Does Lorenz move in to the lead after Towfigh interview?

[Chuck]

Watchful or others….your impression of Lorenz? He seems to have changed Dr Towfighs mind on the desarda repair….a repair she debunked as previously tried and unsupported. Lorenz seems to do all the repairs…shouldice desarda mesh….he may be in the best position to tailor the repair of any surgeon. What are your thoughts>? Conze looks good,,,but he is not high on desarda….so you are getting a shoulice if you go there…with all of its invasiveness

[Chuck]

Vwry impressed with Lorenz….just seems like a really nice guy too compare to Peterson…Grishkan …krpata….all cold as stones…Lorenz just seems very careful and detailed.

[Chuck]

Watchful really surprised that you talked to Lorenz but did not select him….so impressive….and obviously gives a damn….plus he can tailor repairs….seems to do a lot of imaging that might have given you a clue about the size of your hernia.

[Chuck]

I wonder who did Lorenz’s own perfect shouldice….maybe thats the guy to see…not sure why people are so protective of the surgery info…he would not disclose it to towfigh…was it conze…wiese?

[William Bryant]

I can only think he didn’t want to give a competitor a mention. Not sure why else he wouldn’t reveal his surgeon.

[Watchful]

Privacy. Why name someone without asking their permission?

I liked Lorenz, and he does indeed have the nicest personality. For those who are interested in Desarda as an option, he would be a better choice than Conze as I mentioned before.

I had a slight preference for Conze because he has many more reviews, and a few other reasons. However, I think both are superb choices.

My belief is that none of these German surgeons would have done Shouldice in my case because of the size of my hernia. Well, maybe Wiese would have done it. He told me that he does Shouldice on large indirect hernias, but not large direct ones. Mine was indirect. Another thing that’s different about Wiese is that he uses extra long-term absorbable sutures (Monomax) on some of the stitching.

• This reply was modified 3 months, 1 week ago by Watchful.

[Chuck]

Privacy? This isnt a sexual encounter…these guys are in the business of hernia repair. Its common for people to recommend doctors. In fact thats how most find their surgeons. You have ducked the question yourself about who you went to at Shouldice. Given you are the brightest light on this board….many might benefit from your recommendation. While you didnt get a good result….I am sure you picked the guy who you thought was the best Shouldice surgeon in the world. No one does the research you do…then goes to someone with lots of question marks. So I would still love to hear who you selected. Doesnt Lorenz give patients an additional option over Conze..since he is familiar with the Desarda Technique —the other forum genius JF believes that Lorenz should be considered the leading candidate for most patients….JF has put in almost the same amount of research as you………

[pinto]

@William, let me add a possibility why he didn’t name his surgeon: community standard/protocol. In his medical circles, such public naming might be unprofessional. It saves conflict that might arise within the community: “Why didn’t you choose me?”

In the US, a similar policy exists in sports arenas: Doctors are paged not by name but by number, etc. This avoids possible abuse for personal gain by a doctor.

[William Bryant]

Yes Pinto and Watchful that may be the case actually, I didn’t think of that… but then if it wasn’t polite or etiquette I wonder why the question was asked?

Yes you’re right … I’m itching to know!!!

[pinto]

Privacy? It may be a difference between Old World and New World thinking. The question was moderately polite but possibly more acceptable within US circles.

[pinto]

About this surgeon, could some of the commentary here be a bit superficial? I’m unsure how some of his personal attributes will translate into technical/surgical skill.

BTW about a separate matter: Dr. T’s original view of Desarda was quite, quite reasonable. Quite! (I’m not saying it was correct but her reasoning was quite sound.)

• This reply was modified 3 months, 1 week ago by pinto.

[William Bryant]

Yes the Americans, without seeking or wishing to offend, are very open as far as I can tell. UK mote reserved probably Europe too.

It’s hard to know how good his results are as there are none or few of his patients who have posted on here. The same was true more or less, until recently, of the other German surgeons. I think a UK surgeon recommended Scarletville to see Dr Lorenz but I may have mixed that up with Dr Conze. Watchful knows and usually corrects me.

[Jack2021]

It was Dr Martin Kurzer in the UK who recommended Dr Lorenz to Scarletville. Dr Kurzer has (or did when I spoke to him a couple of years ago) the Desarda repair listed as an option on his website. However, when I spoke with him he said he wasn’t particularly experienced with the Desarda repair and pushed a mesh option, saying he’d never had any issues with mesh etc etc.

Scarletville went on to have a mesh surgery in the end, due to covid restrictions at the time I believe.

[Jack2021]

Perhaps Dr Lorenz was uncomfortable saying in a recorded interview who his Shouldice surgeon was, but may disclose it in a private consultation. I wouldn’t be surprised if he’d told Dr Towfigh after the recording ended.

