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I know so many guys……
who got a hernia…did absolutley zero research…went to their primary…who referred them to some surgeon down across the hall. They went in had mesh shoved in open and a week later were back to their lives with zero complications. I simply dont understand how this is possible given what i know now. This really is a simple routine operation for many. I cant help but wonder if i overthought it. Researched it for two years —saw 6 doctors —went mesh for what i thought were very well thought out reasons. There was a good chance I had two hernias. So two 3 inch incisions with surgical pain and risk for chronic pain. Everyone was referring to open surgery as the “old” way…very painful and difficult to recover from. Ate breakfast with three double meshed guys going on 15 years without issues. Studies said risk of chronic pain was the lowest with lap. Now i know that it was probably a lie but at the time it seemed credible. My procedure had zero scarring. Sadly my vanity got me there. I didnt want to look like edward scissorhands got into my groin. Liars like Todd—-mesh is extremely safe- Harris…and paid mesh shill Voeller and Yunis…said risks of mesh were way lower in lap than you would think. The tissue repair guys were all shady —Peterson and GRishkan absolute horrible consults..it was obvious they could care less about the patients. The Desarda technique looked dubious. And of course all the mesh surgeons wrote it off as a flakey surgical technique. At the time Shouldice was requiring the death jab. And they were using Stainless steel –i didnt realize they were open to polyprop…i talked to several guys who had shouldice they were still having pain a year later. A woman who go desarda told me she was sore the next day every time her dog pulled hard…then doctor towfigh basically trashed Desarda…as unproven and a previously failed technique. She said she didnt like shouldice either because it was too tight. A friend did some math and said with all the suturing—you get as much plastic with shouldice as you do with mesh. So the decision was impossible. I never thought that you had to fly to korea for hernia surgery. And at that time there was traffic on this board about Pinto’s recurrance…it made me wonder whether Kang’s procedure was sound. Kudos to you guys who cut through all the noise and got a good result….it really was sheer luck i think.
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This discussion was modified 1 year ago by
drtowfigh.
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This discussion was modified 1 year ago by
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7 Replies
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Hernia surgery in general which I had done to make a lap buck and was said it’s a walk in the park, you’ll have to get it done soon or later etc. As I could say you’ve stayed on this after PTSD etc like most will and I appreciate you for putting out some facts and going through it as myself and many others. To me it’s your eat to deal and manage those symptoms and the BS we go through with this madness and your on here more than anyone to help, for me I was helping than had to let it go cause coming on here would bring all the drama back but being on here brought everything I went through. We are told the golden standard is mesh and I was like oh OK I trust this douchebag lol it changed my life but slowly you get it back as you know bro.
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Yeah, I’m not particularly disappointed that prolene sutures were used instead of steel. I think it’s a really minor aspect in the scheme of things. It’s very rare that this is the thing that causes issues. It’s typically other things about the procedure that get you.
By the way, the problems related to prolene mesh aren’t so much the amount of prolene used in mesh vs sutures. It’s the surface area, the tissues that the material comes into contact with, and other aspects which are specific to mesh (fixation, movement, folding, etc.)
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GI,
I did look into it a bit way back, but I don’t remember the exact numbers. I do remember that the conclusion was that the amount of prolene you get in your body with Shouldice is lower than with mesh.
I would have preferred stainless steel sutures because prolene is slightly more likely to cause some inflammation or granulomas. I was very surprised when they used prolene on me at the Shouldice Hospital. I didn’t even bother asking about that before the surgery because I was so sure they would use steel.
Chuck,
There are many hundreds of thousands (800K?) of hernia surgeries with mesh in the US every year. If the rate of issues with mesh was high, there would be a lot more outcry and noise about this procedure. For example, if a quarter of people ended up with meaningful issues either short term or long term, it would add up to millions so far, and I don’t see that.
Describing lap or robotic inguinal hernia surgery with mesh as “minimally invasive” is indeed misleading. When I learned what is done in these procedures to insert the mesh, the size of the mesh, etc. I realized that this is anything but “minimally invasive”.
I explained before why I didn’t go with Dr. Kang. The extensive track record of Shouldice was important to me, and I was concerned about the risk of recurrence with the Kang technique.
My hernia was indirect, so the Kang technique was very tempting in theory since it’s so much less extensive than Shouldice for indirect hernias. However, I had a very large and long-standing hernia, and didn’t feel like taking the chance without a lot more track record.
If I had a direct hernia, I would be less tempted actually because I think the difference in that case isn’t as huge between what he does and Shouldice, so I think there may be less of a case for not just doing the full Shouldice. Not sure, though – maybe I’m missing some important aspect there.
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Watchful and NFG12, what do you think about the math that resulted in this conclusion? When discussing complex subjects it’s very important that the “facts” are real, and relevant to the discussion. This math seems off unless the person used weight instead of volume for the comparison. Stainless steel sutures compared to polypropylene mesh. 8 gm/cm^3 versus 0.9 gm/cm^3. About a 9 to 1 weight ratio.
Even then, it seems off. “Facts” can be twisted.
“A friend did some math and said with all the suturing—you get as much plastic with shouldice as you do with mesh.”
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Thanks watchful…but i clearly dropped the ball. I was focused on surgical pain…chronic pain and cosmetics. I actually thought lap was minimally invasive. That was the lie that sunk me. You quickly saw through that saying —wow that is invasive—going into the abdomen with big plastic pieces… And it really was. Everyone that had an open surgery that i knew complained of significant pain..and nearly all had dead spots on their thighs or testicles. I wonder how many lap mesh surgeries really turn out fine longterm —i am guessing its not many and that many develop conditions they dont attribute to the mesh. What i dont get is why you wrote off Dr. Kang….i suppose your approach was the most logical…go with longterm track records. But the shouldice repair is almost as invasive as mesh. And it leaves a ton of plastic inside you. Once kang said he had repaired hernias the size of a baby’s head that made me think he could handle anything…in the most minimally invasive way possible
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Luck does play a big part in surgeries and in other medical treatments. It’s the nature of the beast, unfortunately, and doctors rarely give patients an accurate and complete picture. It’s more of a crapshoot than anyone likes to admit.
You really should stop fighting with yourself on this, Chuck. You made a very reasonable choice. It happened not to turn out well, but that doesn’t mean you were negligent in your research or thinking. Most of these mesh procedures (both open and lap) turn out just fine. A minority of cases end up with various degrees of trouble, but that’s the situation with tissue repair as well. There isn’t a hernia repair technique that always works well, and all surgeons have some bad cases.
Dr. Obney who was one of the top Shouldice surgeons was once asked if he was bored after doing tens of thousands of hernia surgeries. He answered not at all because all cases are different in some ways, so every surgery is interesting.
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Watchful, stainless does sound good except that its potential interference with quality NMR imaging of the region has not been well described. Your prolene sutures should not interfere. So should the need ever arise, you will be able to get pretty pictures of your pelvic organs (or of the prolene-induced granulomas ;).
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