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Post Desarda Repair
I had my right side indirect inguinal hernia repaired via the Desarda repair method with Dr. Tomas in Fort Meyers, Fl. When he operated on me he also found one direct hernia and repaired it also. It’s been close to 4 months since the surgery and probably the sutures are absorbed now. I am still dealing with pain which was initially gone after 6 weeks recovery. I returned to work which involves being a package delivery driver. Lots of lifting. My first several weeks back to work were great. No pain. Then I had groin pain in my right inner thigh which is gone and improved with daily stretching. However, in the past few weeks I’ve been dealing with a pain that is similar to that before I had the repair. The pain is occurring between the lower half of the incision line and genitalia. It’s also painful to push on. Not debilitating, but very uncomfortable. Pain level about 4-5 on a 1 to 10 pain scale at its worst. The amount of pain seems dependent on varying degrees of bowel movements and the amount of time on my feet. I’ve gone back to wearing the hernia truss because it seems like the added support reduces pain. I take white willow bark supplements on a daily basis for regular back pain and some of that pain could be dulled down too. I’m still also applying arnica pain cream as initially prescribed. The area that hurts is the same area that hurt the worst during my 6 week recovery and that pain was completely gone after 6 weeks. That pain was virtually non existent for my first several weeks back to work and the pain I experience now has gradually set in to where it is now. The healing ridge is almost completely gone. Why am I having this pain similar to before the surgery, but the difference being it actually hurts to push on it? A bit concerned. The pain levels don’t seem to be fading, but instead yo yo with my bowel movements and time on my feet. Am I having a recurrence or is something else going on? Should I get scanned (CAT and/or Ultrasound) to check things out down there? Any experienced input on this would be greatly appreciated.
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45 Replies
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@ssonic99 Interesting. And I’ll just add this because this is related to your post…(read my post about living a nightmare, incisional hernia and that Desarda clinic).
Ignored… I needed to ask for my records, to get help in Ohio, and was told ever changing protocol to get them by different staff, put on hold forever, just utterly unprofessional and sketchy all around was the impression I got… finally I was forced to say, look people, please send them or I’ll have to cc the Fl Medical Board next time I ask. *Shock*, I got them the next morning. I hated having to do that. Just send them per HIPPA, even if you don’t want to help me.
There was a big error in them I then noticed. They noted pre-op exam diagnosed the hernia type as reducible, indicating usually direct. It was not reducible at all, and was indirect. How they got reducible is totally beyond me…… except I wonder if the reason for the error was because Dr Tomas never bothered to palpate the hernia site in my initial exam and just eyeballed and saw a hernia sac higher up. I wish I was a fan. I hoped I would be. I know stuff can go wrong — but this is not Act of God stuff or fluky one-off stuff.
I asked many times about a raised fatty mound I noticed, that to me, a simple LAYMAN, was a clue I possibly had a recurrence, as I had lingering pain as well. I asked repeatedly to please have someone get back if that was normal and please what the Dr thought — might it mean a problem? Crickets, all the time crickets. And yes it was there because yes I did have a recurrence.
Re sutures, I was told they are absorbable sutures because I asked about that before going on a trip outside the country. Have all in emails.. was told that they were all dissolved after 8 weeks…Then I got back and Esteban said, welp nope, they are still there! And only start to dissolve after 14 weeks or longer.
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the guidelines (European, American?) are rather cautious in all controversial aspects. On the sutures I didn’t read anything, maybe I missed it. Here it seems to me that I have read that Dr Brown uses the absorbable and the drtowfigh use the permanents. Both have excellent results. It appears that both recurrences are rare. How can we know any other effects? For example absorbable sutures are more irritating, but they do not seem to cause damage or infection ..permanents can cause granuloma. it will be a reason why dr brown opts for absorbables and dr fight for permanents.
in conclusion, however, it would be interesting to ask both side effects of sutures, for example granuloma -
Thank you. I can’t say with any certainty that my surgery was a failure. The local MRI doctor saw no recurrence and some scar tissue and that gives me some peace of mind. The scarring maybe where the residual discomfort is coming from for all I know. I feel much better than I did back in December. What is a complete failure is the follow through on Dr Tomas’s part to check on me, the patient, from surgery to complete recovery especially since I don’t live close to Florida. It was like pulling teeth just to get information to fill out an MRI script that my Chiropractor wrote up for me on my behalf.
The reason I mention the insurance thing is because I found an extraneous EOB statement with a fictitious surgery date where an insurance payment was apparently sent to Dr Tomas’s office in the amount equal to the payment I received through an individual claim I made on the real surgery date. Keep in mind his office does not accept insurance, but had my insurance information “on behalf of the anesthesiologists and lee island surgery center.” In suspicion, I sent emails to his financial person (Terry) who handles that stuff and received silence.
