News Feed Discussions In the 70s and 80s hernias were no big deal –now they are hell Reply To: In the 70s and 80s hernias were no big deal –now they are hell

  • Good intentions

    April 27, 2023 at 10:45 am

    I don’t see him mentioning chronic pain. I pulled out a few sections below. Overall it is the typical “this is what I do and why it’s better” presentation that most hernia repair surgeons use.

    The front page is odd in the way he describes using the most Pro-Grip mesh of anyone in the UK. Who would care about that, why would it matter? I think he’s trying to benefit from Medtronic’s marketing of Progrip. Riding the Pro-Grip bandwagon.

    “Mr Sadler now only performs local aneasthetic hernia surgery. He is the largest single user of ProGrip mesh in the United Kingdom (approximately 4000 procedures) and has performed almost 6000 career hernia operations.”

    “Oxford Hernia Clinic was pleased to be the first hernia clinic in the UK to use ProGrip™ as its preferred mesh for hernia repair and we are currently the largest user of the mesh in the UK, having performed over 4000 procedures.”

    Here is one reason doctors and surgeons don’t show any interest in determining whether a hernia is direct or indirect.

    “There are of two types of inguinal hernia, direct and indirect. For patients this distinction is irrelevant as the same operation fixes both types.”

    He says “less painful” but does not mention long-term pain. Looks like it’s faster and cheaper. Those are good things, of course.

    “Open repair is the most commonly performed procedure for inguinal hernia surgery and for the majority of hernia patients would be the technique of choice. After over 5 years of laparoscopic repair Mr Sadler reverted back to this technique because he believes when performed under local anaesthetic using it is quicker, more effective, less painful, safer (complications are very rare and less harmful compared to keyhole surgery) and far more cost effective for self paying patients compared with general anaesthetic.”

    “After performing TAPP (and TEP) for many years, Mr Sadler no longer performs any keyhole surgery, favouring local anaesthetic repair (even for bilateral hernias) as he believes it is safer and more comfortable for patients.”

    He uses the typical way of downplaying other methods with vague statements about risk. Mentions informed consent. Doesn’t give any numbers.

    “No Mesh Technique (Bassini Type) Repair
    We can repair your hernia with a “No Mesh Technique”, this is called a Bassini Type Repair, after the surgeon who described the technique in 1884. This is remained the standard way of fixing a hernia for over 100 years until the “tension free Mesh technique” became more popular. The technique works very well and many patients who had this type of repair have never had any problems.

    However, a ‘No Mesh Technique” will not reduce the chance of having chronic discomfort after surgery (it may even increase) and statistically your hernia is more likely to come back, especially if it is a direct hernia. Mr Sadler will discuss this option with you as part of your consent process.”