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Is Mesh Commonly Used In Redundant Colorectal Surgery?
Question: I had a redundant colorectal surgery -surgeon removed 24" of colong (healthy) and did the resection by cutting a hole in the side of the rectum and capping off the area where the colon was cut. He used mesh to connect to rectum. Is mesh common in this type of surgery? I had a manometry and defecating proctogram at which time I had nerve pain that had me shaking and in so much pain. What could have caused the pain? I had the same tests prior to the surgery, with no pain whatsoever. I have continue severe cramping to include under the hernia repair as I left the hospital with an infection which led to a hernia. Is there anything that can lead you to believe that rectum, anus, gastro pain could be caused by this?
Brief Answer:
Pain could be due to constipation or nerve entrapm
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day,
Dear Ms,
From the short description given by you , I assume the technical procedure that could be done is, Excision of Redundant Colon(Long extra colon), anastomosis , followed by Rectopexy ( correct me if i am wrong: would be very helpful if you could provide detailed operative notes). Rectopexy is a procedure in which non absorbable synthetic mesh like Polypropylene (a sheet of mesh material like mosquito net) is used and wrapped around the rectum , and sutured to sacrum. This provides support to rectum and makes it tighter and preventing prolapse.
Mesh is commonly used in such procedure. When the mesh is fixed to sacrum ( tail bone) behind, some of the nerves may get entrapped and cause entrapment neuropathy pain. It can be managed easily by the Surgeon.
Other cause of pain could be constipation.
I would require additional information
1. What was the pre-operative diagnosis? Long redundant colon?
2. Was the Surgery Open or Laparoscopy?
3. Any post-operative infection in wound?
4. Is there any swelling at surgical site following straining or coughing?
5. Is your bowel movements regular and how is consistency of stools
6. Is appetite okay?
Do get back to me with the details
Wishing you happy and healthy life.
Take Care
Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Surgeon
Pain could be due to constipation or nerve entrapm
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day,
Dear Ms,
From the short description given by you , I assume the technical procedure that could be done is, Excision of Redundant Colon(Long extra colon), anastomosis , followed by Rectopexy ( correct me if i am wrong: would be very helpful if you could provide detailed operative notes). Rectopexy is a procedure in which non absorbable synthetic mesh like Polypropylene (a sheet of mesh material like mosquito net) is used and wrapped around the rectum , and sutured to sacrum. This provides support to rectum and makes it tighter and preventing prolapse.
Mesh is commonly used in such procedure. When the mesh is fixed to sacrum ( tail bone) behind, some of the nerves may get entrapped and cause entrapment neuropathy pain. It can be managed easily by the Surgeon.
Other cause of pain could be constipation.
I would require additional information
1. What was the pre-operative diagnosis? Long redundant colon?
2. Was the Surgery Open or Laparoscopy?
3. Any post-operative infection in wound?
4. Is there any swelling at surgical site following straining or coughing?
5. Is your bowel movements regular and how is consistency of stools
6. Is appetite okay?
Do get back to me with the details
Wishing you happy and healthy life.
Take Care
Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Surgeon
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I went in for prolapse and rectecele; came out with 24" of colon removed; the rectecele is still there; now I have extreme pain in area under mesh where I had to have a repair from infection due to lack of attention. He removed 24" of healthy colon; attached the colon to the side of the rectum using mesh strips; sealed off one section of the colon.
The infection site was packed three times a day for 6 weeks; a hernia grew to 8.3 cm; when it was first checked by him, he said no big deal, but here I am, with pain that is excruciating, first noticed when defecating mammogram saws done - could the X-ray tube have hit nerves where he capped the colon? I can't get answers here. My gastro issues are no longer what they were - I'll have normal movement; constipation, infrequently, then up to three weeks of not being aware of movement. I also have movement under the mesh (small intestines) I hope this is clear. He admitted failure, but that doesn't help me a lot.
Why would he cut a hole in the side of the rectum to attach colon? And, because I had a vaginal wall repair prior to being hit by a car, he said he would see if that repair was ok; only to find out that he didn't see that side. It's such a mess, I'm not sure I am able to give you a clear picture, but, when the proctogram was performed, nerves were hit that had me in such pain, it took two days for them to calm down. Now, I have much movement in abdomen and inside low back that starts the same pain. This is not very easy to explain to a professional, but, perhaps it helps a little. If you need more information, please let me know. Thank you. I'm desperate and cannot get anyone to look at the whole picture.
