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3 week follow-up to determine hernia repair success – incredible
I came across this item and of the responses from what appears to be a hernia repair “specialist” was shocking.
http://skepticalscalpel.blogspot.com/2018/01/is-chronic-pain-after-inguinal-hernia.html
Here’s the paper referred to – https://onlinelibrary.wiley.com/doi/full/10.1002/bjs.10652
And here is the original question from the link above, and the “doctor” ‘s reply.
“Is chronic pain after inguinal hernia repair a big problem?
Yesterday one of my twitter followers posted this:
He was referring to a paper in the British Journal of Surgery that said 15.2% of patients who had inguinal herniorrhaphies complained of severe chronic pain one year after the surgery. Open hernia repairs caused significantly more chronic pain than did endoscopic total extraperitoneal [TEP] repairs, but the reoperation rate was significantly higher for TEP procedures.The study included almost 23,000 patients and was based on data from the Swedish Hernia Registry and a questionnaire sent to the patients one year after their initial hernia operation. Pain was rated on a scale of 1 to 7 and was considered chronic if it was present for more than 3 months and interfered with daily activities.
The recurrence rate for the 18,000 patients who had open anterior mesh repair was 3.4% compared to 23.3% for the 2688 who had TEP repairs.
The authors concluded that the trade-off for less pain was an increased recurrence rate. Only 232 [1.39%] of the 1666 patients with recurrent hernias had undergone repeat herniorrhaphy.
Here is the comment. Cut the nerve, and claim success at 3 weeks. Hard to believe that there are surgeons who are so short-sighted, but he talks like he’s a real surgeon. – Rugger said… Just cut the ileoinguinal nerve. Problem solved. I cut it on everyone and place a hernia prolene system. Never had a single complaint after cutting the nerve, and I ask everyone at 3 weeks follow up. Some of us were told that this is malpractice, but it is not, and many do it, especially with an anterior approach and with putting mesh. January 12, 2018 at 2:24 PM
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