Reply To: Disadvantages of Shouldice repair?

[Jnomesh]

Hey i totally hear where you are coming from. That’s one of the reasons i rx if you do go the mesh route do it with a hernia specialist. They have not only a better understanding of the anatomical area but an understanding of what the best type of mesh to be used for the specific patient. For example not only was the mesh used in me having a lot of issues with other people (bard 3D maxx-please avoid this at all costs as it has a tendency to fold over Bc of its design). The surgeon who removed my mesh felt not only was that type of mesh not the best for thin people like myself he also felt that he surgeon tried to fit to big of a mesh into to little of a space.
some thoughts I have about open repair vs laparoscopic pros and cons.
open repair is not as close to vital organs so doesn’t pose as much risk if something should happen to the mesh. However, if something should go wrong with the mesh and it needs to be removed I feel it is a more invasive procedure and a higher chance one or all of the inguinal nerves have to be cut or aggrebated. It is will also take a little longer to heal.
laprascooic there will be less recover time and less pain in the groin area but there will be three incisions in your stomach for the instruments and the camera and you will be filled up with gas to inflate the stomach and of course general anesthesia. And that can be an uncomfortable process during recovery. Lapro als puts the mesh closer to vital organs such as the bladder etc.
however i also feel from my experience and from corresponding with others that it may well be easier to remove the mesh should it need to be.
my biggest discomfort from my removal was the incisions and gas used for the surgery. I had very little “traditional pain” pain from the removal which I thought was remarkable especially since it had to be peeled off my bladder amongst other things
Don’t get me wrong recovery hasn’t been a cakewalk and their is discomfort that I am going through but people I talk to who have mesh removed openly seem to be in a lot of pain in the early months of the removal.
some more thoughts. Shouldice repair isn’t the only type of pure tissue repair. There is the desarda and bassini repair. But you will have to travel-these seem like less invasive repairs these the shouldice and many don’t use permanent sutures but absorbable ones. There is dr. Tomas in Florida that does the desarda repair, dr. Peterson that does some version of a pure tissue repair and dr. William brown that does a modified bassini approach. Worth looking into if you haven’t already. Of course you will most likely have to travel and pay out of pocket.
I think it also depends on how big your hernia is. If it is small, I really think you should consider anoute tissue repair and may not have to go with the shouldice if it looks a little to invasive etc.
there is a dr. Kang from South Korea on another thread I’ve been on-no mesh repairs and he only does pure tissue relairs and again supports is results are very good. Maybe you can ask him his views on the different tissue repairs pros and cons. He has been great in responding to me
ans finally dr. Towfigh has mentioned that she is now doing a laparoscopic pure tissue repair for select patients. Man this seems promising and with looking into.
i totally understand your hesitancy and I think you are wise in researching this and weighing the pros and cons of each type of surgery. But on the other hand you don’t want your hernia to get larger as your options may dwindle.
whateber decision you make the best thing you can do is select the best and qualified surgeon
for the type of repair you go with. This will dramatically increase a successful repair.
hope this helps