News Feed Discussions Shouldice vs Kang surgery experience

  • Shouldice vs Kang surgery experience

    Posted by Colin M. on May 12, 2021 at 11:39 pm

    Hello all!

    I am new to this forum, but I am guessing there are some people who visit here to figure out which is the best surgery for an inguinal hernia, so I decided to join and make this thread.

    I have had two inguinal hernias (one on each side), and am probably one of the only people in the world to have had both Shouldice repair in Canada and the relatively new Kang repair in South Korea. So with that, I would like to give my experience with the two.

    At Shouldice, I was 13 years old, and I stayed overnight for 2 nights, probably due to my age. The operation took about 45 minutes. With the Kang repair, I was 33 years old and was able to go home 1 hour after the operation. The operation took about 20 minutes. The incision for my Shouldice repair is about 10 cm long, whereas the Kang repair incision is about 3-4 cm.

    After both surgeries, I have so far been able to live a normal, active life like nothing has ever happened. The Kang repair seems to have an advantage over the Shouldice repair in my opinion, based on the more appealing incision size which is hardly noticeable, in contrast to the huge Shouldice scar.

    I should mention I had the Kang repair done on a Saturday and I went back to work Wednesday without any issues (besides walking slowly and moving carefully, of course). I did not take any pain medication after the first day, despite being given about a week’s supply, as the pain was bearable. I feel like I could have went back to work even on the Monday, but taking some time to rest seemed easier.

    Overall, both surgeries were successful. The Kang surgery has the clear advantage over Shouldice, however, due to the much smaller incision.

    If you are not sure which operation to get for your hernia, I’d recommend the Kang surgery in Korea, and would steer clear of mesh surgeries due to the potential complications that can arise.

    Thanks, and feel free to ask any questions!

    MarkT replied 1 year, 6 months ago 18 Members · 73 Replies
  • 73 Replies
  • Watchnwaitin

    Member
    December 17, 2022 at 5:51 pm

    @MarkT – Thanks for the info.

    Seems like the Kang method is a modified Bassini with special stitching and no cut of cremaster muscle or more invasive steps/techniques.

    Has good success from the looks of it but would be nice to have a more complete and precise explanation of what exactly is done.

  • Watchnwaitin

    Member
    December 14, 2022 at 11:52 pm

    Is there a detailed description anywhere of how the Dr Kang method of tissue repair is done? I’ve searched but only found details of the other methods.

  • Mike M

    Member
    June 8, 2022 at 6:19 am

    @William Bryant

    Dr. Kang does have you cough prior to surgery in the OR and marks the area. You are strapped down extensively so movement was never a concern of mine. I suppose some people might be awake in twilight. You are so calm and secure I don’t see how it would matter unless you have a serious pre-existing neurological condition maybe? Dr. Grischkan mentioned he uses the same method too as Dr. Kang.

    I remember feeling some pressure and that is probably part of the tugging and pulling. As I mentioned I woke up during the last repair which was the umbilical. I had wondered if the the Inguinal repair was completed. That is how little I could feel. I don’t even feel like I was moving a millimeter. It took a lot of effort to even give the thumbs up when he was talking to me.

  • William Bryant

    Member
    June 8, 2022 at 3:46 am

    Glad this has been brought up… I always assumed with local you were fully awake, conscious, compus mentus (if that’s how it’s spelt) etc etc. Ie totally aware.

    I did wonder how you stayed still enough.

    If I have this wrong I’d appreciate clarification as I remember when I had surgery under general, when I came round they said, you don’t half wriggle. I wouldn’t want to do that with hernia repair.

    I also recall that Dr Kang asks patients to cough during the procedure. Surely you need to be “with it” to do that.

    I dont want to feel pain, nor risk accidental damage through movement. Is local ok for me?

    My partner said you feel tugging and pulling etc but not pain as such. Is that right?

  • Mike M

    Member
    June 7, 2022 at 9:47 am

    For me – I definitely remember “pain” but it just wasn’t with anything directly related to the surgery. It was with my back about 5mins after I transferred to the tiny (I’m ~6’3″) post-op bed made of bricks lol. I even remember the dream when I passed out and later woke up during surgery. It wasn’t a bad dream just weird as heck. I tried to stay awake at the start but I didn’t even make it to the number 5 when I was counting.

