News Feed Discussions Dr. Kang – 1 Year update – Direct Hernia repair

  • Dr. Kang – 1 Year update – Direct Hernia repair

    Posted by Mike M on April 18, 2023 at 9:11 pm

    It has been 1 year since my surgery with Dr. Kang!

    Everything is going great.

    It is night and day from where I was at before surgery (I almost did not make it to Korea).

    No tension issues now, I can run full speed again, plan on lifting this summer, and have already lifted some heavy weight that would directly impact the hernia without issue. No pain when coughing, no bulging, no pop outs. Nothing of the sort.

    I did add weight back starting around winter for the simple fact it was winter and I didn’t want to “over do it” within the first year. I gave the repair every opportunity to heal and get strong more so out of paranoia then necessity. I did walk and move a lot however for the first 3 months after the surgery.

    Dr. Kang put me back together to where I was at prior to my self-induced injury, perhaps even stronger with the perm sutures. Just to rehash – my hernia developed because of excessive coughing + weight (30% BMI) + maybe a little age? (late 40s) most likely. I am a former “athlete” and lifted heavy in the past but I don’t feel that contributed to creating the hernia.

    I feel with open tissue repair you have to be patient and let your body settle down to accept the new fixes.

    Everything for me was a progressive improvement as the days passed post surgery.

    My hernia was large and I lost weight prior to surgery but I was still on the upper end of the spectrum according to Dr. Towfigh and Dr. Sbayi’s interview regarding a Shouldice style repair.

    It was a difficult repair but Dr. Kang was successful and I feel as long as I do not do anything irresponsibly egregious again (i.e. take care of my health) the repair should last “forever”.

    Mesh was never an option for me and neither was surgery at a major hospital under any circumstance except an extreme critical care emergency.

    My biggest concern with Shouldice was all the slicing and dicing near my “manhood” coupled with the fact there was no Doctor I trusted to complete that specific procedure.

    If I did consider mesh I feel there were a lot of potential good options available in the United States with some reputable doctors that I could trust. However the entire surgical procedure of Mesh was not something I could ever come to grips with at my current age.

    Mesh vs. Open Tissue for me personally was a combination of three things:

    #1. What procedure and environment am I comfortable with enduring as it relates to this type surgery and with what Dr. ?

    #2. What procedure leaves the least possible long term negative impact on my body?

    #3. Recurrence still very important but in last place for me. I think there is a lot of blame to go around in regards to a recurrence with no mesh open tissue repair and it starts with the patient being responsible for their continued health. The body is restored to a “healthy” state, perhaps a little stronger even with a good procedure method, but if the patient continues with the same bad behavior / lifestyle and it breaks as a result it is not the fault of what surgery was done or not done. I feel in a scenario of egregious negligence (which I think we are all guilty of myself included) Mesh could be a better long term option with potential downsides that do not always appear in the “research” stats.

    Conclusion is Dr. Kang stands out for a few key reasons:

    #1. His repairs are successful, minimal, and done in a safe (nearly) stress free environment that is very welcoming to foreigners.

    #2. Dr. Kang is an extremely caring and thoughtful doctor who spends his free time continuing to improve the field of Hernia repair.

    Watchful replied 1 year ago 11 Members · 32 Replies
  • 32 Replies
  • William Bryant

    May 10, 2023 at 11:15 am

    I’m sure there will be continued improvement Watchful. As I say I had surgery, not deep nor hernia, but surgery and it was painful at times for ages after. My mum had surgery it was painful at times for years after, even causing her to double over, but eventually resolved. My partner had surgery and had pain on and off for ages.

    I’m confident you’ll ‘settle’ similarly in time.

  • ajm222

    May 9, 2023 at 6:35 pm

    Thanks, Watchful. Looking forward to it.

