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Chuck,
Not sure the Shouldice Hospital would be an option for you since you don’t have a visible or palpable bump. As far as I know, they don’t operate on such cases, or at least they didn’t in the past. Things have been changing there, so who knows – you would need to contact them if you wanted to explore that.
You can ask for a specific surgeon, and they try to accommodate that.
I don’t agree that it’s a “very poor choice”. They actually do very well with it over there. People were mostly doing quite well after the surgery, and I talked to a number of people who had one side done in the past, had perfect results, and came back for the other side. My case has not been so good so far, but it wasn’t typical.
I think there’s a fundamental issue with not tailoring the solution to the patient. At the Shouldice Hospital, there are very rare cases where they use mesh. They do that when your tissues are of very poor quality. Other than that, they just do Shouldice. If you’re overweight, they’ll reject you, but if not, you’re fine for Shouldice.
The problem is that there are cases where performing this procedure is difficult because of the specific anatomy and nature of the hernia. Some surgeons would realize that based on an ultrasound or maybe during surgery, and decide to use mesh in such a case, or maybe some other tissue repair like a Desarda. Based on what I know now about the details of my case, I think I would have ended up with a mesh if I had gone to one of the Germans who do Shouldice as well as mesh. I don’t know if that would have been a better outcome or not, but in some cases mesh can be superior to forcing a Shouldice, Kang, or some other tissue repair.
I described in previous threads my reasons for not choosing Kang. It’s mostly about the lack of data, and concern about potentially higher recurrence rates. Also, my hernia was not run-of-the-mill. It was a large indirect with a scrotal component. I wanted to “play it safe” with an established well-proven procedure with a long history. I’m not sure how well the Kang technique for indirect hernias works with a hernia like I had. It may be fine – I just thought it was too much of an unknown. As it turns out, even repairing it with Shouldice has been difficult.