We know that that this polypropylene is a defective product. We know that it causes chronic inflammation, that it gets infected. It causes bowels that adhere it causes obstruction of bowel. It causes chronic fistulas. When chronic mesh becomes infected, it becomes a hole. The you could have holes that you could put your fist in. I used to take care of those patients and my long term acute care hospital. Dreadful injury, horrible injuries. You know, since 2014, there's been a material that has been, increasingly used called P4HB.
B: What's P4HB?
V: P4HB is a natural polymer or a propylene is a plastic polymer, natural plastic. So that this natural material that's cultured from a bacteria called E.coli, when it's woven in crystallized, the body degrades that material. Over 18 months. They develop a big clob of this. They then crystallize it in and then weave it into a mesh material. And when they use this material, the body naturally grows into the mesh, and then the mesh degrades completely and goes away. And they have found in studies that the strength of repairs is nearly equal to mesh augmentation. And you don't have chronic infections and you don't have you have no more no more mesh. So you're not having mesh related pain reduction in complications. It's been huge.
B: It gives the body time to let the mesh do what it needs to do and get integrated into the body and serve. Is that what would you say mesh serves?
V: It’s a scaffold. I'd call it a scaffold. Okay. It's something that keeps its structure and tissue grows in, supports that scaffold. And then you take the scaffold away and natural bodies left. The bodies getting rid of the natural
B: You know, most physicians in the United States use mesh in fixing a hernia. That's what occurs. There are several manufacturers of hernia mesh and the physicians have learned to use it. It's easy to put in. It's not it's complicated in some respects.
V: So it's not as complicated. I mean, they don't need others. Yeah. So plastic reconstructive surgeons, they they repair these injuries or hernias without mesh.
B: Whats a hernia?
V: Hernia is, is where there is a defect in the abdominal wall that keeps your intestines and other bits, your organs in the viscous or in the abdomen within its cavity. So when there is a break in the tissue that happens in the groin or by the navel or the belly button, or at a surgical scar site where they had to do a previous operation, like taking out a gallbladder, that you get a hernia through those areas. This P4, hb it cures the problem and then it's gone after 18 months.
B: Did you know that there is a group, hospital in Toronto that does non mesh hernia surgery? You heard that.
V: One after another.
B: I have a neighbor who went there, and had hernia surgery, a year or so ago, a wonderful result. Reason he went I live in Dallas. Reason he went to to, Toronto was because he didn't want any of that mesh in his body. This is a polypropylene and poly, sometimes polyester substance that's put in the body. And actually, the old time way of repairing a hernia is the type of way they're doing it in Toronto with improvements. Right? So they're not using a foreign body. They're not using a foreign substance. They're not using plastic. I don't even have implant plastic in a patient in order to fix the problem. So that's why people are flocking to, Toronto.
V: And they do good work. So, you know, so there's a complication from hernia mesh where the device gets infected and, and, or there's a complication and there's bacterial spillage because it might involve bowel and and the results are terrible. I mean, I've taken care of dozens of people with gigantic wounds that would have to have a feeding tube or IV nutrition, antibiotics, long term wound care to allow that wound to grow in. And then they would, once it was clean of infection, they would try closing it with another mesh, or we'd have an abdominal plastic surgeon see if they could reconstruct. So anyways, with this P for B mesh, they're able to at the time of the complication Ben And they don't have to have the second procedure. And what they're the results are it works. And secondary complications are much less because you don't have mesh in there anymore. Okay. So people are getting these two stage procedures when you really get fix with P4, HB and then they're getting mesh put in again, and then that mesh gets infected and you're back to square one.
B: There's another problem with that second sometimes third and four surgeries to.
V: Patients don't get there.
B: Fix the mesh problem I'll tell you exactly what. An additional and it's serious problem is that whenever you're in the gut, the abdomen, and you're doing surgery like that, right, then you create scar tissue, integrates itself into the abdomen, and then if you have to go back in and do another surgery, a lot of times doctors will have to revise those regardless.