The infection site was packed three times a day for 6 weeks; a hernia grew to 8.3 cm; when it was first checked by him, he said no big deal, but here I am, with pain that is excruciating, first noticed when defecating mammogram saws done - could the X-ray tube have hit nerves where he capped the colon? I can't get answers here. My gastro issues are no longer what they were - I'll have normal movement; constipation, infrequently, then up to three weeks of not being aware of movement. I also have movement under the mesh (small intestines) I hope this is clear. He admitted failure, but that doesn't help me a lot.
Why would he cut a hole in the side of the rectum to attach colon? And, because I had a vaginal wall repair prior to being hit by a car, he said he would see if that repair was ok; only to find out that he didn't see that side. It's such a mess, I'm not sure I am able to give you a clear picture, but, when the proctogram was performed, nerves were hit that had me in such pain, it took two days for them to calm down. Now, I have much movement in abdomen and inside low back that starts the same pain. This is not very easy to explain to a professional, but, perhaps it helps a little. If you need more information, please let me know. Thank you. I'm desperate and cannot get anyone to look at the whole picture.
Brief Answer:
To rule possibility of anal fissure
Detailed Answer:
Hi
Dear Ms,
I would like to reassure you of two things
1. Rectal tube is unlikely to have hit any nerves: Any instrumentation in the colo rectal area will not cause any damage of nerves , unless there is perforation of lumen by scope and hits the nerves outside .
2. Ventral or abdominal hernia no matter how big it may be will not cause such type of pain
I would suggest the following possibility as cause of your pain
1. Anal fissure: Introduction of X ray tube into anus sometimes stretches the peri-anal skin which tears the skin at junction of anus and surrounding skin causing ulceration
2. Nerve entrapment in the mesh used surrounding the rectum.
3. Spasm of Pelvic musculature
In view of pain occurring following instrumentation possibility of Pelvic muscle spasm appears most likely. Also possibiliity of anal fissure is to be ruled out.
I would suggest you to consult your Surgeon for this assessment.
In the meanwhile I would suggest you some simple steps and home based techniques which may provide you some relief
1. Hot Seitz bath: In a tub of lukewarm water( the temperature should be high enough for you to be able to tolerate it) add a handful of common table salt. Sit in it immersing your bottom for 15 to 20 minutes. It will relieve the spasm if any and the warmthness will have soothening effect
2. Local application of Xylocaine ointment to anal opening
3. Laxative like Lactulose which softens the stools will also be benficial
4. Consume lot of water: 3 liter a day
Do keep me updated
Take Care
Regards
Dr Deepak
To rule possibility of anal fissure
Detailed Answer:
Hi
Dear Ms,
I would like to reassure you of two things
1. Rectal tube is unlikely to have hit any nerves: Any instrumentation in the colo rectal area will not cause any damage of nerves , unless there is perforation of lumen by scope and hits the nerves outside .
2. Ventral or abdominal hernia no matter how big it may be will not cause such type of pain
I would suggest the following possibility as cause of your pain
1. Anal fissure: Introduction of X ray tube into anus sometimes stretches the peri-anal skin which tears the skin at junction of anus and surrounding skin causing ulceration
2. Nerve entrapment in the mesh used surrounding the rectum.
3. Spasm of Pelvic musculature
In view of pain occurring following instrumentation possibility of Pelvic muscle spasm appears most likely. Also possibiliity of anal fissure is to be ruled out.
I would suggest you to consult your Surgeon for this assessment.
In the meanwhile I would suggest you some simple steps and home based techniques which may provide you some relief
1. Hot Seitz bath: In a tub of lukewarm water( the temperature should be high enough for you to be able to tolerate it) add a handful of common table salt. Sit in it immersing your bottom for 15 to 20 minutes. It will relieve the spasm if any and the warmthness will have soothening effect
2. Local application of Xylocaine ointment to anal opening
3. Laxative like Lactulose which softens the stools will also be benficial
4. Consume lot of water: 3 liter a day
Do keep me updated
Take Care
Regards
Dr Deepak
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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