News Feed Discussions Our Friend Oceanics’s incisions…

  • Our Friend Oceanics’s incisions…

    Posted by Unknown Member on June 5, 2023 at 1:21 pm

    are huge…compare to kang at 1.5 cm. And Weise is in the same ball park from all reports. Given all the great input on this page I think I will risk the Kang repair for a recurrance. Assuming the good Dr has not retired. I read that large incisions may be necessary to ensure the repair does not fail…but I would think a doctor as experienced and expensive as Conze would have found a way to less damage. What a nightmare this whole hernia surgery area is. I worry that all of us overeducated folks on this forum have turned this outpatient procedure into a total nightmare on par with brain surgery. Again…now up to 71 Lichtenstein repairs —and virtually all said they did no research just went to the surgeon recommended….had the procedure…and minor pain for 3 days…and were then fine forever??? It seems incredible…one guy even played golf 5 days later…can anyone—outside Pinto…who apparently dancing on the beach make a claim like that??

    Oceanic replied 1 year, 1 month ago 4 Members · 10 Replies
  • 10 Replies
  • Oceanic

    Member
    June 6, 2023 at 2:12 am

    Just to clarify my incisions are each 5cm long, not huge at all

    The suturing has been done so well by Dr.Conze the scarrring will be minimal, also I don’t care at all about some scars as long as the surgery goes well and fixes the Hernia, I’m too old to care about cosmetics and even in swimwear no one would ever see them, they’ll be faded to nothing in a year anyway.

    Chuck you’ve got to calm down the hysteria a bit, the syress of all this is clearly not making you think that logically

  • Oceanic

    Member
    June 6, 2023 at 1:55 am

    Just to clarify my incisions are each 5cm long, not huge at all

    The suturing has been done so well by Dr.Conze the scarrring will be minimal, also I don’t care at all about some scars as long as the surgery goes well and fixes the Hernia, I’m too old to care about cosmetics and even in swimwear no one would ever see them, they’ll be faded to nothing in a year anyway

  • Unknown Member

    Member
    June 5, 2023 at 6:00 pm

    And no doctor ever told me what you said…which is…we do mesh because it gives the best result considering recurrance and chronic pain…the doctors were just comparing open to lap…and denigrating tissue repairs….and since there was a chance that i had a bilateral hernia –they all said lap mesh was the way to go. I didnt know how to distinguish one lap surgeon for another…i just picked a guy who had been in practive 30 years and claimed to have done 5000 surgeries..i thought using SILS rather than traditional lap would provide even less trauma…the mesh he used on me was garbage —the dreaded 3d max but two other lap surgeons said it was fine—i dont know how anybody gets a good result…i have yet to meet anyone who got a tissue repair that said “Nothing” when i asked if they had any issues…they all confess to twinges…dead spots…and periodic pain…given the high chronic pain rates for shouldice…the pain rates for kang plus recurrance risk…maybe open mesh is the way to go….with Chen….then pray..

  • Unknown Member

    Member
    June 5, 2023 at 5:54 pm

    Thanks Watchful…Maybe Dr Towfigh is the best to consult on these matters. Though I am sure she doesnt have good numbers for chronic pain either. That yunis interview with Towfigh really sunk me…he was saying open mesh was responsible for the vast majority of his complications business…and he said lap mesh the risks were silly low. I agree those kang numbers dont look great…almost a third report some level of chronic pain? but i suspect shouldice numbers will be worse–and i have seen studies showing nearly 30 percent chronic pain from shouldice. Then its the matter of recurrance..kang says his numbers for recurrance are lower than for mesh. But he hasnt been doing tissue repairs for decades….moreover he is saying he has performed 16,000 operations…that is simply impossible unless he is referring to his hospital. so I just dont know what to believe. I read an interview with David Chen who says his complication rate is .05 percent…and he seems to suggest that lap surgery is where most of those complications come from…so maybe its best to just go to him for an open mesh repair? Would you say he is the best surgeon when it comes to lichtenstien? I cant beleive i am considering mesh again….but these tissue repairs are no party…

  • Watchful

    Member
    June 5, 2023 at 3:06 pm

    MarkT – It’s not so much about cosmetics. I personally don’t care about that at all (not sure about Chuck). The thinking is that larger incisions mean more trauma, cause more nerves to be affected, more pain, longer healing, etc. Also, they give you a hint of the extent of work internally. For me, the incision size per se wasn’t of much concern.

    Chuck – Yeah, I don’t know what to believe either. It’s hard for a patient to get good data about anything in this area. If you look at the chronic pain numbers that Kang just posted, they look far from great. However, I don’t know what to conclude from that because we don’t know the true numbers for pretty much anyone else. All the anecdotes are of limited use.

    I agree that people like us tend to overthink things. Maybe it actually makes the most sense to go with the most commonly practiced procedure, and it’s the most commonly practiced for good reasons, and not because of some irrelevant or nefarious reasons.

    In most likelihood, I would have been better off with a Lichtenstein procedure since my hernia happened to be a tough one to repair with Shouldice. Not sure what that means more generally, though. I do think that Lichtenstein is more one-size-fits-all than any tissue repair, so in some sense it’s a safer bet. It’s probably best to go to someone who can tailor the repair, but extremely few surgeons are excellent at both tissue and mesh.

  • MarkT

    Member
    June 5, 2023 at 2:21 pm

    I would never base my choice of surgery upon something like ‘size of incision’. Unless someone’s line of work depended upon them looking as flawless as possible when naked, I fail to see why this would be a key consideration.

    The incisions are low enough that you never see them with normal clothing, including most swimwear, and they fade greatly with time (mine are barely noticeable, though I suppose that will also depend upon your skin colour).

  • Unknown Member

    Member
    June 5, 2023 at 2:06 pm

    Thanks Watchful –I really have to wonder about the trauma that operation causes. When you watch Todd Harris say that lichtenstien causes virtually zero issues to the point he doesnt even warn patients I gotta wonder just who is telling the truth…its really annoying that all these dopes rolled in for a lichtenstien without any analysis at all and are all fine…while you and i burned the midnight oil to try to get it right and failed

  • Watchful

    Member
    June 5, 2023 at 2:00 pm

    I recall that my surgeon mentioned to me before surgery that the incision is larger for a large hernia, and my hernia was large, so he said that the incision would be 3-4in, and it turned out to be 3.5in.

  • Watchful

    Member
    June 5, 2023 at 1:50 pm

    Mine (from the Shouldice Hospital) is about 9cm (3.5in).

    Not sure about Oceanic’s incisions, but they look like they’re of similar length to mine. I thought they’d be smaller in his case because Dr. Conze told me that he does Shouldice with a 5cm cut, and he makes some clever use of the retractor with his assistants to gain enough access with a relatively small incision.

  • MarkT

    Member
    June 5, 2023 at 8:57 pm

    Is there good evidence that a larger incision is associated with greater complication rates, particularly long-term?

    Personally, I’d be FAR more concerned with the surgeon, repair quality, evidence regarding long-term outcomes, etc. vs. incision size.

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