Reversing a modified Bassini SH repair & implications
Hey everyone, I’ve posted many times here to vent and mostly warn against the surgery that Dr. Brown performed on me.
I’m at a stage where I’m trying to gage the likelihood of getting a surgery where a surgeon would undo the modified bassini repair Dr. Brown carried out on me and restore natural muscle configuration so that I can properly function again. When the muscles are where they are supposed to be, I should be able to rehab and regain function and stability. So I’m opening up this thread to see if anyone has input here.
Before Dr. Brown’s surgery my main issues and pain were in the groin between the pubic joint and the external inguinal ring but at no point did I have a hernia sac or hernia. Now 10 months after his surgery I can’t function or be even slightly comfortable the way I am right now – every single day is hell. I’ve listed it in my other posts but lost proper activation of my entire abdominal wall not only at rest but at flexion – can’t flex properly at all because the tissues won’t move its incredibly tight and uncomfortable. I was told there would be some tightness at the surgery site (groin) that would improve over-time but what It actually is full on mechanical impairment from pubic bone to rib attachments and through all 3 muscle layers and the rectus muscle. Its affecting breathing, back muscles, gait, ejaculative contraction, and obviously my confidence since I cannot properly flex my abdominal muscles at all. Its borderline criminal to do this to an athlete and if I were in a traditional sport rather than being a professional artist I’m almost certain they would never have allowed me to get this surgery or they would be suing right now. Either way – I’m trying to be pro-active and figure out my own way out of this hell before giving up on life altogether.
So I guess there are 2 aspects to this discussion/question.
1. How feasible is it to undo a modified Bassini repair – i.e putting back all the tissues where they originally were without seriously maiming/permanently hurting the patient? Is this even possible after all the overzealous cutting Dr. Brown did when he performed his procedure?? I’ve brought the question up to Dr. Zoland via a call a few weeks back and he said that yes it would be possible to put everything back without seriously hurting the patient. What are the counter-indications here? In terms of inguinal canal integrity, testicular integrity, etc. Would I need a bio-mesh temporarily? Etc.
2. When Dr. Brown performs his surgery, he closes the external oblique opening in two layers – 1 layer being sutured to the transverse muscle and then closes the second half on top of the first half and sutures it to the inguinal ligament.
– So this step alone MAJORLY impairs mechanical function. I am trying to figure out what happens to the tissues when they’re sutured overlapping like this. Do they still maintain individual integrity and shape or do they slowly become one thick tissue/ball of scar. I.E – is it possible to undo where they were sutured, and suture the two halves of the external oblique back together as one tissue instead of an overlapping one and actually regain normal function over-time and with proper rehab??
3. From what I’m understanding – the moment you cut into a tissue that tissue cannot engage at 100% ever again. A muscle has to be able to fully contract and fully relax to be able to properly perform its function in harmony with the rest of the body. But the second someone extensively artificially cuts into the tissue (rather than natural micro-tears from overworking the muscle that heal throughout life) – the muscle loses its ability to do this. We see this in various patients that wake up from surgery and are told that the doctor ”lengthened” their psoas muscle during surgery for example which without fail impairs their psoas for life and create an unbelievable cascade of problems and chronic issues but doctors continue to do this. Dr. Meyers only recently stopped doing this from what I’m reading after realizing it was consistently hurting patients. There are several reports and anecdotal accounts of people having something like this done to them and years of therapy does not help them get proper psoas function ever again.
If this is true and consistent – I cannot wrap my head why doctors wouldn’t approach a ”less is more” approach – even when performing a tissue repair. The idea that someone has a weakness/some tearing in their inguinal floor and that a surgeon decides to extend the defect above and beyond to triple its original size to then ”repair it” by stretching nearby tissues over it is so flawed from a mechanical point of view that I am really struggling to understand why Doctors view this as a viable treatment. I understand that the idea is to ”stabilize” the pelvis or patch a hole but by impairing so much muscle tissue the patient can never actually rehab that stability. He’s now dependent on the sutures holding on while the tissues are perpetually tightened and can never relax. There is no dynamic stability. The patient will inevitably become severely dysfunctional and develop issues way beyond the original issue which we’re already seeing severely in my case.
So now my dilemma is that I’m hoping that someone can go in and put in the muscles back to their original attachments so that I can finally rehab them. But I’m worried that the damage is already done in terms of the connective tissue and nervous input that is impaired because of scar tissue from previous cuts. Cutting into the 2 overlapped halves of external oblique to separate them from their forced attachments to the transverse and inguinal ligament from Dr. Brown’s surgery will obviously cause even more damage to all those tissues – so even if they do undo this overlapping/forced attachments/reconfiguration and suture the muscles back into their original configuration as intended – will those muscles ever regain full function? Or is it already too late. Literature and anecdotal evidence is hard to come by for a clear answer on my end.
Final part – I’m suspecting that the major part of the dysfunction of the entire abdominal wall and the rectus is because the transverse fascia along with the transverse and internal oblique are forcibly pulled across – joining the conjoint tendon to the inguinal ligament to ”repair” the inguinal floor. This outwards pull on tissues is why my rectus is so affected. This is further evidenced by my previous surgery on my right side where the surgeons had only cut into my external oblique and which not give me any rectus or abdominal dysfunction whatsoever – only minimal weakness in the area of the scar.
– Is this step even possible? What would happen here in terms of my inguinal canal? The major component of this ”repair” is this pull of the transverse fascia from the conjoint tendon to the inguinal ligament. So what are the implications here if we were to reverse this??
I’m trying to study this in and out so that if I do end up finding a surgeon I feel genuinely loves his job and wants to help potentially save my career – I cover all my bases and I can go in with a plan in mind.
If you guys know of a surgeon that is great also please go ahead and recommend.
Thank you in advance and sorry for the wall of text and technicality of the questions. Just trying to save my career and my life.
Log in to reply.