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Desarda vs Grischkan’s two-layer Shouldice, etc…
No, I still haven’t been able to get my inguinal hernia dealt with – family medical issues have gotten in the way. The good thing about that is that I’ve had additional time to research and ponder options. The bad thing about that is that I’ve had additional time to research and ponder options. 🙂
Definitely still wanting a no-mesh repair. Shouldice seems overly invasive and I’ve read multiple patient reports of lack of understanding and support by Shouldice Hospital with post-surgery complications. I’ve been seriously considering Desarda repair with Dr. Tomas in Florida or Dr. Parvez in New Mexico and have been In contact with both offices. Have talked on the phone with Dr. Parvez directly, but Dr. Tomas charges $$$ to talk directly to him on the phone so I’ve only talked with his staff at this point. I’m now also looking into Dr. Grischkan’s 2-layer Shouldice repair, but haven’t found any data or studies about it regarding practicality, reliability, long term results, chronic pain, etc. His website says that he’s done over 25,000 hernia repairs, but it doesn’t say how many were his 2-layer Shouldice (no mesh) and how many were his modified Shouldice (using gore-tex mesh) repair, or if the chronic pain or recurrence percentages are different between the two methods.
His website describes his 2-layer Shouldice this way:
“With the appropriate layers opened as prescribed in the Shouldice Method and hernia tissue reduced, the Transverses Abdominis Arch and lateral edge of the Transversals Fascia are approximated in a continuous manner to reduce tension. No wire suture is used as is called for in the pure Shouldice Method, but instead a flexible polybutester suture is inserted to accommodate athletic movements. A second layer incorporating the Inguinal Ligament and Transverses Abdomens Arch is then placed to reinforce the first layer in a similar manner.”
I have no idea if the above method is sound or not, but it definitely trims some steps from the original Shouldice technique. The website also says:
“The modified Shouldice hernia repair takes less than 20 minutes and patients can be discharged within one to two hours following the shouldice surgery. Most patients return to full activities and employment within two to three days following the repair.”
Sounds too good to be true, so I’m very interested in input of any kind.
I’m also interested in the practicality and durability of the 2-layer Shouldice vs. the Desarda repair – which (if either) makes more sense from a structural/mechanical/physiological/reliability perspective. I’m not a doctor so I really have no idea which structures of the inguinal area are most likely to provide the strongest, most reliable, most comfortable repair. Does anyone that knows more about this than I do (which is probably everyone reading this post) have any thoughts?
I do have concerns with Dr. Grischkan’s reported lack of interest in dealing with follow-up problems/complications from his surgery – I’ve only seen a small handful of these reports but I find them very concerning. I want a surgeon that will be there for me if I have problems after surgery, not just before.
The reason I’m looking into Grischkan’s repair is that he’s much closer to me than either Tomas or Parvez. However, I don’t want to end up cutting corners to stay closer to home and end up with an inferior repair and/or a surgeon that won’t take care of me if I have problems after surgery. So I guess I’m trying to rule Grischkan and his 2-layer no-mesh Shouldice repair either in or out as a possibility – thus the reason for this much too lengthy post.
I have also found another less-distant surgeon that has offered to do Shouldice or Desarda for me – whichever I want. But as I understand it don’t think she’s done that many of either, so I feel unsure of the quality of the repair I might be receiving. May be fine, or maybe not. Unsure how to proceed there.
I realize that no single method of hernia repair is guaranteed to give perfect results to every patient. Therefore, I’m trying to do what I can to maximize my chances of a good outcome by doing due diligence on surgeons and methodology before surgery. Any thoughts or information anyone may be able to share is appreciated!
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