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Waikato surgeon upset at surgical mesh criticism

A leading Waikato Hospital surgeon says recent publicity about surgical mesh has the potential to detract attention from real clinical issues and undermine public confidence in well-established standards of care.

Dr Rowan French, the clinical director of general surgery at Waikato Hospital, said some of the criticism amounted to “inappropriate generalisation” and “scare-mongering”. Doctors routinely use surgical mesh in the repair of hernias, gynaecological problems and incontinence.

Advocates have called for the Government to launch an independent inquiry into the use of surgical mesh. Dr French said it was important for the public to understand that the uses of mesh were wide and varied.

“Potential complications are related to the technical aspects and placement location of the mesh and almost never the mesh itself. “Reported problems such as erosion of mesh into internal organs and major pelvic pain are related to the use of mesh in the pelvis to treat prolapse and incontinence,” said Dr French.

The actual reported incidence of these complications is rare. “It is vital that this particular use of mesh is distinguished from the (far more common) use of mesh to treat various abdominal wall hernias. “This particular use is not experimental, it is worldwide standard of care.” “Hernia operations using mesh do have a small risk of problems such as chronic nerve pain.”

“These complications were in fact more common in the era before the use of mesh. We support informed consent with these surgeries including discussion of real and potential risks.

“The current coverage of surgical mesh in the media is misinforming the public and adversely affecting the consent process.”

www.nzags.co.nz/assets/Uploads/Advocacy-and-consultation/Final-version-mesh-hernia-repair.pdf

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Background

Rowan French is a gastrointestinal and endocrine surgeon with a strong interest in metabolic surgery, including both under-nutrition and over-nutrition.

He is a member of many general and obesity surgical societies.

His primary interests include the treatment of breast disease and breast cancer, thyroid and parathyroid surgery, gastrointestinal endoscopy and the surgical management of obesity. He is committed to the treatment of patients at both ends of the nutritional scale.

He has trained extensively in these areas around New Zealand. His other interests include surgical nutrition including intravenous nutrition.

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