Desarda method patient experience

Hernia Discussion Forums Hernia Discussion Desarda method patient experience

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    • #31002
      worldpeace
      Participant

      It’s been 10 days since a Desarda repair performed by Dr Jonathan Yunis in Florida. Since I’ve read a lot of useful information on this site, I thought I would share my patient experience, though some of the details may be obvious.

      Had an appt with Dr Yunis the day before surgery (after an initial remote consult) and he expressed confidence that he could do the Desarda repair for my case and that it was uncomplicated. We had already gone over the options and chosen the Desarda repair since it seemed less invasive and complex compared to the Shouldice method.

      Day of the Surgery: Had General Anesthesia with LMA (Dr Yunis offers this option rather than full endotracheal intubation) at the surgery center. Dr Yunis post-surgery said it was a direct hernia (contrary to the expected indirect prior to the surgery) and the Desarda repair went through without any complications. After recovery, was able to walk to the car without assistance with some pain – the numbing effect was still on.

      Later in the day, went for a walk outside the hotel room. The transition from lying down to sitting up and out of bed was painful but once I started walking, the pain was not much. Had a couple of Tylenol 500 mg tablets that day.
      Applied ice/gel wraps 20 mins every hour for the next 48 hours.

      Day 1 – Day 3: Pain increased once the numbing effects of the local anesthetic wore off. I think the peak was on the evening of Day 2 and continued till Day 3 afternoon. Dr Yunis called the day after surgery and said to expect some bruising and swelling over the next few days.
      Took a couple more painkiller tablets on Day 2 and one on Day 3.

      Icing:
      Used small round gel wraps that you keep in the freezer for a couple of hours and then can be applied for 20-30 mins.

      Supplements: Taking ginger, turmeric tablets, Bromelain tablets. Stay hydrated.

      Bowel care: Took Colace a day before surgery.
      Followed by another Colace the day of surgery and the next day.
      Added a Dulcolax tablet (stimulant that increases the intestinal movements) on Day 1. Had a bowel movement on Day 2 – that provided relief! I think you need both a stool softener and a tablet that stimulates the blocked bowels to be effective.

      Other tips: Try to avoid coughing, sneezing and laughing! While being painful, it also stresses the operated area. Hugging a small pillow over the incision during those activities offers relief.

      Day 4 – Day 5: Pain decreased and there were no more stabbing sharp pains. I didn’t notice much bruising or discoloration. There was stiffness getting in and out of bed and some pain while making any sudden turns or movements. Continued to take walks of around 1.5 miles daily.

      Took the flight back on day 5. Had asked for wheelchair assistance but didn’t use it since I was in okay shape to manage on my own – didn’t lift any bags since my family accompanied me and helped take care of that.

      Day 6 – Day 10: Noticed a decrease in pain after exactly 1 week after surgery. There is little swelling on the incision and apart from that some pain while getting in and out of bed. Hope that this will reduce gradually over the next days and weeks.

      Overall, the pain has been tolerable and the entire recovery experience much less painful than I had imagined (took a total of probably 5 tablets of Tylenol and Advil combined and no prescripion opiods); I think to a large measure this has been due to the quality of the surgery and the technical expertise of Dr Yunis. Kudos to him and his staff for running a very good surgical team and office. Prior to the surgery, I had exchanged a lot of emails with Melanie, the nurse, who patiently answered all of them – a very positive experience.

      In summary, post surgery, it’s been a combination of exercise (walking), supplements, icing and Dr Yunis’s surgical technique that has led to a less painful experience so far. Again, this has been my experience, given there is a lot of individual variability with respect to pain occurrence and tolerance. Thanks again to this forum.

    • #31003
      William Bryant
      Participant

      Thanks for update. Could you do an update in future too

    • #31004
      Watchful
      Participant

      Great summary, worldpeace. Glad it went well.

      Do you have any more details on why you (and Dr. Yunis) decided to go with Desarda vs Shouldice, and general anesthesia vs sedation/local?

    • #31006
      Chuck
      Participant

      thanks for posting…why did you choose desarda technique…and if you wanted desarda…why didnt you go to Tomas who was nearby and focuses exclusviely on that techinque? i will be very interested in your ongoing reports as many desarda patients report that they are still feeling pain and weakness a year later..

    • #31010
      William Bryant
      Participant

      From what I’ve read the recovery is slower with Desarda, or can be, Chuck. Two years until full strength apparently. Gradual improvement.

      Not sure that means pain or just tissue bonding though.

    • #31148
      worldpeace
      Participant

      @chuck: thanks for posting…why did you choose desarda technique…and if you wanted desarda…why didnt you go to Tomas who was nearby and focuses exclusviely on that techinque?
      I chose Dr Yunis first, the technique later. I was convinced Dr Yunis had enough experience with both techniques and so postponed the technique decision later …

      @watchful: Do you have any more details on why you (and Dr. Yunis) decided to go with Desarda vs Shouldice, and general anesthesia vs sedation/local?
      On GA vs LA with sedation, here are the factors that came up:
      1. From the viewpoint of the surgeon/anesthesiologist, what’s the patient’s risk profile for GA?
      2. The doctor suggested GA in my case
      3. For a small percentage of patients, the LA nerve block may cause a temporary numbness of the leg due to it affecting the motor nerves and hence cause difficulty in walking on the surgery day.
      4. For LA, the overall surgery time may take longer by another 20 minutes or so since the doctor has to do the ultrasound guided nerve block in addition.
      5. Given the relatively short surgery time, there was less likelihood of post anesthesia side effects such as nausea and difficulty passing urine. I was given to understand the anesthesiologist had a good control on those side effects.
      6. The GA was done with a LMA instead of full endotracheal intubation.
      7. Patient’s fear of going through GA – the fear of losing full consciousness.
      Considering all the above, I chose the GA. Both options were available.

      Desarda vs Shouldice: It wasn’t a straight decision to go with Desarda but finally chose this because I felt the technique was less complicated than Shouldice even though the history and data are more favorable for Shouldice. There is tissue manipulation in both cases.

      Thanks.

    • #31150
      Watchful
      Participant

      @worldpeace: Thanks for the detailed response. I understand your thinking, but I think my choice would be local anesthesia and Shouldice. The thing that bothers me a bit with Dr. Yunis is that even though he’s willing to do that, he prefers to do general anesthesia and Desarda (your procedure). I feel a little hesitant as a patient to nudge the surgeon to do something that isn’t his first choice. I don’t know why it’s not his first choice – maybe because it’s more complex and time consuming, or maybe he feels that it’s not the best in his hands, or maybe something else. I didn’t ask him for his reasons. There are reports of him doing it successfully (e.g. Thunder Rose), so I’m probably overthinking this.

      Alternatives for that procedure are Dr. Sbayi or the Shouldice Hospital. I’m also considering Dr. Kang in South Korea who seems to be doing a modified Marcy with local anesthesia.

      • This reply was modified 2 months, 1 week ago by Watchful.
    • #31515
      worldpeace
      Participant

      @chuck and others, I thought I’ll post an update since it’s been 2 months since the surgery.
      – The incision has healed and I see a thin line where the skin was cut but the skin is sealed. There’s a bit of hardness around the incision and it’s slightly raised, hoping that will go down with time.
      – No pain while doing daily activities
      – Had a twinge of pain when I had a bout of deep coughing (due to dust) but that went away after the coughing subsided
      – Haven’t been lifting heavy stuff so not sure if that can cause pain.
      – Been able to jog around the park without any discomfort.

    • #31558
      William Bryant
      Participant

      Hello worldpeace, hope you’re still doing ok? When you get a moment perhaps another update if possible?

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