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Medium inguinal Hernia – Traditional Tension Repair
I am 65 years old and have been diagnosed with a medium inguinal hernia on the right side. I am also HLA-B27 positive and been diagnosed with non-ankylosing spondylitis. Due to chronic inflammatory issues I am reticent to allow the use of mesh in my body. I am in good health, not over weight and physically fit. Which of the tension repairs would you recommend and are there any surgeons in the San Francisco Bay/San Jose area that you can recommend to do this type of repair?
Thank you for reading my post and considering my question.
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9 Replies
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Medium inguinal Hernia – Traditional Tension Repair
Thank you so much. Dr. Brown called me this past Saturday morning and we discussed my hernia. He does do tissue only inguinal hernia repairs and he refers to his technique as a low-tension repair. He said his technique is a combination of the Shouldice and Desarda techniques. I am very pleased to know there is someone near by that can do this type of repair. I am not ready for surgery yet, but I will make an appointment to see him when I am ready.
quote :Hi HowardF,This may or may not be helpful to you, but there is a Dr William Brown in Fremont California who specializes in “sports hernias” and does a tissue repair for it. Yes a sports hernia is different from a real groin hernia, but my understanding is the repair is similar to a ‘real hernia’ repair and sometimes real hernias are found during the procedure, so there must be an understanding of both conditions. It could be a resource for you to consult with, or maybe not, I have no experience beyond just stumbling across the doctors name and site a few times from researching my own condition.
If you do decide to have a tissue repair or a biologic laparoscopic repair, please do post back with your results, surgeon, and experience, there are many of us who would be interested in hearing about the experience!
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Medium inguinal Hernia – Traditional Tension Repair
Hi HowardF,
This may or may not be helpful to you, but there is a Dr William Brown in Fremont California who specializes in “sports hernias” and does a tissue repair for it. Yes a sports hernia is different from a real groin hernia, but my understanding is the repair is similar to a ‘real hernia’ repair and sometimes real hernias are found during the procedure, so there must be an understanding of both conditions. It could be a resource for you to consult with, or maybe not, I have no experience beyond just stumbling across the doctors name and site a few times from researching my own condition.
If you do decide to have a tissue repair or a biologic laparoscopic repair, please do post back with your results, surgeon, and experience, there are many of us who would be interested in hearing about the experience!
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Medium inguinal Hernia – Traditional Tension Repair
Both should be covered by insurance.
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Medium inguinal Hernia – Traditional Tension Repair
Dr. Towfigh,
Thanks so much. I have contacted two of the surgeons you recommended and one has gotten back to me. He said my options are a primary repair or laparoscopic repair with biological mesh. I am assuming the primary repair would be covered by my insurance and the biological repair would not. I will make an appointment to see you when I am ready to move forward.
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Medium inguinal Hernia – Traditional Tension Repair
it’s hard to find a surgeon that has a lot of experience in tissue repair alone. they tend to be older surgeons (in general). also, northern california has great surgeons but not too many hernia specialists.
Try
– Hobart Harris
– Marc Zare
– Jeff Gutman -
Medium inguinal Hernia – Traditional Tension Repair
Thank you. I need at least one more surgeon so I can have two opinions. Preferably someone in the south bay near San Jose. Maybe someone else who reads this board can add a recommendation.
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Medium inguinal Hernia – Traditional Tension Repair
He can do both types of repair.
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Medium inguinal Hernia – Traditional Tension Repair
Dr. Earle – Thank you. I am assuming Dr. Ramon Berguer does not do the traditional tension repair since he is a laparoscopic surgeon. Can you recommend someone closer to San Jose that does traditional tension repairs? I reside in the Santa Cruz area.
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Medium inguinal Hernia – Traditional Tension Repair
HowardF – It’s important to keep in mind that all of the non mesh repairs use the same type of permanent material that the many mesh products are made from. So the goal of repairing the hernia with permanent sutures will not meet your goal of no foreign material being implanted, unless all absorbable materials are used (mesh or no mesh). If absorbable materials are used to repair the hole, then theoretically the hole will have a greater chance of re-appearing once the materials go away. There is some data about lap inguinal hernia with a biological mesh that doesn’t get absorbed, but remodels. It’s a single study, so not sure how that would work for you. You will have to decide if you want to take a chance for higher recurrence, or a chance from a mesh/suture reaction from permanent material. Ramon Berguer is a laparoscopic surgeon in the Bay area that I would trust to help you make these decisions for yourself. Ed Felix in Fresno is a hernia specialist that could also help. Hope this helps!
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