  • Watchful

    May 9, 2023 at 5:30 pm

    Thanks for the kind words, David M. I was thorough in talking to a variety of surgeons, but I didn’t have an accurate picture of my hernia because of a grossly inaccurate ultrasound. If I had known how bad it was, I wouldn’t have pursued tissue repair. I was aware enough to avoid tissue repair on a hernia of this magnitude. No one knew, though. The only way for me to find out would have been to go to an expert in hernia imaging, and I don’t know of any in the US. Maybe Dr. Towfigh could have arranged that, but she didn’t want to pursue tissue repair in my case, so there was no opportunity for that. For mesh, it didn’t really matter.

    ajm222, William – I have chronic pain and discomfort. It’s not severe, and it’s not debilitating, but it’s definitely annoying and disturbing occasionally. I’ll write more around my 6-month anniversary. There has been an improvement, but it has been extremely slow and gradual. I do expect things to improve further with time, but I’m not sure by how much.

  • William Bryant

    May 9, 2023 at 6:46 am

    Yes Dave And Ajm, and also if they are improving Watchful.?

  • ajm222

    May 9, 2023 at 6:41 am

    @Watchful – can you perhaps explain in more detail what you’re lingering symptoms are today? i may have missed that recently. could be useful to some. thanks.

  • David M

    May 9, 2023 at 6:28 am

    Let me reword that:

    I continue to be amazed at the thoroughness with which Watchful approached his surgery and the open mindedness with which he shares his post surgery journey and thoughts. Very nice.

  • David M

    May 9, 2023 at 6:16 am

    I continue to be amazed at the open-minded ness and thoroughness with which Watchful approaches his post surgery and the sharing of his journey.

  • pinto

    May 8, 2023 at 8:33 pm

    Not until recently had I heard that Dr. Towfigh also does pure tissue repair. Could it be that she is a “unicorn” mesh doc in the same way that the great Yutani baseball player is called that—-unusually adept at two very different approaches? All the mesh docs I talked with spoke as if there was no other possible approach. Would a mesh doc even risk professional standing to be seen appreciably offering it? I know of a non-mesh doc who spoke of feeling ostracized because of his choice. Would Dr. Towfigh also feel some pressure within her medical circles in the same way if she spoke too positively about non-mesh surgery?

    Another point concerns Marcy repair mentioned. I believe someone posted that Dr. Towfigh considers that repair suitable for children but not adults. Yet above in this thread, a post reports that she identifies Marcy doable with slim women patients. If these hearsay reports true, then why not also for slim men? And as I recall her saying, Kang repair seemed Marcy-like, thus questionable. (He though posted at HT his is not to be so characterized.) Any ideas for tying these loose ends together?

    • This reply was modified 1 year ago by  pinto.
  • Max L

    May 8, 2023 at 8:25 pm

    @herniated and @good-intentions

    Thank you both for the helpful advice. I have emailed Stephen Kwon and hope to hear from him soon. I may consider a consult with Dr. Towfigh if I do not hear back from Stephen Kwon in the next few days. I am also open to contacting Biohernia and the Desarda Clinic. One thing I am sure of is that I do not want mesh due to the high incidence of chronic groin pain being reported post mesh implant. Thank you all.

  • Good intentions

    May 8, 2023 at 7:41 pm

    It would be very interesting to know what she considers “trouble”, and how she could differentiate your hernia from others. Does she have a belief that she can predict “trouble” with a patient based on the type of hernia repair performed?

    I doubt that the trouble she referred to was chronic pain. The vast majority of attempts to define an avoidable cause of chronic pain from mesh have been failures. If anyone has a provable way to continue to use mesh and reduce the chronic pain rate they have not made a good case for it in the literature.

    The mesh products seem to have inherent chronic pain properties.

  • Watchful

    May 8, 2023 at 7:11 pm

    She mentioned on a number of occasions that she prefers Marcy (instead of mesh) on small indirect hernias in skinny women.