V: But if you’re putting in mesh, that's a it's like a scar tissue machine. It just builds scar tissue forever.
B: Every time you have to go into the abdomen and do another surgery, you have a greater degree of risk of of problems happening because you've got that scar tissue pulling against itself and pulling against the abdominal tissues and creating. One of the worst things that can create is a bowel obstruction. And a bowel obstruction is a. You ever heard of a strangulated bowel? That's bowel obstruction. And then that can be caused by all of the scar tissue developing from all of these surgeries. So if you have a surgery and the mesh goes bad, they're taking out that mesh, possibly putting some more in. And whatever they're doing is creating another sort of it creates more scar tissue.
V: It's it's just a big mess. So but we're really looking closely at the complications of mesh that are compounded because doctors are not providing P 4 HB. And these people, then they have secondary complications from the subsequent hernia mesh. So so we're looking at this both against the manufacturer and in a combo case because I mean I don't know why the doctor is not using P 4 HB when clearly the the data and all the literature is pointing that this is a superior prosthesis or implant.
B: Or what it's called legally in my business is a safer alternative, safer alternative design, a safer alternative device, which, which means just what it is. It's it's safer than the product that we're sueing on.
V: Yeah. So P4, HB it's manufactured asphasic mesh, but I think there might be other types of P4 HB out there. I know they're starting. They've used it on for slings and stress urinary incontinence. So so I think P4 HB is is going to replace polypropylene.
B: What about the polyester message that caused similar problems to the polypropylene. Yeah it's all plastic. It's all bad. And the other thing you do is you create scar tissue. And every time you go in and create scar tissue it creates more scar tissue. And so it's kind of a vicious circle.
V: The vicious circle is brutal because you're often having to wait three, four, five weeks for that, that initial damage where you have been cut open and cut out, dead mesh, well, dead dead tissue that's adherent to mesh, that's in fact, did you wait 3 to 4 weeks to let that granulation while you're in the hospital getting I.V. antibiotics and you're getting your wound packed? It's brutal. Okay, so so we represent those who have been implanted by mesh when against the manufacturers. And we are representing people who, instead of being having been offered this superior graft, have suffered serious early complications from that graft against the doctors who are not going to the safer alternative design.
B: Safer alternative design, safer alternative, important in our business because what we like to do and you don't have to do this in every case. But but what we, what we do is when we take a case, we look to see if there's a safer alternative to what they're doing, which people do have problems with in Ariat. It's a problematic thing, right? It's, I'll let the doctor talk for decades.
V: I mean, so we are looking at seriously injured people who were candidates for a safer material, but we're also obviously suing the manufacturers who continue to sell these defective devices and for the harm these devices have caused.
B: And the harm can be serious. It can be deadly.
V: You could put your fist in these in these. They're they're gigantic. And I mean big cavities where they've had to take out mesh. It's just a miserable, serious medical problem that can be avoided.
B: So it's miserable when they're having to go through that at time. But it also can remain miserable. Some of these people have lifelong problems and it's all because of the defects in the products. And there there are two types of mesh product that generally we see. And that is and I'm talking about in the synthetic mesh industry that's polypropylene and polyester, two types of mesh. One is multi filament and one is monofilament. And what these things do they are plastic right. You remember mesh is a plastic. So every time someone has mesh put in their body they're having plastic put in their body.
V: And it stays in your body and it causes chronic inflammation. And if that mesh gets infected, thus those infections can be serious because the antibiotics can't get into the mesh to treat.
B: That's right. That bacteria on a mesh product, and implanted product like that, that bacteria goes for that mesh. And so it's a mesh lover.
V: So, so, so when you think about the safer alternative design of aphasic or P 4 HB, the material provides the support to allow for healing, and it continues to heal as the the scaffold is then disintegrated by the body. So these chronic complications that could be painful, that can be chronic pain from the mesh, the chronic inflammation, it's gone.
B: What we do is we represent folks who have been injured by medical devices and other products, and then we follow all suits and we try cases.