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Petitioner submission of 12 November 2021

PE1865/VVV – Ban the use of all surgical mesh and fixation devices

The topic of the report done by Scottish Health Technologies group (SHT) regarding inguinal hernia in men keeps popping up. It was not widely reported that this was being carried out. Very few men took part. I believe the report can't be completely accurate. I am hoping the next report will be shared far and wide. I have spoken with SHT and they have said they had high numbers taking part and they can see the issues around mesh. I just hope it's reflected on the report.

It's been reported that there are 5000/6000 hernia mesh operations a year carried out in Scotland with a 0%-5% complications. With roughly 20/30 mesh removals being done a year. I'd like to ask where they got these figures? Also they stated they didn't have numbers of hernia mesh removal. If the committee can look at Jackie Baillie MSPs submission from a few months back she asked the Scottish government for the statistics for hernia mesh surgeries and bowel mesh surgeries you will see they stated they don't hold this data. So where have the recent figures and statistics suddenly came from? 

In my opinion the reason for few removals is we the patients don't have a clear patient pathway. GPs aren't aware of where to send us as there are no clear routes. 

Also as for hernia mesh removal surgery in Scotland this is being done by cancer surgeons and plastic surgeons as the general surgeons putting this mesh in aren't qualified in removal. So, we are taking up specialist surgeons’ spaces in theatre. Due to cancer surgeries being put back so are we who are awaiting Mesh removal so numbers will be low. 

There is a power imbalance with surgeons knowing best. We aren't given informed consent. We aren't given choice as all that's being taught is mesh repair. I agree with Mr O'Kelly we need to close this gap. Are medical colleagues aware of who can carry out natural tissue repair? I have found out myself through this process who can and can't do natural tissue repair. 

If you look at the evidence from the Shouldice hospital they have collected and compared the data. When you are looking at the data on hernia mesh repair you are only looking at reoccurring hernias. What about the quality of life? Chronic pain? Debilitating conditions? Mesh isn't good especially when it goes wrong. The numbers for Shouldice recurrence is lower than mesh complications at 3%. 1% of natural tissue repair patience have some pain afterwards but not chronic. I can provide the name of the surgeons at Shouldice. They don’t use mesh. They don't only treat inguinal hernia. They treat all mesh patients removing the mesh and repairing with stitching their own tissue. They treat umbilical, inguinal and bowel prolapses with natural/native tissue repairs with successful statistics if you look on their webpage for their statistics. ASK THEM DIRECT. WRITE TO THEM AND ASK THEM. Not at all what the Scottish government are claiming.   

Also a plastics surgeon at Glasgow Royal doesn't use mesh for vaginal or bowel reconstruction or prolapse. My surgeon at Glasgow Royal isn't using mesh when he removes my mesh he is using my own tissue and stitches. So there are alternative surgeries and surgeons who can do repairs without the use of mesh. All have surgeons who work under them who do not use mesh. Woman are now using these surgeons privately in private clinics for vaginal prolapse as they are still only being offered mesh on the NHS. 

The Scottish Government say lessons are being learnt here but we aren't seeing it filter through. Who ensures this is being filtered? 

Create a clear mesh centre for all mesh affected with surgeons qualified to insert and remove mesh. We want fully qualified surgeons backed with patient data who can implant and remove mesh If they are going to use it. Give us the professional pathway. Train our surgeons in both technics. Give us our voice and choice. Make it patient/surgeon lead and friendly so discussions can be made and held. Give us our informed consent working together in partnership.   We want fairer treatment and compassion from the NHS. We also would like redress for the personal loss of income, our lives and for the injustice we have faced. We would also like the sunshine fund to have a transparency over which surgeons are getting incentives.

Some related articles may be of interest: 

The surgeon Robert Bendavid has argued for longer studies on the women who have had mesh fitted, because in short-term studies the data are not capturing the level of risk. Westminster Hall - Hansard - UK Parliament

Is Shouldice the best NON-MESH inguinal hernia repair technique? A systematic review and network metanalysis of randomized controlled trials comparing Shouldice and Desarda - ScienceDirect

Re: Recurrence of inguinal hernias repaired in a large surgical specialty hospital and general hospitals in Ontario, Canada - PMC (nih.gov)).   

https://journal.nzma.org.nz/journal-articles/mesh-abdominal-wall-hernia-surgery-is-safe-and-effective-the-harm-new-zealand-media-has-done-response-to-dr-steven-kelly-s-article