Does hernia mesh need to come out the same way it goes in
No. I have seen several of my critic bloggers say that it does and that other doctors are saying so. This is mostly just bloggers but if other doctors are saying this it is the voice of inexperience. I have heard of many serious disasters and near deaths from attempted laparoscopic removal of laparoscopic mesh. I do a formal laparotomy with the incision from the belly button to the pubic bone. My blogger critics say that this is unethical which is rediculus. Laparoscopic or robotic surgery is not safer than open surgery with an incision. Even this being open surgery it is ambulatory surgery. Takes an hour and a half, not 4 hours. My main concern is saftey, not appealing to lizard brains.
My anology for minimally invasive surgery is that it is like a bullet wound. Small entrance wound and all of the damage is inside. For mesh removal I can operate circles around laparoscopic and robotic mesh removal surgeons.
One very big problem with the laparoscopic approach is that the surgeon has no sense of touch. When I remove laparoscopic mesh I palpate the posterior wall of the inguinal canal and the femoral canal. If I find a hernia I fix it with a mesh free anterior approach. Usually I do not find a hernia because it has healed or nerver was there and no repair is necessary. A laparoscopic mesh removal surgeon cannot see or feel these hernias like I can and they simply put more mesh back in.
Imagine shoing a horse with a robot. In some surgery nothing will ever beat a skilled surgeon's human hand.