Lots of negative posts about the Desarda repair on Reddit

[Chuck]

I had thought Desarda might be the best way to go. Now not so sure. Stories of recurrance. Stories of continued pain with exertion years later. I wonder if anyone gets a good hernia result. I guess Kang is back in the lead again.

[Chuck]

This is interesting….Yunis says mesh increases durability of the hernia more than 50 percent over no mesh.

[Chuck]

And Yunis 2 year recurrance rate with tissue repair is 5 percent…with an incomplete survey…..this is a lot different than the 1 percent you get quoted when you call his staff. And its only 2 years later!!!! This is a tissue repair forum for the most part…and i think folks dont give enough consideration to how fragile tissue repairs really are. Hernia surgery is a real cluster right now. With no good options…and very little good info. Kudos to Dr Yunis for being honest here

[Watchful]

Higher risk of recurrence is the main reason the Shouldice Hospital is very strict about not accepting overweight patients. Dr. Sbayi follows the same rule. I don’t think Dr. Yunis does the same, so that may affect his recurrence rates. Also, you’re looking at his results as a surgeon who is relatively inexperienced with tissue repair.

I don’t think the higher recurrence rates (when compared to mesh) are a surprise to anyone here. I know Dr. Kang reports extremely low recurrence rates, and I don’t know how to explain that. Maybe something to do with the groin anatomy of Koreans, who knows… Weight is definitely less of a widespread issue there.

If there is a misconception about tissue repair, it’s not about recurrence. It’s about chronic pain. I believe many here, including myself, thought that this is where there is an order of magnitude advantage for tissue repair. Going from 12% with mesh down to 1% with tissue repair. Well, that doesn’t appear to be true, not even for Dr. Kang.

[Chuck]

Watchful – agreed…my main reason for going lap mesh was those tissue repairs just intuitively looked painful – big incisions – sewing weak tissue to weak tissue under tension just seemed guaranteed to be painful to me and my discussions with tissue repair patients consistently found that even those that were happy with the repair continued to feel it doing very ordinary things. Meanwhile all my meshed friends kept saying they felt nothing. Its funny that you saw it differently with the invasiveness of lap surgery–which in retrospect should have struck me as well. Looks like we were both wrong. I cant help but wonder if we both just went to our primary care and hand mesh slapped in open like the vast majority of guys if we wouldnt have both gotten good lasting results. Several guys on natural hernia cure with large hernias went that way and all were fine….yet we hear over and over from the likes of Yunis and others that open tissue repairs are the most problematic. Its looking like kang is back in the lead for me…that korean doctor really looked hard for negative reviews and found none….she also said koreans are super complainers and will cry like babies over any issue…so the fact that she found none for kang argues well for him…I like that kang has studied this issue with the goal of doing the best surgery possible….most of the rest of these docs are just going throught the motions

[Watchful]

Chuck,

I think I would have gotten a better result with open mesh, but I can’t tell for sure, of course. One thing which is clear is that the surgery would have been a lot less difficult (even my surgeon admitted that). My hernia was particularly large, though.

I totally understand choosing Kang. There aren’t really any perfect or close to perfect options with inguinal hernia repair. You just have to pick your poison intelligently, and hopefully in a way that would be the best fit for your particular case (easier said than done as I know from experience). More importantly, pick one of the best surgeons, and Kang certainly seems to be in that category.

[pinto]

Excuse me but let me chime in here a moment. Remember how some of you guys like to make me the poster boy for Kang recurrence? Well it goes both ways fellas: Kang Repair is painless both in surgery and post. That’s my experience for two surgeries.

I say this after reading how @Chuck so imaginatively thought of tissue repair as nearly like a giant sewing needle pressed through your innards and outers. Why do you not also think of massive plastic sheets thrust inside of you and stapled there in some cases? Of course to each his own, but some of you guys seem so erroneously fixated on misunderstood pain statistics.

Anyway who here has the experience of not one but two recent surgeries from the same surgeon? It’s double jeopardy. It’s almost infinitely superior to just one surgery in terms of experience. I’m not saying any particular doc is the best because ultimately it comes down to personal choice. However, I can’t tell you how happy I am in dodging the bullet of chronic pain—Twice!!

[Watchful]

Pinto,

It’s great that you don’t have chronic pain, but you did get a recurrence. Fortunately, you dodged the bullet of chronic pain, but a reoperation is really risky for that. Not a risk you want to take. Also, what were those posts of yours about excruciating post-surgery pain (during the Taxi ride, etc.)?

[William Bryant]

Thanks Chuck for finding that ref Desarda – can you link to one or two or copy and paste some excerpts please if you have time!