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[USER=”2844″]ssonic99[/USER] I am really sorry for your experience and your situation, it seems most of the doctors are nice when you meet them and before the operation but once you pay them and after the operation, they don’t want to know anything about you or any questions.
It seems Desarda with Dr. Tomas is not a good surgery and people should avoid it. I understand no-mesh repair has a very high risk of recurrence, I am still waiting if my symptoms go worst.
Hope you can recover soon
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[USER=”2758″]Dill[/USER] after researching for a while I found that they can use absorbable sutures. Even Dr. Desarda did it with good results:
Simply that doesn’t make a lot of sense, but for some reason that works.
I think any suture is better than a mesh.
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@kaspa–I think most surgeons will go with the prolene sutures for pure tissue repair unless specifically asked to use absorbable by their patients, which is what I requested knowing there is a greater risk for reoccurrence. My surgeon may very well end up saying “I told you so”, but because I know myself and my body, I thought it might resist a plastic material. I did trust my surgeon and if he refused the absorbable, I would have still had the repair done by him. The suture materials are not as problematic as the mesh, which I was definitely sure I would not take.
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[USER=”2844″]ssonic99[/USER] Shame on him. Thinking about this makes me question his results. Like how many others have been ignored who had post-operation problems? Does he just include successful operations in his findings? Not saying he’s bad surgeon, I’m sure many have had successful repairs done by him. But it’s worth questioning.
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I am sad to report that I am officially being ignored by Dr Tomas’s office. I got the follow up MRI done back in April/May because of hernia recurrence concerns. The MRI was received by their office. I sent follow up emails to Dr Tomas’s assistant Esteban and I don’t receive replies after all that effort. I even copied BJ who is a patient liaison person on the most recent email. All I was looking for was that in his professional opinion as the surgeon who did the work whether everything still looked ok. It’s been 3 months and no response. Very suspicious. I’m not particularly concerned about my condition as much because there has been improvement in the last 3 months. However, the low level of professionalism just to put my final concerns away is remarkable and very concerning. There is a lot more to this hernia repair story that I’ve been holding back (thought to be a misunderstanding) that almost caused me to go home running for fear of my life mostly because of the anesthesiologist, but I may have to come out of the closet with this story and write multiple very factual reviews disclosing everything from start to finish. At this point I will offer the following advice. BJ or some other person will say they are collecting insurance info on behalf of the anesthesiologist and lee island surgery center (if you go there). Don’t give it to them. Let those two entities get the information by them calling you or you call them. I’ll leave it at that for now.
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And also consider a consult with dr. Brown in CA.
many great testimonies on this site from people who have had non mesh repair with him. See Dog’s post -
hi [USER=”2944″]mattl[/USER] open a new topic, this was related something different. Thanks!
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Hi guys new user here. I was just diagnosed with a inguinal hernia, gotta clarify with doc if its indirect or direct however I am 32 active with weightlifting and sports and looking for best repair option.
I have narrowed it down to Kang and Desarda with Dr. Robert Tomas. Obviously a trip to FL would be a bit easier for me but wondering if benefits of Kang’s is worth the trip.
I did notice everyone talking about types of sutures Dr. Robert Tomas uses. After browsing on his site I came across this:
“Dr. Tomas uses absorbable sutures on the skin and subcutaneous tissue and uses absorbable sutures for re-constructing the floor with a one inch strip of the external oblique aponeurosis which is the muscle that covers the inguinal canal..” https://ufirstrejuvenation.com/no-mesh-hernia-and-surgery-center/hernia-surgery-faqs/
So I hope that helps clear up any confusion.
Can anyone recommend pros and cons of Desarda vs Kang… My doc here just wanted to do a robotic mesh.. =(
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quote SickofPain!:Dr Robert Tomas told me I had a hernia, but I did not. He claims he does the Desarda technique which uses no mesh, but a true Desrada uses dissolvable internal stitches. Tomas opened me up two separate times because he said he missed it the first time. Then he sewed up my oblique muscle so tight with PERMANENT STITCHES and I was in agony during the surgery. I could not take a deep breath for almost two years. I ended up having to search for a surgeon that would reverse what he did and remove those awful stitches. It was a brutal surgery because the stitches had shredded my muscle. I can finally breathe now. I went through 2 years of hell for nothing. I had no hernia. What he said was a hernia is still there.I got very sick from those stitches because my body was fighting them and it turned into big granulomas. You should see the mess they took out of me. It was awful. I am now scarred and deformed. My bikini days are gone!! I will always be weak now from all the damage that was done by those sutures cutting into my muscle.
Be careful. Ask a lot of questions
[USER=”2895″]SickofPain![/USER]
What kind of hernia did you have and when did you have it repaired by Dr Tomas if you don’t mind me asking?
