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Inguinal hernia repair with absorbable stitches
Hi, everyone!
I’m supposed to have an inguinal hernia repaired in August or September, and my doctor wants to use a mesh, but I won’t allow it. I’m here because I want it to be repaired with absorbable stitches, so I’d like to hear opinions on the (original) Bassini vs Desarda techniques. Also, out of curiosity, does anyone know if it’s possible to do Shouldice with absorbable stitches?
I know some people ask, so I’m a female, 23, slightly underweight and my hernia measures 4mm.Thank you in advance.
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17 Replies
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I had similar problems with sitting for extended periods, but only when sitting in an office type chair in front of this computer screen. So I switched the chair to an upright back wooden dining table chair and that made a big difference. I might never use that office chair again, it seemed to create pressure in certain areas due to its design.
I also have found that going for short runs, 1 or 2 miles, has a positive effect. I think that there are probably pockets of scar tissue left behind that have poor circulation, after the trauma of the mesh and its removal. On the other hand, I found that hiking or walking over uneven ground or hills for extended periods makes me more sore, overall, across the lower abdomen. A different type of muscle usage I assume.
I had been waiting until I felt like I had found a steady base, physically, to speak from before giving any advice or thoughts on healing from mesh removal. I’m in pretty good shape now but still spend a lot of time taking care of the area that was damaged. It’s still a huge part of my life. Good luck.
AGF, sorry for taking over your topic. I hope that your questions got answered. To Jeremy B’s point, don’t too hard try to stick in your insurance plan’s coverage area. It will limit your choices. Any extra cost will level out over the many years you have ahead of you.
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Thanks. I’m approaching the year mark since my lapro mesh removal (mesh was balled up and rock hard-had it in me for 6 years). My remaining symptoms are like no others when I speak to other people who have had their mesh removed. I don’t have any “classic” pain. I move around fine and don’t hurt. What I go through seems to be in different areas and feels different when I walk (feel virtually nothing when upright) when I lie down (can be different degrees of burning and oresssure feeling- and better if I’m on my side) and sitting which is the worst. It’s not instantaneous when I sit but builds to a burning and pressure feeling. And to make matters worse the symptoms feel different depending on the type chair, it’s angle and depth. Someone’s I feel it in my side/flank area like something is fiercely pulling my whole side inward from the inside . Sometimes I feel pressure and burning in my upper thigh-sometimes if I take my thumb and put pressure on the thigh area when sitting it feels better-and if I lift my waistband up during any of my episodes I feel better, so I’m pretty sure whatever is going on is made worse by pressure from my waistband.
tje other interesting thing is the groin area where a hernia appears or is does not bother me at all-all my issues are more lateral on my left side-so outer groin crease and upper thigh and them at times the flank and side abdomen.
Like you I am trying to keep track of what and when things seem to bother me.
my surgeon very flippantly and in passing said my colon was pressed up against the mesh or vice versa and I seem to notice some of the left sided upper abdominal issues may occur after eating and what I eat. So I’ve definitely changed my diet and am tinkering with it as I go along.
sometomes in certain sitting positions I feel my whole left side abs are twisted or like someone is grabbing them from the inside so I really feel like the mesh mesh being folded up into a ball probably changed my inner abs and having removal probably didn’t help either. So I am seeing a wholistic body healer in 2 weeks. I actually saw her 3 years ago when I was having issues and she helped a lot. She is very gentle and intuitive. Unfortunately she is 3 hours away from me where my sister resides.
tje sitting is easily what bothers me the most and makes social activities very challenging and stressful.
I am back to gently playing sports with my kids and attending all their school and after school activities and feel kind in back to functioning in daily living. Unfortunately there are still these “pain” issues for me that I can’t seem to pinpoint what is going on. Most likely nerves to some extent although it is weird that burning would occurs when lying down and sitting but not standing up and walking. Still stumped
Always a pleasure to be able to keep in contact with other mesh removal people and I think the time you are giving to this forum is great and informative.
take care. -
quote Jnomesh:Hey good intentions. Did you happen to do any type of body work that helped you post mesh removal-like myofascial release or ART etc?
jnomesh I have not done any program type rehabilitation work. It’s all been just me and what I’ve been able to learn, plus my experience from past injuries. I started with the knowledge that pretty much all of my lower abdominal wall had been torn apart and put back together, and went from there. I avoided strenuous activities until I was confident that the entry points for TAP surgery should have been healed and strong then slowly increased levels and duration of activity, with long periods in between to let healing happen. I think that that’s important, to let things settle down before exercising again. The swelling and soreness takes much longer to diminish than for a normal injury. If I had a daily physical job I would probably be suffering.
