-
Incisional Hernia – post wound infection from an open appendectomy
Glad to have found this forum – trying to make sense of incisional hernia repairs, fidninga good surgeon etc. can be pretty daunitng.
Cliff notes – I had laparoscopic apendectomy (emergency) which had to be converted to an open procedure performed in January of this year. I woke from surgery with about a 7 inch vertical incision to the right of my belly button.
Day 4 post op, developed a pretty sever wound infection. Resulted in home health care – wound packing with Iodiform for almost nine weeks. Finally cleared by surgeon and was advised I could return to normal activities.
A few days later, felt a pop in the area of the incision, went back to the surgeon who originally stated I had weakend fascia. It got worse, i got a CAT scan and received the news that I had a hernia which is gradually getting larger. Original surgeon said he would open me up again, put in mesh and close it up. I wasn’t feeling very confident in the response especially after just recovering froma pretty nasty wound infection plus the associated shock of being laid up for quite some time.I then consulted with two different local surgeons – Dr. Clark Gerhart who I found via the American Hernia Association and Dr. Tanner Long who was recommended to me by a doctor friend.
I am lookng for guidance on the best possible procedue to repair / any other factors to coinsider with surgeon choice.
I am leaning toward a robotic repair due to prior infection and subsequent recopvery. I live in Eastern PA.
Thanks in advance!
-
7 Replies
-
quote drtowfigh:Good question. Very hard to know. Online reviews are not necessarily accurate for surgeons. Other healthcare providers may have some insight if they work with them. This forum is also very reliable.Thank you.
-
quote Good intentions:There is quite a bit on the forum about incisional hernias. Including some very recent comments in relevant threads. Nothing has changed much over the six years since this forum was started.
Since you have a large incision it would probably be very difficult to find a surgeon who will know how to close it effectively with sutures. If you decide to go with a mesh procedure, do extensive research on the types of mesh, and how they are used, ,and what the benefits are of each. Many clinics and hospitals have their “meshes” chosen by their purchasing departments. Lowest bidder mesh. The purchasing departments lump all mesh products in to one category, despite the device makers efforts to differentiate their products.
In other words, you need to become an expert in mesh devices and how they are supposed to work, if you want to increase your odds of success. There are at least four distinct polymer fibers used to make mesh, and many many different knit patterns. There are coated meshes, mesh-like biological materials, degradable meshes, and composite meshes. Supposedly they all have distinct pros and cons but few surgeon wills probably be able to describe well what they are, or why they believe in any certain product.
Take your time and learn. You’re at high risk of developing a persistent problem. You might also consider that you should not have acquired an infection from your original surgery. That clinic might be dirty, and best avoided.
Do you have any insight into the best way to compile this info?
-
Good question. Very hard to know. Online reviews are not necessarily accurate for surgeons. Other healthcare providers may have some insight if they work with them. This forum is also very reliable.
-
quote drtowfigh:The type of repair is best chosen based on the size and location of the hernia, your own risk factors, and the skills of the surgeon.
There is no one best repair.
Pick a surgeon who can do all options and go through pros and cons of each.
Dr. Towfigh, how can you really tell who is a better surgeon?
-
The type of repair is best chosen based on the size and location of the hernia, your own risk factors, and the skills of the surgeon.
There is no one best repair.
Pick a surgeon who can do all options and go through pros and cons of each.
-
Thanks GI – I think I have read everything here on Incisonal Hernia’s, at least what I could find via search. I am curious about what type of repair techniques people have received with incisional repairs and/ or best type of repair.
I am due for a follow up with the surgeon and believe there are different tissue techniques that go hand in hand with mesh replacement.
My goal is to find a good surgeon, with a large number of incisional repairs.
Hopefully, one of the doctor’s here will chime in.
-
There is quite a bit on the forum about incisional hernias. Including some very recent comments in relevant threads. Nothing has changed much over the six years since this forum was started.
Since you have a large incision it would probably be very difficult to find a surgeon who will know how to close it effectively with sutures. If you decide to go with a mesh procedure, do extensive research on the types of mesh, and how they are used, ,and what the benefits are of each. Many clinics and hospitals have their “meshes” chosen by their purchasing departments. Lowest bidder mesh. The purchasing departments lump all mesh products in to one category, despite the device makers efforts to differentiate their products.
In other words, you need to become an expert in mesh devices and how they are supposed to work, if you want to increase your odds of success. There are at least four distinct polymer fibers used to make mesh, and many many different knit patterns. There are coated meshes, mesh-like biological materials, degradable meshes, and composite meshes. Supposedly they all have distinct pros and cons but few surgeon wills probably be able to describe well what they are, or why they believe in any certain product.
Take your time and learn. You’re at high risk of developing a persistent problem. You might also consider that you should not have acquired an infection from your original surgery. That clinic might be dirty, and best avoided.
Log in to reply.