    I actually consulted with her in person. She was willing to do mesh (either Lichtenstein or lap), but not tissue repair (Shouldice) in my case. I think it was a reasonable call, and most likely the right call in hindsight since Shouldice turned out to be a difficult surgery in my case. She didn’t predict that it would be difficult, but she thought that the risk of recurrence would be too high. Maybe I should say that she reached the right conclusion, just possibly for the wrong reason. We’ll see – hopefully there will be no recurrence. She thought that mesh would not cause trouble in my case, so she saw no reason to go with tissue repair with its higher risk of recurrence.

    I had a really good impression of her – she’s thorough, spends enough time (an hour), and writes proper notes (unlike all the other surgeons that I saw). Clearly, very experienced and careful. If I hadn’t been fixated on tissue repair, I would have most likely gone with her for the surgery.

  • Jack2021

    May 8, 2023 at 6:13 pm

    Dr Towfigh talked a bit about her thinking re tissue repairs for women in her Hernia Talk video with Dr Andreas Koch. They had similar perspectives on this, if I remember correctly.

    The whole talk’s worth a watch for anyone who hasn’t seen it.

  • Good intentions

    May 8, 2023 at 5:29 pm

    One often cited factor to consider when choosing a surgeon is experience. I am certain that Dr. Kang has much more experience in pure tissue repairs than Dr. Towfigh does.

    The text on the web page does not describe what a patient who is a good candidate for pure tissue repair would look like. I think that if a person went to Dr. Towfigh with a hernia and did not request a pure tissue repair they would get a lap TEP mesh repair. That is just a feeling derived from her posts on the forum. She has mentioned in the past that, maybe, women should be getting more pure tissue repairs than mesh. Implying that mesh repairs are over-prescribed for women. Not clear where that thought process is going though. It was just a comment on the forum.

  • Herniated

    May 8, 2023 at 3:30 pm

    The following is a quote from the Beverly Hills Hernia Clinic web site (Dr. Towfigh’s clinic):

    “Since the introduction of mesh in the 1980’s, most surgeons have lost the art of non-mesh tissue repairs of the inguinal hernia. Dr. Towfigh is experienced in non-mesh tissue repairs and regularly offers it to her patients who she feels are good candidates for that. Dr. Towfigh offers robotic-assisted laparoscopic non-mesh hernia repairs as well!

    The benefit of tissue repair is mainly to reduce the risks associated with mesh implantation.”

    Cost – I have no idea – but I have heard that everything in California is very expensive.

  • Good intentions

    May 8, 2023 at 11:38 am

    @drkang might work. Or you can go directly to the Gibbeum hospital web site.

    Stephen Kwon is the contact person for travelers. His email address is at the bottom of the web page. I copied it from there.

    [email protected]

    Dr. Towfigh is a proponent of lap TEP mesh implantation. And, I believe, very expensive. Beverly Hills.

  • Max L

    May 8, 2023 at 9:42 am

    Hello all. After reading various members reviews of Dr. Kang and Gibbeum Hospital, I am considering having surgery with Dr. Kang. I am not interested in laparoscopic mesh repair, which is the only option I have here in California. What is the best way to contact Dr. Kang and schedule surgery with him? I would appreciate anyone’s advice.

  • Watchful

    April 21, 2023 at 7:44 am

    Hen egg size is nothing. My indirect hernia was somewhere between zucchini and eggplant size. Not a brilliant idea to do tissue repair for that in my experience.

  • David M

    April 21, 2023 at 6:39 am

    Thanks for the response. I may have already asked you that, now that I hear the answer. A hen sized egg doesn’t sound all that big to me, but it does give something of encouragement for tissue repair for those with hernias of that size.

  • Mike M

    April 20, 2023 at 8:05 pm

    Hen sized egg is how it was described to me for the direct hernia.

    I also had my belly button hernia repaired which was 1cm, pretty small?

  • David M

    April 20, 2023 at 4:10 pm

    Mike M, How big was your direct hernia? Tennis ball? Baseball? Golf ball? Somewhere in between?

    Does anyone remember who else that Dr Kang treated had a direct hernia?

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