I had talked to a physical therapist when I was having mesh problems, and looked around the internet, and found that there are really no physical therapy programs designed for mesh implantation or mesh removal. We’re all pretty much on our own.
At this point in time, about 8 months post mesh removal, I’m just expanding the envelope, both for level and duration, and keeping track of cause and effect via a daily log. My experience from past injuries was helpful in that I know that the body will keep working to get right, even years after an injury. So my time-frame might be longer than most, as long as I’m making progress I’ll stick with my program. So far it’s been a steady slow climb up a long and slippery slope.
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Hi good intentions,
i was the same weight before the surgery however i have also realised that with the mesh wateva instant move i do or strain slightly it is a very uncomfortable situation. I kicked a ball once after 6 months and couldnt get out of bed for a week. I was told after that it was scar tissue re adjusting. I did a lot of heavy lifting combined with football. Although the surgeon states that he dsnt like to use mesh in athletes involved in intense sports i still believe in my situation permanent sutures from the first surgery would of been more ideal rather than ones that are absorbed. -
Hey good intentions. Did you happen to do any type of body work that helped you post mesh removal-like myofascial release or ART etc?
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quote Baris:I believe its something he does quite common as he knew i was involved in high level sports at the time and still used absorbable.
Hi Baris. Could you give more detail on your situation? Your story sounds very interesting, in many ways. I think that the “holy grail” of hernia repair is one method that works for everyone. What type of sport, and did you gain the 35 lbs afterward, or does Shouldice just like very skinny people? Was your sport a high frequency sports like running, or a high intensity sport like weight-lifting? Or a combination of both like soccer (football)?
I was very athletic, mainly soccer, before my hernia repair with mesh and I found out why very few, if any, professional athletes get repairs with mesh. The mesh is a constant irritant to the surrounding tissue, which cannot handle the stresses and strains of continuous high level activity, with mesh. Since the mesh is gone I am slowly working my back to a higher level. All of my personal data, three and a half year’s worth, points to the mesh as the main cause, with the extensive unnecessary dissection as a secondary cause. It’s incredible how much healthy tissue was damaged to insert mesh in to areas that had no problem.
It would be great if you could tell more. Dr. Mucschaweck is known for working on athletes and her association with Biohernia is important.
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Hi jeremy.
He told me the day before surgery exactly what he will do. I actually went to him for a desarda repair thinking that would be nore ideal and better and found him through moham desarda website. However he said once he will open me up he will decide which technique is suitable. After surgery was completed and inwas out of recovery i was told that a shouldice technique was peformed with absobable sutures. So no i didnt specifically request it. I believe its something he does quite common as he knew i was involved in high level sports at the time and still used absorbable. -
Baris, did Dr Kock just go ahead and use absorbable during the Shouldice or did you request it?
Did he say he had good luck historically with absorbable?Thanks in advance
Jeremy -
Hi jeremy,
i had my surgery done in cottbus germany by Dr Koch. It was arranged through bio hernia and he is a specialist in removing hernia mesh. I had my first in august 2017 didnt hold with absorbable sutures. I went back with complaints and he said no hernia. I insisted that i did and once he opened me i up at the start of december 2017 i had hernias again. he said he went over one side with a short permamanent suture and the other side he put a mesh over although i had enough muscle and it was indirect hernias. The side with the stitch reoccured straight away. The mesh side repccured after 3 months. I conctacted the shouldice clinic and they were very dissapointed why a surgeon will use the technique with absorbable sutures and without the cremester muscle being cut as this does not reflect back on the success of the technique. Cutting the cremester mucle makes a big difference with reoccurence rates with this technique as the founders have stated. They were more shocked the fact that although i had hernia why the doctor reoperated on me after just 3 months as they state that it takes 1 year for the muscle tissue to heal properly. So now i am scheduled to have surgery again at the end of the year this time at the shouldice clinic with the chief surgeon. I was asked to lose 35 pounds and was told that if that certain weight wasnt reached they wouldnt operate as again it made the surgery more risky. Its been a tough time but hopefully ill get there. But the hardest and most frustrating for me was the fact that i believed that i had done enough research and believed in ideas that sounded way too good. If your opting for a shouldice id certainly say contact the clinic in toronto. Doctors will say they have learnt there and so on. However speaking to the chief surgeons assistant they can only come and watch for a couple days and training is not provided. If shouldice id say contact the clinic. -
Baris, who performed your shouldice repair?
