My meshless hernia repair in Germany
02/20/2020 at 3:54 am #21909
I have decided to write up my experiences with a mesh-less hernia repair in Germany as the information may prove useful to other people facing the same decisions as I recently have.
I first noticed that I had an inguinal hernia in early Jan, there was no pain, just a swelling that disappeared when I lay down.
I started with my GP and got a referral to my local NHS hospital. However it soon became clear that that the waiting time for the operation did not match my personal plans of getting it done before I was travelling and out of the country for 5 months. I therefore decided to progress it privately. I made an appointment to see a surgeon with my local private hospital. Then with amazing apposite timing I read this news article https://www.bbc.co.uk/news/health-51024974, and watched the associated program on the BBC iPlayer. Until this point I had no awareness of the potential problems of mesh.
When I saw the surgeon he advised that a mesh repair was 100% safe and the only sensible option for me as this technique had a much lower rate of failure subsequently. However I did note that he advised that there was a 10% chance of chronic pain afterwards. He was very dismissive of the problems raised in that article and in the BBC program. I subsequently spoke to a second surgeon and got much the same message. However a 10% to 15% chance of chronic ongoing pain seemed too high for me to be happy with, so I investigated options for a mesh-less repair.
I soon found the website for Biohernia, an organisation based in Belgium that seeks to put patients who want a mesh-less repair in contact with specialist surgeons who can do one. n.b. Biohernia do not do the treatment, they just make the arrangements. The main contact there is Nahom Welldeiesus, who was very efficient and helpful. There appeared to be 3 options, an expensive operation in London with Dr. Ulrike Muschaweck, or 2 surgeons in Germany advised as follows.
“Our surgeons :We work together with Dr. Andreas Koch in Cottbus and Dr. Martin Wiese in Frankfurt. They both perform more than 400 non-mesh operations yearly and have been doing so for over 20 years. Next to their daily activities, they perform a lot of scientific research to change global policies on the use of plastic meshes in hernia repairs. Because of their experience and expertise they are highly regarded by their peers and in the athletic world.”
Waiting time was a very reasonable 2 to 4 weeks and I was offered a range of dates with Dr Wiese, and I made all the arrangements. Subsequently I did more research and I noticed that Dr Koch had a much higher profile on the internet with many good reviews and I wondered if I should change my plans. However Nahom assured me that there was nothing to choose between them in terms of experience or success rate, so I stayed with Dr Wiese and had no reason to regret that decision.
I met with him the day before the planned operation and he said all the right things to make me feel that I had made the right decision, i.e. a shouldice repair would suit me very well as the hernia was small and I was not overweight. Furthermore he claims to have done about 8000 such operations with a failure rate of less that 1%. A huge difference to the 2 surgeons that I spoke to in the UK. Interestingly I have read that the failure for mesh-less repair is around 2% to 3%, if true then it is higher!
The next day I reported to the surgery at 8am, everyone spoke very good English and seemed very professional, so I felt confident that I was in good hands and was relaxed about it all, even before the GA kicked in at 9am.
I came round at 10:15, and was walking back to my hotel across the road by 12:30. Dr Wiese was very clear that it was important to keep moving, “more walking, less pain, quicker healing”, he said several times. So that afternoon a walked 8.5km through the pleasant fields and woodlands surrounding Kelkheim.
I had another consultation the next day to discuss the dos and don’t s of my recovery and to receive all the paperwork. After that I walked 11.5km. The next day I flew back to the UK.
Now 16 days post op and things appear to be progressing well.
As to cost in the UK I was quoted £2373 for local, or £3007 for general. Cost in Germany under general was 2384 Euro, about £2,080, so it was actually cheaper in Germany even taking into account travel and accommodation costs. Finally under a still current EU directive I can reclaim the costs from the NHS, which I am in the process of doing. (Leavers need not apply)
02/20/2020 at 5:02 am #21910AlephyParticipant
Thanks for sharing! If I may ask did the surgeon cut the cremaster muscle?
I am also wondering what will happen after brexit is finalized as far as getting surgery abroad is concerned…here in Switzerland there is no way for me to reclaim back the money for the procedure even if far less expensive than here…
02/20/2020 at 5:23 pm #21926ColtParticipant
I am also wondering did they cut cremaster muscle
What would have been the cost in us dollars
02/21/2020 at 1:31 am #21933
I believe the cremaster muscle was not cut, in my research prior to the operation it was refered to as a ‘modified shouldice’, as cutting the cremaster muscle was found in practice to have no advantage.
On the prefilled form Biohernia gave me to reclaim the cost from the NHS the operation was described as follows.
“Operation performed in day surgery setting. Mesh Free Bilateral Shouldice Repair with neurolysis of the inguinal Nerves (Ileoinguinalis, Ileohypogastricus and Genitofemoralis) and restoration of the inguinal floor with a fascia flap”
In my post op report from Dr Wiese it was described as follows: Herniotomie shoouldice repair 4 rows Prolene 2×0. No sutures to remove”
02/21/2020 at 4:37 am #21934AlephyParticipant
The neurolysis of the nerves was planned or deemed necessary during surgery?
02/21/2020 at 6:34 am #21935saroParticipant
Also,hi again. your hernia was bilateral. How is open incision possible?
03/08/2020 at 11:06 pm #22165
OK – final report from me. Now 5 weeks post op and I am feeling 100% normal, doing everything just as I was before with no pain or inhibited movement. I am completely satisfied with my treatment.
On the financial side I have had my claim for costs approved by the NHS, so that is a nice bonus.
One thing to correct. Some of the information I posted above was cut and pasted from the pre-filled form I was sent to help me claim the costs back from the NHS. All the info on the form was generic to Dr Wiese, apart from the the following which was obviously left over from another patient.
Operation performed in day surgery setting. Mesh Free Bilateral Shouldice Repair with neurolysis of the inguinal Nerves (Ileoinguinalis, Ileohypogastricus and Genitofemoralis) and restoration of the inguinal floor with a fascia flapso ignore all that.
- This reply was modified 2 weeks, 6 days ago by John C.
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