muschaweck procedure

[kaspa]

I once considered Muschaweck, but she charges 6,000-7,000€ enough to take the repair anywhere else in the world, and as Dr. Towfigh already said her method isn’t validated outside her clinic.

Dr. Kang’s (not that expensive) isn’t validated either.

In a time of “mesh do it better” publishing tissue methods would be of utmost importance for this area to evolve.

Since Shouldice, only Dr. Desarda published a new tissue approach as far as I know.

[drtowfigh]

The Muschaweck procedure, aka minimal repair, has not been validated outside her clinic. Nevertheless, she is highly respected within our hernia specialist community.

I do not recommend the procedure for moderate to large direct hernias, as the tissue repair becomes too tight. Since it is a local repair, it does not benefit from the laxity of nearby tissues to offset local tension.

[JamesDoncaster]

@drbrown Do you ever use the Muschaweck technique to repair inguinal hernias? If not, do you know of any surgeon in the USA that does use the technique?

[Alephy]

I still cannot understand how the patients recover so quickly after the surgery….and they get back to full activities in no time

[drtowfigh]

Size is often classified based on bulging amount.

[Alephy]

So the size is inferred from the presence (size) or not of the bulge? or is it something that is determined at surgery and the surgeon acts consequently?

[drtowfigh]

It’s not routine to measure the size of a hernia as it is a dynamic scan.

[Alephy]

Shouldn’t the Ultrasound also mention the possibile size of a direct hernia? or is this something that cannot be determined by the ultrasound exam?

[Alephy]

Ah no they also mention “small direct ones”…

[Alephy]

I checked it out…they say on their website that the mushaweck procedure is only used for sports hernias and indirect hernias…..so it cannot be used for direct ones?

[Alephy]

I will check but it might be still her in fact given she is based not far from Munich. Does her procedure work also for direct hernias?

[UhOh!]

There’s the Hernia Centre Munich that seems to utilize her method; not sure if the price is any different?

[Alephy]

Yes, I was considering going for a visit with her, but I am not covered by my health insurance to go to Germany and it is expensive at her clinic…

[Good intentions]

Dr. Muschaweck has been repairing professional athletes, many soccer players, for many years. I forget to mention her because she is based in Germany.

Here is a sample of old information and new. Soccer might be one of the most demanding sports as far as core strength is concerned.

https://www.theguardian.com/football/2007/sep/28/newsstory.sport2

https://www.facebook.com/Aspetar/videos/groin-injuries-beyond-football-by-dr-ulrike-muschaweck/1319523514772491/

https://www.facebook.com/Aspetar/videos/how-soon-will-i-recover-after-the-hernia-surgery-drulrike-muschaweck/2113637782264067/

https://bleacherreport.com/articles/1665608-xabi-alonso-surgery-comeback-timetable-for-real-madrid-spain

[Alephy]

Well in Switzerland I was given an US and I am supposed to have a ct scan as well….

[UhOh!]

So I had a chance to read a little more about this procedure (though there doesn’t seem to be a ton available specific to inguinal hernias) and something interesting occurred to me: it seems to be the only procedure, besides Dr. Kang’s, where imaging is routinely done (since that seems to be how “sports hernias” are typically diagnosed). Like Dr. Kang’s, it also seems to do the least damage to surrounding tissue structures.

From this (admittedly, limited) information, I come to only one conclusion: Preoperative imaging allows for less cutting/sewing because the surgeon already knows the extent of the damage and there’s no need to visually examine the deeper structures during surgery.

How has this not become part of the discussion among doctors? And, more interestingly, how have device makers not picked up on it as a reason to market more ultrasound equipment (and training) specifically for this purpose?

[UhOh!]

Is this method fairly similar to Dr. Grischkan’s two-layer Shouldice? From the diagram on Dr. Grischkan’s website, it looks like healthy tissue is incised only with an indirect hernia (since that same tissue is already torn with a direct hernia), but I can’t quite tell.

Anyone in the U.S. known for using this method, specifically?

[Alephy]

So also in the muschaweck the cremaster muscle is used to close the hole?

[drtowfigh]

It’s all marketing.

back pain doesn’t affect type of repair choice.

[Alephy]

Thanks for your answer! So what is the difference between the two? It seems the mushaweck is marketed as a less invasive procedure with a very quick return to physical activity! Does it also require the use and loss of a particular muscle? Thanks again!

Ps: does an history of back pain warrant a specific procedure more than an other? This is a bit off topic more of a general question