Shouldice vs Kang surgery experience

[Johnso]

William:

Here is a link I found wrt stainless steel sutures. Nickel is listed and I believe it is generally used in the manufacturing of stainless steel. I don’t know what percentage of nickel is in the sutures used at Shouldice.

https://suturebasics.com/surgical-stainless-steel-suture-wire-material-316lvm/

I believe most surgeons doing Shouldice repairs outside of the Shouldice Clinic use a synthetic suture such as prolene but I am not an expert.

johnso

• This reply was modified 2 years, 7 months ago by  Johnso.

[William Bryant]

Thanks Johnso… I dont suppose anyone knows if the stainless steel shouldice use has nickel in it?

As I’ve said elsewhere I do get skin irritation from some metal watch backs, some belt buckles and some coat zips if they go up to neck.

[Johnso]

William:

Dr. Towfigh did a Hernia Talk Live Session with Dr. Spencer Netto from the Shouldice Clinic last year. Here is the link:

https://www.youtube.com/watch?v=x-5vJbGU2Co

If you are interested it is worth a listen to hear what they do with the cremasteric muscle, the nerves and why they still use stainless steel sutures.

On the internet I have found 2 different stories as to why Dr. Shouldice started using stainless steel sutures but the most common and probably the actual reason is its minimal inflammatory properties.

Colin:

I wonder if a highly sensitive metal detector would be able to detect stainless steel sutures and therefore satisfy your curiosity.

johnso

[Colin M.]

I am quite certain only Dr. Kang and his son are able to conduct the surgeries. My surgery was done by the younger Dr. Kang, who happened to speak English really well btw which was convenient.

[William Bryant]

Thanks Colin.

Was it Dr Kang who did the surgery himself? Do members of his team carry put the surgery too on occasions meaning you can’t always guarantee having Dr Kang himself?

[Colin M.]

Hi William,

I hope someone can answer these questions because I’m curious as to the materials as well now.

As for the nerves, I haven’t permanently lost any feeling from either surgery. After the Kang surgery (since I can attest to that, being so recent), I only had temporary numbness at the site and in part of the scrotum for about 3 months post surgery, after which all feeling came back. I was told in advance that this is what would happen as well.

Upon searching, it appears one nerve is cut during Shouldice surgery (probably in both surgeries I’d assume, but I can’t find that info for Kang). I don’t remember how it felt exactly after Shouldice surgery, but I can at least tell you I have all feeling in that area right now as well.

[William Bryant]

I don’t know if anyone who contributed to this thread is still posting but if they are…

Does shouldice Canada still use metal thread? If so what type of metal?

Is Kang method metal and plastic and foreign material free?

Do either or both cut cut nerves?

Finally thanks Colin for the initial post, most useful getting view of someone who’s had both types of repair.

I do take the point made there’s 20 years between them.

[Colin M.]

I currently live in Korea, so I did not. But, at the moment, any visitors must quarantine for 2 weeeks, so you would have to before getting the surgery, I’d assume.

[Spartan]

Did you have to stay 2 weeks in a hotel in S.Korea before getting the surgery? If not, when was that Covid 19 lifted in S. Korea?

[Colin M.]

@mitchtom6:

I’d describe my lifestyle as quite active. I play sports occasionally, and I used to do heavy weightlifting 3 times a week prior to COVID.

After the Shouldice surgery, I was always worried about lifting heavy due to a fear of causing damage to the surgical site (kind of psychological I guess). However, after some time, I got the courage to start lifting heavy again (eg. 100+ kg bench, squat, deadlift), and I haven’t had any issue.

Due to COVID lockdowns, I haven’t weightlifted yet after the Kang surgery, but if I ever do, I will report back how it goes. I’d assume it should be fine as well.

@pinto:

This is the first I’m hearing about steel suturing. My mother also says she can’t recall. But this is a great question because I do indeed occasionally feel an awkward feeling from the Shouldice location every now and then. A “tinge” is a good description of it. It feels almost like something is poking me, like a splinter kind of feeling.

I had no clue what that feeling is and why it comes every few months and lasts for a couple minutes (sometimes longer). I used to think I had an ingrown hair or something I could just never seem to find, but that didn’t really make sense. But the sensation feels a bit close to the surface of the skin like that. Now that you’ve mentioned steel suturing and a tinge feeling, I guess that might answer that question! You may have just inadvertently solved a 20 year old problem of mine. Thanks!

@Good intentions:

It has been 2 months since my Kang repair. I have been playing basketball a bit lately and I have been riding a bike on weekends for the past 3 weeks so far. Currently, I have no issue with the Kang surgery. I know it has been a short time, but I will continue to update if anything arises. Eventually I will get back to weightlifting and see how that goes as well. However, I do some light exercise at home for the time being.

With the Kang surgery, up until about a month after surgery there has been some burning sensations near the site that were a mild nuisance. These usually happened if I stood or sat in the same position for too long. Dr. Kang also warned me about these uncomfortable feelings that may occur for the first few weeks. However, this no longer occurs and I feel completely normal now. I ride bikes at the same intensity now that I used to without any problem. Running, jumping, etc. during basketball hasn’t been an issue either.