Apparently if PDS slow absorbing sutures are used it will hold and give your body enough time to heal.
Dr. Grishkan will do a two layer shouldice with absorbable upon request.
What type of repair did you end up going with?Thanks in advance!
Jeremy -
quote idoncov:You probably mean 4cm, not 4mm?Dr Brown is not a fan of meshes. He’s very responsive and will answer your questions personally.
Dr Brown is Amazing Person !
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Hi
ive had a shouldice technique operation with absorbable sutures and it only lasted a couple months. When i called the actual shouldice clinic to explain to them the issue and schedule surgery there they told me that a shouldice technique should never be peformed with sutures that are absorbed as this is highly likely to fail and were quite shocked this orocedure was actually performed.. -
I believe the Desarda repair by Dr Robert Tomas is done with absorbable stitches, I am not sure if other doctors go that route. You’d have to ask directly
Where are you located? Perhaps a no-mesh hernia surgeon is located near you that you could consult with.
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You probably mean 4cm, not 4mm?
Dr Brown is not a fan of meshes. He’s very responsive and will answer your questions personally.
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Just out of curiosity, does your hernia hurt? How were you diagnosed? Do you have a bulge or just physical symptons?
Where are you located? Perhaps someone can recommend some regional options near you for a non-mesh repair.
As for absorbable sutures, that is much more rare as far as I know, but I think Desarda repairs in Florida by Dr Robert Tomas are done with absorbable stitches. Other surgeons may use them as well, maybe by request, you’d probably need to inquire directly and ask.
A partial list of surgeons in the USA who are able/willing to perform a no-mesh hernia repair using a traditional suture technique (various types of repairs, ask for clarification) include the following doctors:
– Dr Shirin Towfigh in Los Angeles, California
– Dr David Chen in Los Angeles, California
– Dr Edward Phillips in Los Angeles, California
– Dr Robert Burns in Newport Beach, California
– Dr William Brown in Fremont, California
– Dr Paul Dally in Vancouver, Washington
– Dr Robert Martindale in Portland, Oregon
– Dr Michael Mastrangelo in Bend, Oregon
– Dr Kevin Petersen in Las Vegas, Nevada
– Dr John Etlinger in San Antonio, Texas
– Dr Zafar Parvez in Gallup, New Mexico
– Dr Samer Sbayi in Long Island, New York
– Dr Michael Reinhorn in Newton Massachussets
– Dr Igor Belyansky in Annapolis Maryland
– Dr William Meyers in Philadelphia, Pennsylvania
– Dr David Grischkan in Cleveland, Ohio
– Dr Paul Szotek in Indianapolis, Indiana
– Dr Bruce Ramshaw in Knoxville, Tennessee
– Dr Jonathan Yunis in Sarasota, Florida
– Dr Robert Tomas in Fort Meyers, Florida
– Shouldice Hospital in Toronto Canada (just in case you’re near the border)
There are quite likely to be other surgeons with significant no-mesh hernia repair experience. If anyone happens to know of any other surgeons then feel free to add them to the list, or offer any input.
Good luck and keep us updated on your case, progress, and decision making.
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Look up William Brown in California, his website has great info on the different kinds of suture repairs and he does not use mesh.
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Hey AGF, yea you definitely don’t need mesh but you will likely have to travel to get Non-mesh repair with a competent surgeon. To answer your question there is a guy in Cleavland, OH, Dr. David Grischkan who will perform a partial 2 layer sholdice with absorbable if you request, I will go to him if mine is a direct hernia, I’ve spoke with him on the phone personally, but am now thinking of going with Dr. Brown since most likely my hernia is an Indirect type and he can perform a more specific technique for that type (marcy repair). I get an Ultrasound tomorrow and hope that I can get an answer.
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