News Feed Discussions 3rd Hernia repair required – need "perspectives" on fixing

  • 3rd Hernia repair required – need "perspectives" on fixing

    Posted by Matteo on September 26, 2018 at 2:11 pm

    First, thanks for this forum. While I wish I didn’t need such a thing – it’s wonderful that a forum like this exists for those who need it (and finally decide “doing the homework” for their own self-care is in their best interest).

    I’d like some insights from others as I navigate the need for a 3rd surgery to repair one of the bilateral inguinal hernias. The last I had (on the left side) less than 2 years ago (laparoscopically – which the doc said afterwards was one of the most challenging due to scar tissue). I’ve also had an umbilical hernia repair and as a baby, a right-side inguinal repair which seems to be fine. I’m now through with general surgeons (even with extensive hernia repairs) and looking for specialists. Strongly desire this to be the last time I have to go through this. I’ve seen 3 general surgeons and mostly all have stated the same things more or less – but leave me a bit unsatisfied. My questions to this forum are:

    • Anybody know a specialist in the Portland, Oregon area they’d recommend? (If necessary, I’ll travel to Seattle or LA area… but would like to start in PDX)
    • Collagen. “bad protoplasm” I’ve been calling it. Should I take steps to evaluate this being a possible condition? One doctor I saw said he didn’t “feel” this was an issue for me as he prodded the area. Another said the area of the hernia, considering this will be the 3 fix, could be pretty stringy and when asked how to fix it – mentioned “getting creative” and a possible solution was stapling the mesh to my pelvic bone. Is that wise?
    • Plugs. All docs to date said… mesh with plugs (possibly 2 of them given the perceived size of the hole). Plugs have a pretty bad wrap in this forum. Anybody have success or recommend a different direction?
    • Imagery. Should I get an MRI, CT or Ultrasound? Reading the threads I hear mixed reviews on the value for diagnosing. My gut says it can’t hurt. My pocket book says it will.

    My gut says spend the time and money to image and meet with as many specialists to get this as right as possible tho it will create some real life, immediate term impact. Would love some thoughts to assist with clearing the fog to help define the approach. For the time being, I can put up with inconvenience and discomfort in an effort to find the right solution but also need to get to making a decision. Any thoughts would be appreciated – especially doctors in the Portland area who could provide up-to-date insights and handle what has been called a “complex” hernia repair. Thanks.

    John Fortem replied 6 years ago 4 Members · 4 Replies
  • 4 Replies
  • John Fortem

    Member
    October 1, 2018 at 10:00 pm
    quote dog:

    Great Business ..one inserted it…Second remove it ..You see every one has job! Well …Will you trust surgeon who created mess in the first place to undo it? I wouldn’t

    True and true…

  • dog

    Member
    October 1, 2018 at 1:47 am
    quote John Fortem:

    I agree on the previous statement that “initial hernia repair and fixing a failed repair are two distinct specialties”.

    I have read about several cases where the surgeon gladly repairs a hernia with a mesh, but when the patient presents with complications, the surgeon agrees that the mesh is the reason for the complications and that the mesh needs to be removed. But they don’t easily agree to attempt to remove the mesh themselves, and send the patient off to see another surgeon who specializes in mesh removals.

    Depending on where you live in the world, you may have to travel to another state, country or even a different continent to have the mesh removed. Just because the original surgeon doesn’t dare to attempt to remove the mesh, because of the added risks with that procedure alone. But they are all scalpel-happy to have the mesh implanted without reason or questioning…

    Great Business ..one inserted it…Second remove it ..You see every one has job! Well …Will you trust surgeon who created mess in the first place to undo it? I wouldn’t

  • John Fortem

    Member
    September 29, 2018 at 11:58 am

    I agree on the previous statement that “initial hernia repair and fixing a failed repair are two distinct specialties”.

    I have read about several cases where the surgeon gladly repairs a hernia with a mesh, but when the patient presents with complications, the surgeon agrees that the mesh is the reason for the complications and that the mesh needs to be removed. But they don’t easily agree to attempt to remove the mesh themselves, and send the patient off to see another surgeon who specializes in mesh removals.

    Depending on where you live in the world, you may have to travel to another state, country or even a different continent to have the mesh removed. Just because the original surgeon doesn’t dare to attempt to remove the mesh, because of the added risks with that procedure alone. But they are all scalpel-happy to have the mesh implanted without reason or questioning…

  • Good intentions

    Member
    September 26, 2018 at 4:59 pm

    Dr. Martindale of OHSU seems to have a reputation for understanding and fixing difficult situations.

    It’s not clear if you’re counting the repair as a baby and the umbilical repair as part of the three, or if you’ve really had five surgeries. If you had bilateral repair via laparoscopy less than two years ago then you probably had two large pieces of mesh implanted, and you’re saying that one has failed. There are many different types of mesh available for repair, and many different ways to use them. Those details could be important. The scar tissue problem might have been from the entry point for laparoscopy at the navel, where the umbilical hernia had been repaired.

    OHSU has a very long wait time to get in, generally, but seems to be a very good institution. The initial hernia repair and fixing a failed repair are two distinct specialties, I believe. You’ll want somebody that knows how to work around and with the mesh that’s already been implanted.

    https://www.ohsu.edu/providers/robert-g-martindale/332DF38FFB324681949B3E75BD3B492B

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