[Good intentions]

Thanks for posting Colin. Parents with children would get great value out of your experience with the Shouldice repair. 20 years, and passage through puberty to adulthood, with no problems, is a success and what any parent would want for their child. Even many of the mesh proponents in the community of surgeons recommend against mesh for adolescents, but there are probably thousands of kids who get it anyway.

And the experience at Gibbeum Hospital is one more verification of a non-mesh option. I have the same question as mitchtom6 about your lifestyle and activities, and also how long it’s been since the Kang repair. Are you a runner or biker, do you play sports, physical labor, etc.?

Good luck.

• This reply was modified 3 years ago by  Good intentions.

[pinto]

Colin, did Shouldice use steel suturing? If so were you made aware of it at the time? And if so again, do you ever feel a tinge or something?

[pinto]

Almost every post is from personal experience. Personal experience is vital.
Colin, you wrote, >I just thought after experiencing two leading hernia surgeries, I could compare the two.<
Of course you can, Colin. But you also were making a claim that X is better than Y, which surely invites discussion. Please recognize that. As I said, your experience can fit in immediately (and variously).

[mitchtom6]

Colin,

Thanks for your stories. You truly are part of a very, very small population of folks who has experienced these two different non-mesh varieties.

How would you describe your lifestyle? Do you do a lot of physical activity? I’m glad both procedures have been successful for you.

Americans are not used to looking internationally for medical care.

Take care!

[Colin M.]

Hi Alephy,

Thanks for your response. I was a patient who had no medical expertise, and I’d assume most patients don’t. I wouldn’t expect patients to know about the tissues involved such as the cremaster muscle previously mentioned, and I don’t think they would care much about that either.

I think what prospective patients care most about is if the surgery will be successful, and if they can live a normal life without complications afterwards. Younger patients may care about the surgical site’s appearance as well, as they could be self-conscious about that, as I was when I was a teen.

I hope my post can help inform some people needing hernia surgery by sharing my story. I think it is especially useful for people living outside of Canada. Had I not searched extensively for Shouldice alternatives, I would not have found out about the Gibbeum hospital in Korea. I was very close to spending thousands more to travel to Canada and get another Shouldice surgery or to take the risk of getting a mesh surgery.

[Alephy]

Hi Colin,

Personally I found your post very interesting, you described your personal experience with the two surgeries, which is what people have been doing here since the very beginning. No one is saying that they are showing scientific results out of one’s experience, for that there are medical articles (which are not submitted to this forum for review as far as I know:)

[Colin M.]

I just thought after experiencing two leading hernia surgeries, I could compare the two.

A few doctors recommended me to do a mesh surgery before my second hernia operation, saying non-mesh is only for children (which I knew was wrong since Shouldice had many adults, but I couldn’t afford to travel back to Canada from Korea).

Luckily, I found out about the Kang surgery and had a great experience with that. Because of that, I thought I could compare the two since they seem to be two great non-mesh repair methods and they were both very successful. I also want people to be aware of their options and not almost get tricked like I did into getting a mesh 🙂

I will search the forums and see where I can contribute. I probably should have done that before starting a new topic. I appreciate your kindness and understanding as I’m a new user here.

[pinto]

Colin, everything flows from purpose. I’m unsure what you want to do. This thread was couched kind of like a strawman debate, which I think you realize that now. What is it that you want to say? When you’ve got that run with it. There are already existing threads that talk about these individual IH methods. Maybe that’s the way: Fit your experience with what was being discussed. I think you would fit right away. 🙂

[Colin M.]

Hi pinto,

Thanks for the feedback again.

In this case, would it be better to give a detailed walkthrough of my experiences with both hospitals and surgeries (or my most recent one, since Shouldice may be different these days) instead of evaluating the advantages/disadvantages? If you think that would be beneficial to readers, please let me know!

[pinto]

Hi Colin,

Your points are well taken. Let me clarify my post by noting your original post began by saying “people who visit here to figure out which is the best surgery for an inguinal hernia.” If we’re trying to do that then wouldn’t we want to be systematic doing it?

Because modern medicine is so technological, taking two cases separated by twenty years surely is lopsided. The earlier one is disadvantaged by its older tech or possibly less developed technique. That has to be an unfair comparison.

If I am not mistaken your purpose was to compare the two IH methods you experienced and concluded by saying that one was better. Perhaps that’s true but technically it’s a weak comparison to say the least. I don’t think you would personally decide on a surgery for tomorrow based on that kind of comparison, right? Your post based its conclusion on a Shouldice incision measurement more than 20 yrs. ago or more. The length of incision possibly has shortened over time. Moreover decision of surgery surely wouldn’t be based solely on incision, right?

I appreciate the uniqueness of your experience and welcome your sharing. It would be more appreciative, I believe, if it were less evaluative because of the reasons stated. Friendly chat is appreciated but technical talk prized. Some people will make possibly life-altering decisions based on the information at HT. It’s in our collective interest to together develop information most helpful in that regard. Thank you for your kind attention.