[William Bryant]

I think I’m the most guilty of that Pinto but not as in a criticism as such, more as in praise that the surgeon rectified it and it remains trouble free.

not something we’ve read about when an issue has arisen elsewhere at for example Bio, Shouldice, Dr Koch, etc etc. Although to be fair Shouldice did and do put right others issues as in Baris case.

[pinto]

Watchful: “It’s great that you don’t have chronic pain, but you did get a recurrence.”
So what? Hello, up above you changed the topic from recurrence to chronic pain about which Chuck talked about concerns of chronic pain. Thusly my posting about chronic pain. You really try to twist things to avoid the reality that if you make me an example of recurrence—then logically you must consider me for chronic pain. And it has been zilch, zero chronic pain for me—not only for one but two Kang surgeries.

Quote: What were those posts of yours about excruciating post-surgery pain (during the Taxi ride, etc.)?

You know you are wrong in saying that because a taxi ride almost immediately after surgery does not qualify for chronic pain. If you would loosen the vise on your view about Dr. Kang, then you would admit my experience about chronic pain contradicts your frequent takes on Kang Repair.

Watchful, I believe you are prejudiced against Dr. Kang:
About recurrence, you seem ready to excuse surgeons such as Dr. Yunis, but I don’t recall you granting Dr. Kang the same accord:

“Higher risk of recurrence is the main reason the Shouldice Hospital is very strict about not accepting overweight patients. Dr. Sbayi follows the same rule. I don’t think Dr. Yunis does the same, so that may affect his recurrence rates.” (Watchful)

You have referred much to Kang recurrence rates but have you ever noted that he is very liberal about in-take conditions of patients? However wouldn’t the degree of strictness apply for chronic pain also? It is widely agreed that pain or its absence prior to surgery is a likely determinant of chronic pain. Surely in-take policies of surgeons must also factor.

[Watchful]

Pinto,

Recurrence is bad. Reoperation is risky both for chronic pain (which you didn’t get luckily), and an increased probability of another recurrence with time. You reported severe post-surgery (not chronic) pain, but then claimed your experience was painless, which baffles many here.

The fact that Dr. Kang reports chronic pain rates similar to those reported by mesh studies is disappointing. If that’s the case, why not just go with mesh?

I would ask any tissue repair surgeon the same question, not just Dr. Kang. Other tissue repair surgeons don’t report such high chronic pain rates, but it’s unclear whether that is the true picture with them or it’s simply a result of a lack of follow-up or some other misleading factors.

[pinto]

You ignore the point of not affording Dr. Kang an allowance for liberal in-take policies that you afford for others. It has nothing to do with me. You appear to be biased against Kang and won’t admit it.

You continue to falsely claim or imply that I had an inordinate amount of pain. I don’t believe you read my accounts about it. If for example you never had any pain during your first week from Shouldice surgery, then you would have a case. Of course I assume that sometime during the first several days, patients will experience some pain. If you never had any pain then I applaud your doggedness to hound me about what appears to be nonsense. Everyone must have some pain—for God’s sake it is surgery. Surely beyond the first week I never had any pain from my two surgeries.

Despite having gone through this same topic with you previously, it appears you do not believe me when I say I didn’t have pain beyond the first week. Apparently because you have had a lot of pain by your surgery, and I sincerely am sorry to hear that, you cannot imagine it possible, a painless post-op. Well I’ve been having one.

[Good intentions]

A link to the Reddit thread would be helpful.

Here is Pinto’s story, linked at the bottom. There was a taxi ride and very intense pain. Then a year or more goes by and a recurrence (or a new hernia, unclear). No description of how soon the pain diminished or what was happening in that year to year and a half.

Pinto, instead of just telling people that they are wrong why don’t you just describe what really happened? Nobody knows, it’s like a guessing game. You have not provided the whole story.

Pinto / Dr Kang

[Chuck]

If you just search Desarda repair on reddit you will see the comments….its a lot of what i constantly worry about. Some people saying I am glad i got the repair but i get sore if i lift weights….or when i get out of bed i get a lighntening bolt of pain. And they are still struggling years later….There are some saying it failed right away–there are others like that on the reviews of Tomas that show up on the internet review sites. KAng is probably the only doctor publishing accurate chronic pain rates….but as I have stated before there are independant studies showing shouldice pain rates of 36 percent. No some will say well those are not from the shouldice clinic…but who knows? All of the mesh docs i saw in DC said they had seen patients with chronic pain from “that clinic”—of course they could be lying to scare you into mesh….in the end there is zero clarity on recurrance rates and chronic pain —-prove me wrong…someone please?

[Author]

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