    As far as moving – I don’t think I did but I was strapped down. Dr. Kang did ask me if I was ok when I woke up. I gave him the thumbs up. I just remember feeling pretty chill and closed my eyes. Non-eventful from my side. I hope I didn’t make Dr. Kang’s life too difficult that day. He didn’t saying anything so I think that is a good sign.

  • Watchful

    Member
    June 7, 2022 at 9:20 am

    Seems like with this type of anesthesia some don’t wake up during the surgery, some are awake for at least part of it not feeling anything, and some are awake during the procedure feeling stuff. At least based on reports from Shouldice Hospital patients.

    One confusing thing about local with sedation is if you don’t feel pain, or if you feel it but don’t remember it later. These are not the same thing…

  • Mike M

    Member
    June 7, 2022 at 4:09 am

    Dr. Kang I felt zero pain during the operation with local sedation and my op lasted a little longer than normal because of the two hernias.

    I did wake up the last 15mins in a twilight still nothing and this includes when I was transferred off the OR table.

    I do not really remember pain until later in the day around nighttime. It came on gradual and not all at once. The pain wasnt that bad until I moved. That lasted the first 2 days maybe? then by the 3rd day I was moving around better.

  • Watchful

    Member
    June 7, 2022 at 3:06 am

    I’ve been wondering about that too. There are quite a few reviews of the Shouldice Hospital where people complain about feeling significant pain and other sensations during the surgery. It seems like local anesthesia with sedation isn’t an exact science…

  • Wim

    Member
    June 7, 2022 at 1:39 am

    Dr Kang uses local sedation, do you actually feel nothing? I once had surgery with local sedation (not hernia) and when they cut the pain was still one og the highest pain I ever experienced.

    In case of hernia better to be strapped to the table because if you move your body during the surgery?

  • Mike M

    Member
    June 6, 2022 at 8:53 am

    @KC

    I recently had a Dr. Kang repair (7 weeks ago) and was initially dead set against using permanent sutures.

    However after doing a lot of research I found that using permanent sutures is probably the one main talking point that both mesh and non-mesh doctors can agree on in regards to hernia repair.

    This is the only option I went back and forth on up until I was literally on the operating table. Dr. Kang asked me one last time before local was administered and I decided it was in my best interest to defer to Dr. Kang’s medical opinion. Dr. Kang used 2-0 prolene non-absorbable sutures on me for inguinal and 3-0 for my umbilical hernia.

    Pinto also influenced me (unknowingly lol) when I asked him what Dr. Kang used on him once he discovered his sliding hernia. Pinto was there about a week or so prior to my arrival.

    I also found doctors (including Dr. Kang) switch to absorb on the portion of the repair that closes the subuc fat and the external oblique aponeurosis. Also glue to close the incision itself.

    Dr. Sbayi in the video listed above calls the sutures the “rebar” support for the body (collagen).

    I was worried what if I happen to gain a little weight, what if I have a bad cough, what if I lift too much, etc. etc. The permanent sutures gave me a little piece of mind it will make the repair stronger.

    Dr. Grischkan went into detail with my first appointment (evaluation only) in regards to how benign and safe the sutures were especially went compared to mesh. Dr Towfigh also elaborates on the size, safety, and value of perm sutures in detail on one of her podcasts which is great.

  • KC

    Member
    June 6, 2022 at 7:14 am

    Colin M,
    when you had your hernia repaired by Dr. Kang, did you use absorbing or non-absorbing suture for repairing your internal structures (not the external skin which is always closed up by absorbing suture)?
    If I am not mistaken, with Dr. Kang, patients can choose either absorbing or non absorbing sutures for internal structures.

  • spinotza

    Member
    October 26, 2021 at 11:52 pm

    Hey there @Scarletville. I’m also getting ready to get a mesh repair privately in the UK. I am also curious which clinic you chose/was assigned to. I’m thinking of getting it at the Oxford Hernia Clinic butI can still change my mind! Kang/Desarda/Shouldice would normally be options too but I’m not comfortable getting a surgery abrod in covid times, just in the small chance something bad happens I’d rather be in my home country where I have a support network.

