Finding no-mesh inguinal hernia surgeons on west coast?

[drtowfigh]

Finding no-mesh inguinal hernia surgeons on west coast?

Thank you for reaching out to HerniaTalk forum for your questions.
There is no tablet or medication to cure a Hernia.
Surgery is the only cure. Exercise and loss of weight and improvement in core abdominal muscles can help limit symptoms.
Feel free to read through all the different posts on this forum to get more information on each.

[taimur Ahmed]

Finding no-mesh inguinal hernia surgeons on west coast?

Hi sir/mam..this is taimur Ahmed aged:-22 , I had inguinal hernia since 8months – 1yr ..is any medicine are there treatment? Nd if no medicine then , it will cure by laparoscopy ?r with any tablet?

[drtowfigh]

Finding no-mesh inguinal hernia surgeons on west coast?

There is no study that shows polypropylene or other mesh can cause autoimmune disorder. There is also no study to confirm that those with autoimmune disorders do worse with mesh.

Anecdotally, I have treated patients whose autoimmune disorder flared up or presented with an autoimmune disorder soon after mesh implantation. In some, removal of mesh reduced their symptoms. In others, there was no change.

In short, we don’t know enough to answer this question. In my practice, I tend not to place mesh in patients with lupus, rheumatoid arthritis, fibromyalgia.

[DrEarle]

Finding no-mesh inguinal hernia surgeons on west coast?

I am not aware of any good data to suggest there is even an increased risk of a problem, let alone a given subtype of disease. None of the polymers used evoke an immune response, but all evoke a foreign body response of variable, and unpredictable intensity. Some of the coated mesh products however can have contents in the coating that could cause an immune response in rare circumstances.

[Chaunce123]

Finding no-mesh inguinal hernia surgeons on west coast?

Are there specific types of auto-immune disorders that increase the mesh risk? Or is it any auto-immune problem at all? Even something simple like hay fever, celiac, or psoriasis? Or is it worse auto-immune disorder like lupus, RA and MS?

[drtowfigh]

Finding no-mesh inguinal hernia surgeons on west coast?

If the hernia is small, I would err on no mesh.

[goldenmsc]

Finding no-mesh inguinal hernia surgeons on west coast?

Would you recommend mesh or tissue repair for male inguinal hernia with documented autoimmune disorder?

[drtowfigh]

Finding no-mesh inguinal hernia surgeons on west coast?

I promote the use of tissue repair for inguinal hernia only in those who are
– super thin
– women
– have an inflammatory disorder
– infected

I for sure do not recommend it for:
– obese
– large build
– recurrent hernias

The American Hernia Society has a quality collaborative (www.ahsqc.org). It will soon be helping surgeons track their outcome for inguinal hernias and will help be the database nationally. Please ask your surgeon to sign up and add their patients to this.

[DrEarle]

Finding no-mesh inguinal hernia surgeons on west coast?

Chaunce123 – it seems easy enough to send out a survey. But by the time you have one validated, it’s very hard to get all that info stored in a single place. It’s one of the things the federal government should have done, and create a single medical record for the US. But that’s a whole other conversation. One thing to consider regarding having your own tissue “heal” to repair a hernia, is that your own tissue is defective, hence the reason you have a hernia in many cases. Using defective tissue to repair a problem caused by defective tissue doesn’t make sense to me.

[Chaunce123]

Finding no-mesh inguinal hernia surgeons on west coast?

Dr Earle, thanks, those are certainly good points that are all worth considering. It seems like long-term follow up is missing for many procedures in the USA which is unfortunate. Maybe something as simple as having follow-up surveys to patients at 6 months, 1 year, 5 years, 10 years, 20 years to checkup and poll outcomes would be a good idea.

For me personally, I am just more comfortable with the idea of letting my own tissue heal together than having a permanent mesh which can’t be removed if it became problematic. If it was easily removable without major side effects, I would probably opt to try the mesh repair and see if it helped my situation. Hopefully researchers and device companies are working on this stuff.

[DrEarle]

Finding no-mesh inguinal hernia surgeons on west coast?

Chaunce123 – Excellent perspective. I would also like to reiterate that if you ask a surgeon his/her rate of chronic pain two years after operation, few, if any will know. So if they tell you it’s zero, they are not telling the truth. If they state they’re in a small area, and surely their patients would return to them, therefore their numbers are accurate, they are not. If someone advertises on the internet and has a bunch of patients from out of town, they definitely do not know. Just though I would mention those things as well when asking your questions.

Something else you should think about is the rationale for your desire not to have a mesh. If it is because someone you know had a bad outcome with mesh, you should know it’s more about the technique and surgeon rather than the mesh. Having said that, mesh can cause problems, but they are uncommon when you look at those definitely related to mesh only (excluding technique/surgeon), and the denominator of the hundreds of thousands of pieces of mesh used for hernia repair every year.

Hope this helps!

[Chaunce123]

Finding no-mesh inguinal hernia surgeons on west coast?

I am just a patient seeking info and have done a bit of research on groin injuries and hernias, so I am glad if any information I have gathered is helpful to others. This is one of the best forums on the web, being able to talk to doctors directly is invaluable!

Dr Towfigh, can you share some of your specifics on tissue repair? Do you have specific requirements or limitations for the patients you do the tissue repair for?

[drtowfigh]

Finding no-mesh inguinal hernia surgeons on west coast?

Chaunce 123 this is an excellent post. I’m going to move it up on the top. Agree 100%.

[Chaunce123]

Finding no-mesh inguinal hernia surgeons on west coast?

Doctors I have found regarding the original tissue repair type on this side of the country is follows:

– Dr David Johnson in Palm Springs CA used to work at Shouldice, so one would assume he still does a Shouldice repair if requested?

– Dr Shirin Towfigh in Beverly Hills CA has mentioned on these forums she does a tissue repair in some situations. Perhaps Dr Towfigh can offer her thoughts on this?

– Dr Kevin Petersen in Las Vegas NV advertises on the internet as a no mesh doctor and is mentioned frequently on web forums

– Dr William Brown in Fremont CA does a no mesh repair for inguinal hernias and for sports hernias and is frequently mentioned on web forums

Elsewhere you have Dr Grischkan in Ohio, Dr Tomas in Florida, Dr Meyers in Philadelphia, and Shouldice in Toronto.

Surely there are others too, but who and where is anyones guess. Many are retiring or have retired. The one person I knew who got a no mesh repair somewhat recently had their doctor retire almost immediately after, but they said they only did no mesh on fit patients and only used mesh on obese patients. THEORY: that may be why the tissue repair is becoming much less common, as people are mostly obese now. Shouldice makes you lose weight for example, they will not operate on an obese patient. There are famous sports clinics in Philadelphia and in Germany that are similar, it appears they do tissue repairs on fit patients only.

The questions you want to know of the doctor if you go this route are this:

– Are you eligible for the tissue repair?

– Do you recommend this repair FOR YOUR SPECIFIC CASE and why?

– What is your overall EXPERIENCE with the tissue no mesh repair?

– What are your complications with this repair?

– What is your rate of chronic pain? What is the severity for the patient?

– What is your rate of recurrence?

You don’t want to get a no mesh repair from someone who has only done one once but is willing to try it out on you, you want one from someone who has done many of them, someone who knows the anatomy because its very complex (just look at a medical textbook yourself, most things make sense and are identifiable and then you get to the groin section and suddenly none of it looks like anything and none makes sense, the inguinal region is very complicated) and preferably you want someone who DOES many of them on a regular basis.

If you know of another regular tissue hernia doctor in your area you should add them to the list.