When I had a hernia ultrasound in the UK, the radiologist told me he’d had a hernia repaired with mesh and he reckoned his surgeon and a couple of others he named would probably do tissue repairs too. When I asked which one did his surgery, he told me without hesitating, but suffice to say they were all general surgeons and only offered mesh.

[David M]

The post in the following thread by baris named Lorenz as the surgeon that Dr Koch would go to if he had a hernia. So, it’s the best bet that the surgeon who did the Lorenz surgery was Koch. And vice versa.

No-mesh Shouldice Hernia Surgery in Germany / Europe

[David M]

Watchful, did you go to Germany for your consultations with the Germans or have those consultations remotely? Just the three – Wiese, Lorenz and Conze?

[Watchful]

Those were remote video consultations. That was a mistake – I should have gone in person to Conze and/or Lorenz, and have them do the ultrasound. International travel was still a pain at the time because of the pandemic.

[William Bryant]

Just watched the Dr Lorenz video on Dr Towfighs YouTube. Very good, seems experienced in a number of techniques. Good point about poor collagen in older patients which makes me wonder how that is found out? Does it show on imaging or only when the operation is undertaken?

I also understand a bit more now, thanks to Dr Lorenz, what a uk consultant meant when I asked him about chronic pain and he said it may be due to arthritis prior.!!!

Dr Lorenz made this plainer, promptes initially by Dr Towfigh, talking about a patient of hers who had spondylitis and his chronic pain following hernia repair stopped after she realised and he got treatment for spondylitis – but not until he’s had nerve blocks, implant and neurectomy. Which didn’t solve it.

[pinto]

@William, what do you make of that: “he said it may be due to arthritis prior.!!!”

Seems preposterous to me but what do I know. People cannot distinguish their prior arthritis pain and post-op pain? Was that doc saying the patients mis-attributed their arthritic pain to that of their surgery? Or he’s saying the surgery triggers increased arthritic pain?

Being curious I googled the matter but couldn’t find any link with arthritis and post-op pain. I wonder if such associations might be made to divert attention away from the offending mesh, if the case.

[William Bryant]

It was a UK consultant who said it to me, I didn’t understand it and dismissed at the time. But I’m guessing he meant if you had an underlying issue it manifesr after, for some reason. Maybe I misunderstood as it was at the end of the consultation.

[pinto]

I’ve had some, what I consider strange, encounters with some general surgeons who do hernia mesh surgeries. If I never had a hernia and not experienced as I am now, I would have been shocked. Hernias are the pits, but at least I got some good experience dealing with medical services. 😀

[William Bryant]

Here’s another hernia repairer stating chronic pain is sometimes due to pre existing condition… I still don’t fully grasp it but that’s Dr. Towfigh and her patient with spondylitis, My UK consultant saying chronic pain could be down to existing problem such as arthritis and now biohernia….

“98% of hernia surgeries without mesh are performed successfully. Less than 2% of patients develop a form of chronic pain, often this chronic pain can be attributed to previous aches or lifestyle.” – biohernia

[Watchful]

William,

This statement from Biohernia makes no sense. I think what they’re trying to say is that in some cases the chronic pain actually existed before surgery, and wasn’t caused by the surgery.

Also, I don’t know where they’re getting the 2% figure. It’s meaningless unless they actively follow up with patients (similarly to what Dr. Kang did recently).

[William Bryant]

Hello Watchful, that’s what we’re trying to fathom. I don’t know if you remember but I was told pretty much the same thing by a UK consultant. When I asked about chronic pain he said it maybe that patients had a condition prior to surgery such as arthritis.

I dismissed it as me not understanding it as he couldn’t, in my view, be serious.

But now we have that biohernia statement.

And Dr Towfigh mentioning on the interview with Ralph Lorenz, one of her patients had spondilitis I think it was and that was cause of chronic pain.

I can’t see it myself so relying on the brainier forum members here.

In addition to that it’s been claimed size of incision can be a factor in chronic pain. As can be if the hernia was painful prior to surgery.

[Watchful]

These are all talking about cases of chronic pain unrelated to the hernia surgery. Sometimes people have pain for some other reason, and they attribute it to the hernia surgery.

If pain in the area shows up right after the surgery, and it wasn’t there before the surgery, it’s extremely unlikely that it’s caused by something else. If it shows up later on, it may be a little more challenging to tell.

Attributing the pain to some other cause can be correct in some cases, but it can also be used as a gaslighting tactic.

[William Bryant]

Yes that is exactly what I think and that is why it dismayed me when the UK surgeon said what he did.

In Dr Towfighs example, the patient was treated for hernia related chronic pain via neurectomy etc prior to being treated for spondilitis. In that case it was wrong way round! It wasn’t Dr Towfigh who did the hernia surgery related pain issue treatments so no fault there. I think it was down to her the underlying cause was found.

[Author]

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