    • This reply was modified 2 years, 8 months ago by  spinotza.
  • William Bryant

    Member
    October 26, 2021 at 2:51 am

    Hello Scarletville,

    Good to hear you are mending well. Hope it continues.

    Do know …

    Which surgeon did the mesh repair and which type of mesh was it?

    Was it NHS or private?

    Good Intentions has a “good” mesh successes thread – maybe if you have time post details there as they may be of use to others.

    Once again glad it’s working out well for you.

  • pinto

    Member
    October 23, 2021 at 4:12 pm

    Jack, thanks for the backup there. I couldn’t find the thread you mentioned. That’s what I had in mind.

  • William Bryant

    Member
    October 23, 2021 at 2:05 am

    Which is the surgeon in the UK that dies the desarda repair Jack? I’d it the Leicester doctor or the younger surgeon in Northumberland (I’ve lost track of names).

    Yes Jack, desarda is another option and thanks for reminding me.

    So, of the 3 ( Desarda, Shouldice or Kang). Which would be forums members first choice if there were no limiting factors such as time, distance, etc.

  • Jack2021

    Member
    October 22, 2021 at 6:15 pm

    And the Desarda repair is a third option to consider as well isn’t it?

    I might be wrong, but I think Pinto may have been referring to Scarletville from the UK, who recently posted about his experience in Germany with regard to ‘local anaesthesia and conscious sedation’ – https://herniatalk.com/forums/topic/german-covid-19-restrictions/

    Although not mentioned in that post, I believe Scarletville’s operation was possibly carried out by Dr Ralph Lorenz, one of the German doctors I mentioned to you in another post, William. Dr Lorenz is a member of the European Hernia Society Board and he offers both a modified Shouldice repair or a Desarda repair for his tissue based repairs.

    Here’s the set of posts where Scarletville talks about booking in with Dr Lorenz. https://herniatalk.com/forums/topic/dr-js-own-hernia/

    I’ve messaged @scarletville to ask if it was Dr Lorenz he saw and how his recovery is going, but he hasn’t replied as yet, but hopefully he will soon.

    What do others think about the Desarda repair, as there is an option for this in the UK (and I don’t mean with the consultant in London who in the end referred Scarletville to Dr Lorenz)?

    I know there are posts here on HerniaTalk that list issues for some and positives for others re a consultant in the US, but all other research and meta studies I’ve seen, appear to be very favourable with results seemingly on a par with the Shouldice repair.

    My experience from contacting a number of consultants across the UK and Germany is that they all know each other pretty well. Some mentioned that the hernia specialist community is relatively small, which is perhaps a concern considering the number of repairs carried out worldwide.

    German COVID-19 Restrictions

  • William Bryant

    Member
    October 22, 2021 at 8:29 am

    Thanks Pinto. It sounds as though that went well. One thing that does bother me is Dr M has one or two bad reviews and I believe she is within biohernia umbrella. Anyway I note one of the replies mentions UK patient got in touch with PALS to ask which is UK surgeons may do mesh free – so might try that. Thanks again, more food for thought for me.

  • William Bryant

    Member
    October 22, 2021 at 8:20 am

    Thanks Pinto. It sounds as though that went well. One thing that does bother me is Dr M has one or two bad reviews and I believe she is within biohernia umbrella.

  • pinto

    Member
    October 22, 2021 at 4:12 am

    Here is one item about surgery in Germany but I don’t think it’s the one I had in mind. But it looks just as good:
    https://herniatalk.com/forums/topic/my-meshless-hernia-repair-in-germany/

    My meshless hernia repair in Germany

  • William Bryant

    Member
    October 22, 2021 at 3:27 am

    Not sure I have Pinto, thanks for mentioning it. What thread was it on? I am from the UK, you’re right, and by sounds of it, it sounds like the German repair was very successful. Was it Dr Koch? Thanks for thinking of it for me. Anymore info greatly appreciated.

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