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Non mesh West Coast Surgeon recommendations for small recurrent inguinal hernias
I was diagnosed with two small inguinal hernia’s via ultrasound approx 7 months ago. There is no bulge but they sure do get sore after activity, flexing stomach, carrying groceries etc. They are recurrent from childhood and the pain has gotten worse over the past few months. After watching that 60 minutes report I am looking to avoid mesh repair. Would appreciate recommendations for experienced non mesh surgeons on the West Coast that I could get in touch with. Possibly laparoscopic non mesh repair? I am located in Seattle.
Thanks,
Woody
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14 Replies
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quote dog:drtowfigh That would be GREAT news! I spoke with Dr. Jonathan Yunis MD FACS ..according to him.{he already does them} .. but recovery similar to open ..so what is benefits ,,Is it also your experience outcome please let us know ?Depends on the patient. Less cutting than open. Different scars. It’s an alternative repair.
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The anatomy from the inside is different than the anterior open anatomy. So, there is no comparison. Also, the approach from the inside does not include a release of any tissues so it is higher in tension.
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quote UhOh!:Also, when you are comparing the outcomes, I’m assuming you’re referring to recurrence rates, as compared to your own open mesh-free recurrence rates (vs. the historically high recurrence rates reported overall during the pre-mesh era)?HeyUhOh! But your question made me think..why from inside you can’t fix as durable as from outside ?
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quote drtowfigh:It’s considered a tension repair. As far as we know the outcomes are likely to be similar or worse than open repair, but that’s just a hunch. We are studying this next year in a clinical trial. Awaiting funding.Does it repair from the inside, like lap, or from the outside, like open, and which open repair type does it most compare to (in terms of what structures are affixed to what)?
Also, when you are comparing the outcomes, I’m assuming you’re referring to recurrence rates, as compared to your own open mesh-free recurrence rates (vs. the historically high recurrence rates reported overall during the pre-mesh era)?
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drtowfigh That would be GREAT news! I spoke with Dr. Jonathan Yunis MD FACS ..according to him.{he already does them} .. but recovery similar to open ..so what is benefits ,,Is it also your experience outcome please let us know ?
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It’s considered a tension repair. As far as we know the outcomes are likely to be similar or worse than open repair, but that’s just a hunch. We are studying this next year in a clinical trial. Awaiting funding.
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drtowfigh Thank You! But with robotic repair you possibly cant stitch it together as well as with open..correct ?
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We’ve had good results from it for small hernias in low risk patients. We are now studying it in more typical inguinal hernias.
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quote Momof4:Dr. Shirin Towfigh, that started this forum, offers a no mesh robotic repair to a select group of patients that will do well with this type of repair. Not sure who qualifies, but certainly worth calling her office to get some information. She has been so helpful to me and is the most in depth hernia surgeon that I have been to and I have been to many of the top specialists! Dr. Andrew Wright is in Seattle. I know he is a hernia expert but don’t know specifics about his repairs. Wouldn’t hurt to call his office as well. Best wishes in finding the best repair for you that lets you live your active life pain free. I am still on that journey!
Dear Dr. Shirin Towfigh, drtowfigh Please let me know what advantages to mesh robotic repair ..against open one ?… Is it more save or faster recovery.? .more durable..less recurrence
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– Dr William Brown in Fremont, California
– Dr Shirin Towfigh in Los Angeles, California
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This may or may not be helpful, but I stumbled into a story of a woman who had an inguinal hernia repaired without mesh somewhere in Seattle Washington, if anyone is interested in that story they can find it here:
https://butternutrition.com/female-inguinal-hernia/
The specific surgeon is not named, but perhaps someone could reach out to the author and request additional information.
The comments to the article are also interesting, many other women reporting their own experiences with hernia repair and recovery, how much more difficult and painful it is than c-sections and other abdominal surgeries, etc.
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Out of curiosity… where is your pain and what is it like? How long have you been in pain for? Do you know for certain the pain is from the hernias? Are they direct or indirect hernia? One side, or both sides?
Reported no mesh hernia surgeons in the western USA include the following, be sure to verify directly yourself because some of this is second/third hand information, or gathered from comments on various internet discussion forums:
– Dr Paul Dally in Vancouver, Washington (unconfirmed)
– Dr Robert Martindale in Portland, Oregon
– Dr Michael Mastrangelo in Bend, Oregon (unconfirmed)
– Dr William Brown in Fremont, California
– Dr Shirin Towfigh in Los Angeles, California
– Dr David Chen in Los Angeles, California (unconfirmed)
– Dr Edward Phillips in Los Angeles, California
– Dr Robert Burns in Newport Beach, California
– Dr Kevin Petersen in Las Vegas, Nevada
– Dr John Etlinger in San Antonio, Texas (unconfirmed)
– Dr Zafar Parvez in Albuquerque, New Mexico
There are likely others as well, but they are increasingly hard to find.
Frequency and familiarity with the no mesh hernia repair procedures is critical because it is an anatomically complex region and the classic tissue repair procedures are quite complicated.
Also, your own body matters too. Most no-mesh hernia repairs have to be done on patients with a normal or reasonable BMI, as being too overweight can make the procedure less effective.
As far as “non mesh laparoscopic repair” that is going to be difficult, but Dr Shirin Towfigh in California apparently offers a solution in that regard. I am not aware of any technical details about it however. You also may be able to find a surgeon willing to perform a simple Marcy repair or pediatric style laparoscopic repair without mesh if it is an indirect hernia, but most surgeons would probably consider that as experimental on an adult.
As [USER=”1176″]Momof4[/USER] mentioned Dr Andrew Wright at U Washington Seattle may be a helpful resource with referrals, but I believe he himself is only a laparoscopic mesh surgeon, possibly the same with his colleague Dr Allison Perrin, though I could be wrong.
Also, keep in mind these aren’t necessarily recommendations, they’re just said to be surgeons willing to perform the hernia repair procedures without using mesh.
Anyway, best of luck. Keep us updated on your case, decision making, and progress.
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Dr. Shirin Towfigh, that started this forum, offers a no mesh robotic repair to a select group of patients that will do well with this type of repair. Not sure who qualifies, but certainly worth calling her office to get some information. She has been so helpful to me and is the most in depth hernia surgeon that I have been to and I have been to many of the top specialists! Dr. Andrew Wright is in Seattle. I know he is a hernia expert but don’t know specifics about his repairs. Wouldn’t hurt to call his office as well. Best wishes in finding the best repair for you that lets you live your active life pain free. I am still on that journey!
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Dr. William brown CA.
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