need help- 2nd hernia repair gone bad

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Anyone know about Dr. Poor at Vincera Institute in Philadelphia Pa ? Possibly need mesh removal and muscle repair , and wall reconstruction.

[Chaunce1234]

I’m sorry you’re going through this.

As for the MRI being conclusive or not in terms of showing a hernia, that may depend on who looks at the actual imaging and not just reading the written report. Dr Towfigh has studied this specifically before. Also keep in mind most people are laying down on their back during an MRI / CT, which can hide a hernia.

You could also request a “dynamic Ultrasound with Valsava” at the location of pain and the area of the prior hernia repair, often the dynamic ultrasound while bearing down can show a hernia that is otherwise difficult to see. Some clinics perform that ultrasound while the patient is standing for added abdominal pressure / gravity.

I don’t specifically know of any hernia expert in Kansas, but perhaps another forum user or a surgeon on this forum can offer some nearby options. As general advice, you will want to seek out a surgeon with significant experience doing re-do surgeries and with managing hernia related pain. Ask if they have seen cases like yours, and if they were able to resolve it.

Some potentially helpful resources, though they are not in your immediate state, include the following:

– Dr David Grischkan in Cleveland, Ohio

– Dr Paul Szotek in Indianapolis, Indiana

– Dr Bruce Ramshaw in Knoxville, Tennessee

– Dr Jonathan Yunis in Sarasota, Florida

– Dr Igor Belyansky in Annapolis Maryland

– Dr Shirin Towfigh in Los Angeles, California

– Dr David Chen in Los Angeles, California

Best of luck and keep us updated on your case and progress.

[Jnomesh]

I would highly rx dr. Igor Belyanski in Annapolis MD. Highly skilled surgeon who is seeing more and more patients with hernia and mesh issues . Expert at removing mesh if necessary.
there is also dr. Bruce Ramshaw in TN, dr. Towfigh and dr. William brown in CA to name just a few.
if you have a recent cat scan you can send it to dr. Belyanski and he will review it to see if there are any signs of mesh migration or folding etc as well as other things. Dr. Towfigh specializes in rewddk f MRI’s which could also be helpful in seeing if there are any other anatomical issues like a muscle tear or something. Do your research see a Couple of specialized surgeons travel if necessary-you want to get it right and resolve what is going on.
ive heard of dr. Rosen and many have been disappointed with his suggestions regarding hernia/mesh pain. He will removed openly placed mesh if it is very obvious that it is the mesh ie infection or pieces of the actual mesh coming through the skin as one person spoke of.

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Can anyone recommend an abdominal wall specialist ? Maybe my problem is a tear in the lower abdominal wall (left of my penis) and not a muscle tear. I live in Kansas.

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I had a local doctor test me for a hernia. His diagnosis was “no hernia”. He ordered an MRI and his conclusion again was “no hernia”. I believe that means I do not have a recurrent hernia. Are there other tests that need to be performed? Also, I think that maybe one of the internal muscles attached to the internal ring tore loose and that is why the ridge on the top of the hernia repair scar rapidly released tension.

Also, does anyone have experience or knowledge about Dr. Paul Szotek from Indiana and his abilities of dealing with a situation like mine? My email is [email protected]

Thank you for sharing your knowledge.

[Good intentions]

I see now. He/she was probably referring to the Kugel technique, not the Kugel plug. I linked to Bard’s page below. The number of combinations possible for hernia repair is incredible, and apparently, none is significantly better than another.

I like to use Google Scholar to see if the person in question is still publishing. If they are then they are most likely on top of recent developments. I linked to Dr. Rosen’s results also. It looks like he favors laparoscopic implantation, but hasn’t published within the last few years. Still, researchers tend to stay up to date, as a matter of course.

Of course, you might be getting ahead of things. Knowing if you’ve had a hernia recurrence as opposed to just mesh pulling free is probably important. Chaunce1234 has a list of surgeons who will remove mesh. Search his past posts. I had mine removed by Dr. Peter Billing of Eviva in Shoreline, WA. Dr. Towfigh will remove mesh if necessary. She is the administrator of this site.

Some doctors will reply if you write them a latter or send an email. The more information you get the better.

https://www.crbard.com/CRBard/media/ProductAssets/DavolInc/PF10156/en-US/wo69hvwbqqhwjozqrirj4t1waytx5hdz.pdf

https://scholar.google.co.uk/scholar?start=10&q=Michael+Rosen+hernia&hl=en&as_sdt=0,38

https://www.surgical.theclinics.com/article/S0039-6109(13)00084-4/abstract

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Yes, the balled up mesh was removed except for a small residual of the mesh that was stuck to a muscle and that residual
was used to reconstruct the canal floor by joining the residual and oblique and transversal muscles to the inguinal ligament. The newly created internal ring
was just lateral to the pubic tubercle. Also, the operative report seems to say the newly created ring is between the abdomen and the mesh.

On the operative report, the doctor said “An Onflex Kugel Patch from Bard was positioned in the preperitoneal space.” Could you recommend doctors who you feel would be capable of removing this mesh for me? I am from Kansas.

Do you know anything about Dr. Michael Rosen at Cleveland Clinic Hernia Center?

Thank you for your response.

[Good intentions]

I would find an older surgeon with lots of experience, as you suggested, an expert. The Onflex device is one of the more complex hernia repair devices and since you’ve had two surgeries already things are probably pretty messy down there. I don’t think that you want somebody with little experience giving it their “best shot”. The Kugel device is not part of the Onflex device portfolio. So that’s confusing. I’ve linked the Bard page below, and another about the Onflex device.

I think that you’ll have to do some internet research. You might also need mesh removal if the current device is causing the problem. Was the original balled-up mesh removed? If you don’t have all of your medical records it would be worthwhile to get them. There might be important details about the two procedures that you’ll want for the next surgeon.

Good luck. Wish I could be of more help.

https://www.crbard.com/Davol/product-search?pg=2&devicetype=hernia+repair+%26+fixation

https://www.hindawi.com/journals/srp/2016/6935167/

[[email protected]]

Thank you for commenting.
Yes, I can travel. I have my car pillowed up in the back and my wife can drive, so we can travel 400 miles per day.

By fail, I mean that for 2 years after the last surgery, I was able to move around pain free. Three months ago while exercising (treading water vigorously with my legs), I pulled my left groin. I felt a tearing of flesh just left of my penis and the ridge on the top of the previous hernia repair scar rapidly released tension. The ridge of the repair scar has moved down and left on my abdomen and now the pulling and hurting sensation is along this ridge and my left pubic area. The last repair replaced the mesh with an Onflex kugel patch from Bard. The repair has always been tight. Both surgeries were open inguinal surgeries.

I am 74 years old, weigh 160 pounds, and was in good health before this happened.

[Good intentions]

Here is a good place to start, use the search tool below. Can you travel? Supply more detail and there might be more specific information. It’s not really clear what you mean by “fail”, or even what type of hernia you had repaired.

There many different types of repair materials, and methods, and several different types of hernia. Information about yourself, the activities that caused the problem, and the repair itself will all help in finding an appropriate doctor. Good luck.

https://americanherniasociety.org/find-a-surgeon/