How is mesh procedure done for bowel obstruction?

Answer 1

I think you may be confused about what you're asking. Mesh is a material that is typically used for the repair of an abdominal wall hernia. The presence of a mesh hernia repair is a frequent cause of bowel obstruction because of inflammatory adhesions. If there is any involvement of mesh in the treatment of bowel obstruction, it would typically be that the mesh needs to be REMOVED in order to treat the bowel obstruction!

Bowel obstructions are either functional or mechanical. A functional obstruction is where there is some problem with the normal physiology of the intestine so that things do not move along. An example of this would be something like Hirshprung's disease in which kids are born without the normal nerves in the wall of the colon and they cannot move things along. They obstruct and require surgery as babies. Another example is when people use too much pain medication and slow the movement of the intestine. Sometimes this can lead to severe bloating and pain - a functional obstruction.

Mechanical obstruction is when something is physically blocking the passageway. One example would be with a tumor. Another would be a swallowed foriegn object. The most common mechanical obstruction, and the most common obstruction overall, is due to surgical adhesions and hernias.

Adhesions are scar bands that glue the loops of intestine to eachother and to the abdominal wall. These occur any time the body is healing a surgical incision. The healing process doesn't necessarily differentiate between injured tissue that SHOULD heal back together, and non-injured tissue that should be left to be separate. It all just gets caught up in the scar. The points where the intestine are subsequently attached to the abdominal wall are then places where the passageway inside can get kinked shut. When it does, it obstructs, or partially obstructs. If the intestinal loops that are kinked shut are also pinched inside a hernia, it can be disasterous. The segment of bowel can die and perforate, leaking infective content all over the abdomen. Abdominal disasters like this can be a cause of death.

Adhesive bowel obstruction that is not associated with a hernia is often temporary in nature. With rest, these partial obstructions will open up by themselves about 80% of the time. The patient needs to be in the hospital during this time, and intravenous fluids should be given because the patient can't eat or drink till the bowel opens back up. If at any time the patient starts to get sick, urgen surgical exploration is indicated.

In cases where hernia repair has occured in the past, and where mesh was placed, the mesh can become adherent to the bowel. This can be a particularly dense adhesion and can be very difficult to clean up surgically. If the patient didn't seem to be having a bowel emergency, most surgeons would try to leave "well enough alone" in this circumstance unless the bowel obstruction seemed total, or was multiply recurrent over time. If surgery was performed, the strong likelihood would be that during surgery, some bowel would need to be removed, and the former hernia repair would be replaced by a temporary closure - effectively garunteeing that the hernia comes back in the near future.

This isn't a rare scenario in patients who have had multiple abdominal surgeries. Bowel obstruction, hernia mesh, and the challenge of reoperative surgery are things we have to make judgement calls on, all the time.

If you have any more specific questions, I'd be glad to help.

Answer 2

Using endoscopic guidance, the stent is moved into place, and the sheath is removed, the stent expands to produce a channel. There are some good pictures in the attached article.

Answer 3

Instead of surgery, why don't you go to herbdoc.com and cure yourself of any and all diseases naturally?

Answer 4

They stick something up ya asshole and ream the mesh out!

http://www.willyblues.com/