Dr Bruce Ramshaw – long time off!

Hernia Discussion Forums Hernia Discussion Dr Bruce Ramshaw – long time off!

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  • This topic has 8 replies, 5 voices, and was last updated 2 weeks ago by Luke.
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    • #26995
      Mark
      Participant

      Dr. Ramshaw has not been practicing since this covid hit. Because of he had a reputation that is second to none, or at least it seems, I wanted to consider him for a pure tissue repair I need for an inguinal hernia. Problem is I have no idea what he specializes in…if mesh or pure tissue. And if he does any pure tissue repairs does he do many? He may be worth waiting for him to start practicing again. Anyone who knows Dr Ramshaw please chime in on what repairs he offers and what he is best known for.

    • #27031
      Good intentions
      Participant

      Dr. Ramshaw is a proponent of mesh repairs. In some ways, he is a denier of the premise that mesh itself causes pain or discomfort. He has stated explicitly that “mash does not cause pain”. His arguments on that topic are kind of convoluted and weak. He has his patients take a psychological exam before surgery, I believe, to see if they will be able to deal with the foreign body feeling.

      He’s an interesting person in the field, very popular and active. But he is firmly in the mesh repair camp, I think.

      Here is a video from a couple of years ago.

      Mesh: Must Avoid or Must Have? 2018 SAGES Meeting

    • #27034
      Good intentions
      Participant

      Here are a couple more articles with his comments.

      https://www.generalsurgerynews.com/In-the-News/Article/01-19/Surgeons-Call-for-Closer-Surveillance-of-Mesh-After-Implantation/53739?sub=6CB4505D3F4E7434F342E8CEDDD36EA48483E49B459AF20B8C3C8A9101426

      “The relationship between mesh and chronic pain is poorly understood, Dr. Ramshaw said. “Let me be clear: Mesh doesn’t cause chronic pain but it may be a contributing factor as part of the many factors that can contribute to chronic disabling pain.”

      Register for this newsletter and you can read this one –

      https://www.generalsurgerynews.com/Opinions-and-Letters/Article/03-20/Value-Over-Volume/57512

      • #27048
        Mark
        Participant

        Good intentions,

        Amazing response and info…very thankful! I had no idea, I watched the interview on herniatalk and he is all about research rather doesn’t really talk about actual hernia surgery like the other guests. it was disappointing to say the least. If that is the case…I will rule him right out as I’m only considering pure tissue repair as this is a first time surgery for me. Thanks again!

    • #27037
      Good intentions
      Participant

      And there is this. I have not watched it but it is probably informative. It’s the Herniatalk Q and A with Dr. Ramshaw from May 3rd.

    • #27039
      Good intentions
      Participant

      Here’s the view on the psychosomatic angle. My mesh removal surgeon found that the mesh was surrounded by edematous tissue. I don’t think that my brain produced it. I felt great before surgery and expected a good outcome.

      https://medicalxpress.com/news/2020-02-team-hernia-surgery-recovery-outcomes.html

      “The predictive model suggests that the emotional status of the patient prior to surgery—levels of depression, anxiety, grief, or anger—influence recovery outcomes. Patients may experience less pain if their fears or emotional issues are addressed before surgery.

      “If we begin prehabilitation, which includes a holistic assessment—not limited to physical and emotional condition—of the person prior to the intervention, then we may be able to affect outcomes,” Koszalinski said.”

    • #27106
      Alephy
      Participant

      I watched the video, the first one, and I found it interesting. He mentions a pure tissue recurrence rate of up to 12%, depending on the method/individual etc. : this is in stark contrast with what some doctors quote i.e. I was told durng a visit that it is more than 30%. He also mentions the necessity to discuss the procedure with the patient, with the assumption that the doctor (who knows better) guides the patient, based on his/her goals: this part I also agree, with the understanding though that if the patient happens to know for a fact that something does not work, the doctor should not pretend to force it on the assumption that he knows better. As an example, years ago Asbestos was widely used in the building industry: now I am not an engineer, but if one told me they plan to use heavily Asbestos to build the house where my children will spend a good chunk of their lives, and that I should trust them, well I would first ask questions, then point to the facts, and finally get angry

    • #27702
      drtowfigh
      Keymaster

      Dr Ramshaw is among the pioneers of laparoscopic ventral hernia repair. His practice slowly evolved into treating patients with chronic pain and mesh-related problems for both ventral and inguinal regions.

      He is currently on sabbatical and it is not clear when he will start treating patients.

      With regard to the % quote, it may very well be true that in your surgeon’s experience, their recurrence rate is 30%. These values are very surgeon and technique and patient dependent. To use your home construction analogy, it’s like asking what’s the square footage of the house you build? An average square footage may be provided, but the real number varies per builder.

    • #27711
      Luke
      Participant

      Dr Towfigh that helped tremendously thank you!

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