"I would not want my wife to undergo this procedure," the French doctor wrote in an email to a colleague in 2005. "And I don't think I'm alone in that."
The email from Dr Bernard Jacquetin - about a controversial pelvic mesh device he invented for implantation in women - drew gasps from the public gallery when it was read to the Federal Court in Sydney on Tuesday, on the first day of a class action brought by more than 700 women against Johnson & Johnson.
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Vaginal mesh class action lawsuit begins
Hundreds of women suffering pain from vaginal mesh implants launch a class action against Johnson & Johnson in the Federal Court.
Dr Jacquetin was part of a Johnson & Johnson transvaginal mesh evaulation team, the court was told, and his email was included in an internal company document.
Tony Bannon SC, acting for the women, told Justice Anna Katzmann that the subliminal message of the email was "those of us who were in the know".
![Members of the class action against Johnson & Johnson, Gai Thompson, Joanne Maninon and Carina Anderson, leave the ...](http://web.archive.org./web/20170706124333im_/https://www.fairfaxstatic.com.au/content/dam/images/g/x/4/i/5/d/image.related.articleLeadwide.620x349.gx4i27.png/1499199677982.jpg)
"Once one understands what is really involved with this, you wouldn't want your wife, your sister, your mother to undergo this, except in extreme circumstances," Mr Bannon said.
Mr Bannon said his clients' lives had been "dramatically altered for the worse" since undergoing the procedure for incontinence or pelvic organ prolapse, which can happen after childbirth.
"Their enjoyment of life has been seriously compromised," he said.
Each of the 700 women had suffered continuous, frequent and often unbearable pain, he said.
![Gai Thompson underwent pelvic mesh implantation surgery.](http://web.archive.org./web/20170706124333im_/https://www.fairfaxstatic.com.au/content/dam/images/g/x/4/i/4/t/image.related.articleLeadwide.620x349.gx4i27.png/1499199677982.jpg)
Up to 100,000 Johnson & Johnson pelvic mesh devices have been implanted in Australian women.
The three lead complainants in the case were seeking substantial damages in the hundreds of thousands of dollars, Mr Bannon told the court.
![Carina Anderson, a member of the class action, outside the Federal Court in Sydney.](http://web.archive.org./web/20170706124333im_/https://www.fairfaxstatic.com.au/content/dam/images/g/x/4/n/k/5/image.related.articleLeadNarrow.300x0.gx4i27.png/1499199677982.jpg)
The court heard evidence from another internal Johnson & Johnson document from May 2010, which described the kind of doctor the mesh devices were aimed at.
They were doctors who could "do" a Johnson & Johnson TVT mesh device in eight minutes.
Johnson & Johnson envisaged these doctor-clients as the kind who would see the devices helping enhance their reputations and revenues.
They were more likely "mid-career doctors" who saw their practices as businesses.
The court heard the internal Johnson & Johnson document pictured doctors who would use the product as the type who would also enjoy holidays in St Moritz and Lamborghinis.
The document quoted one of the imagined doctor-clients as saying "that makes four (mesh surgeries) before lunch, that works for me".
Mr Bannon told the court the document exhibited the internal approach of Johnson & Johnson to the mesh devices.
He said there was a valuable market to be gained out there by emphasising the speed of the mesh surgery.
The court will also hear of the lack of evidence supporting the safety and efficacy of pelvic mesh devices.
One of the women implanted with a pelvic mesh device, Jo Manion, left the courtroom after Mr Bannon read the internal Johnson & Johnson documents.
Ms Manion was visibly upset through some of the evidence.
The hearing continues.