800,000 hernia repairs in the US each year -how many tissue?

Hernia Discussion Forums Hernia Discussion 800,000 hernia repairs in the US each year -how many tissue?

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    • #30944
      Chuck
      Participant

      anyone care to guess..we have about 5 or 6 tissue guys…that can do good reapirs…so maybe 2000 tissue repairs per year? is this why we don’t hear many tissue repair failure stories…i know when i was looking into this i found a ton of people posting on tissue repair boards that had continuing pain from tissue repairs…even years after the repair. Having mesh inside me is driving me crazy and i want it out….but struggling with the idea thaat tissue repair is the holy grail despire Good intentsions constant effortsz to make it that …as watchful has pointed out there are a ton of shouldice chronic pain reports…my lap doc said he saw shouldice patients from the clinic with chronic pain…there are studies should 25 percent chronic pain from shouldice….most seem to think berlyansky can get mest out just fine…but then putting in a shouldice…will that make me worse or better???

    • #30946
      Chuck
      Participant

      and unlike lazy Towfigh i will post a study 36 percent chronic pain shouldice

      https://pubmed.ncbi.nlm.nih.gov/15243743/

    • #30954
      Watchful
      Participant

      Thanks for the link, Chuck. The numbers from the Shouldice Hospital are different, though. 1% debilitating chronic pain, and an estimate of 5% for chronic pain in general.

      The issue with general studies is that they are not focused on the top surgeons. There’s a huge variation in the quality of the work of different surgeons (and doctors in general). It runs the gamut from sloppy corner-cutting work causing harm to meticulous by the book minimizing bad results. It seems that with tissue repair the quality and experience of the surgeon are particularly critical.

    • #30958
      Chuck
      Participant

      Yea but as you point out…lots of lousy docs at the hospital…one guy was called out four or five times…HArris maybe? Not many outside the shouldice hospital do the surgery and those that do are experts…so the pain is really a risk with shouldice. I still think kang has best odds..its too late for me…i am in urinary agony daily thanks to fing catheter i didnt know would be used…looking at deaath with dignoity

    • #30959
      Watchful
      Participant

      They injured you with the catheter, and it never recovered?

    • #30960
      Good intentions
      Participant

      You should see a good urologist Check. Focus on one problem at a time. The mesh should not cause urinary problems unless it is eroding in to the bladder.

      Thanks for finding and posting that paper. The results are definitely extremely different than any that I have seen. Even the Lichtenstein method is reported as having very high pain and causing physical constraint.

      I looked through all of the primary author’s work and found that he publishes a lot but has only published one other inguinal hernia-focused study. I can’t find any sign that he or they learned their Shouldice or Lichtenstein technique at the two main sources of training for those methods. It looks kind of like they self-taught themselves, solely for the purpose of the study. They had done one similar study about six years earlier.

      I will just say what my cynical side is saying to me, to stay in character – it looks like they were looking for benefits to laparoscopic mesh implantation, did some reading about the competing methods, and found some people to practice on. Where is the evidence that they were competent in those methods? It might be in the full publication, that has to be paid for to view. Maybe somebody has a college account and can dig it up.

      The paper did get a lot of attention. It has been cited 55 times.

      https://pubmed.ncbi.nlm.nih.gov/10023558/

    • #30971
      William Bryant
      Participant

      With mesh, can see why there maybe pain, curling up, folding over, digging in.

      But why with Shouldice?

    • #30972
      Watchful
      Participant

      Many reasons… Nerves can be damaged during the procedure – a number of them are there. The spermatic cord needs to pass through the repair which can be too tight. Scar tissue can press on things.

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