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Was looking at Operation Technique on his website where I found the long and short of his two books sold on Amazon. Says he uses PDSII no.1 or ‘0’ (Monofilament Polydioxanone violet, Ethicon) continuous sutures. These are absorbable as far as I know.
I searched for the book, Look Inside, on the kindle app and amazon and found the results for the two books under his name mentioned above. “Look inside” didn’t come up for some reason. Wherever it’s at, he’s probably reiterating the history again since history apparently dictates that at one time he did use non absorbable sutures in the repair technique.
While I don’t have access to that article in Hernia (2006) without paying for it, I was able to read the abstract. That (1-12 yr) follow-up study was performed on 860 patients with 920 inguinal hernias between August 1990 and December 2003. Sounds like he might have had a mixture of patients with and without absorbable sutures possibly as part of that study. It might explain the mixed messages. The end result of the study showed zero recurrences of 920 inguinal hernias. That’s a good thing.
I’ve viewed the MRI scans myself. While I am no expert, I don’t see any foreign bodies like sutures in those scans. They would stick out like a sore thumb. I had an appendectomy done 13 years ago. The surgeon at the time through open surgery used surgical staples (stainless steel) internally to close up the incision. These staples show up on x rays. I first noticed this when my Chiropractor sent me to radiology to have my spine x rayed to check my spinal alignment. Until that time, I never knew they were there until the x ray tech asked me what they were. Then we concluded that they were metal staples from that surgery. So now every time if I’m asked before any kind of radiology if I have any foreign metal body inside me, I check yes.
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In Dr. Desarda’s he only tells about Prolene in his website “Operation technique”.
I also checked amazon.com and it seems Dr. Desarda published a new book available in paperback or kindle. In “Look inside”, if one searches “Prolene” it happens 3 times (pp. 86, 89, 90). If one searches “absorbable”, it happens 11 times (between pages 7-75). But one can’t access the pages, so I don’t know the context.
In his article in Hernia (2006), Dr. Desarda only tells about Polypropylene interrupted sutures, but in fig. 2 legend, he mentions “continuous absorbable sutures” (an error?).
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Wow! I never knew that at one time Dr. Desarda used non absorbable sutures. I read that publication because it really peaked my curiosity since I assumed absorbable sutures were always used. If you go to Dr Desarda’s website and read the history of the Desarda Repair, he mentions the publication from BMC Surgery back in 2002 and subsequently after that time the repair method improved to use absorbable sutures. It’s had other improvements since it’s origins that I never knew about. I’d post the link to the history, but I’m not sure of the forum rules. I found it by googling “History Desarda Repair”. Fascinating read.
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In his article in BMC Surgery, Dr. Desarda only tells about Ethilon or Prolene sutures, both non-absorbable.
Shouldice Clinic also use non-absorbable suture (in stainless steel!).
It’s worrisome that some doctors choose to use absorbable sutures when standard is non-absorbable.
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He received the MRI CD and results on Friday May 31. I have not heard back from him at all this week. Looks like I’ll be making a phone call on Monday morning.
I definitely would not call my pain excruciating by a long shot. Just really annoying when I become physically active especially when lifting or have a large bowel movements. He said he used dissolvable sutures and that he was trained and mentored multiple times by Dr. Desarda from India. That’s on his website including explanation and pictures of his procedure. It’s just strange how my pain was a zero for about a month after about a 6 weeks recovery, then now this.
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[USER=”2895″]SickofPain![/USER] thanks for sharing your experience and I hope you feel better. It is good to know that some doctors are not what they claimed to be.
@ssonic99 hope your are feeling better with your recovery and I wish your doctor makes him responsible on what he did to you. -
quote drtowfigh:Use of permanent sutures are standard of care
for hernia repair, especially pure tissue repair . It would not be evidence based to say they should never have been there in the first place.When it is stated that absorbable stitches are used…..permanent stitches should NOT be there.
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quote SickofPain!:Dr Robert Tomas told me I had a hernia, but I did not. He claims he does the Desarda technique which uses no mesh, but a true Desrada uses dissolvable internal stitches. Tomas opened me up two separate times because he said he missed it the first time. Then he sewed up my oblique muscle so tight with PERMANENT STITCHES and I was in agony during the surgery. I could not take a deep breath for almost two years. I ended up having to search for a surgeon that would reverse what he did and remove those awful stitches. It was a brutal surgery because the stitches had shredded my muscle. I can finally breathe now. I went through 2 years of hell for nothing. I had no hernia. What he said was a hernia is still there.I got very sick from those stitches because my body was fighting them and it turned into big granulomas. You should see the mess they took out of me. It was awful. I am now scarred and deformed. My bikini days are gone!! I will always be weak now from all the damage that was done by those sutures cutting into my muscle.Be careful. Ask a lot of questions
DrBrown one more time glad about my choice of surgeon … i hope dr Brown respond ,he does no mesh surgery non stop for decades.
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