Small to medium, reducible Inguinal hernia exercises; potentially avoid surgery!?!?

[Jeremy B]

I am excited to hear that there is a possibility to avoid surgery by strengthening the musculature surrounding a small/medium reducible hernia.
I did find an interesting study that also suggests this is possible: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3276927/
Dr. Towfigh, what exercises have you seen be beneficial to patients?

Sincerely
Jeremy

[LeviProcter]

Core exercises (planks, etc) can strengthen core.
None of these will fix a hernia. Goal is to prevent them from coming out less often by strengthening the abdominal wall therefore making the hernia defect have less laxity and change the contour of the defect to be less accommodating
.
Also, avoiding smoking and strive for weight loss to decrease fat on intestines to lower intra-abdominal pressure to prevent abdominal contents from pushing into them. High fiber diet and lots of water to making defecation less stressful and require less abdominal pressure.

[Jeremy B]

Thanks Levi, My plan is to see if I can just get it to a point where it doesn’t require surgery.
If I did go the surgery rout my goal would be as minimal of a procedure as possible. No mesh, absorbable PDS, facia only repair, main nerve branches preserved, maintain a functioning cremaster. (minimal or modified sholdice)

Does anyone know of a surgeon near minnesota that performs a quality tissue only repair?
The seemingly least invasive repair I have found in the states is with Dr Grischkan in OH, two layer Sholdice, does anyone have any experience with this guy? Or maybe a robotic no mesh repair from Dr Towfigh.

Finally is there anyone trying to pioneer a better approach than what exists?
maybe something to facilitate facia remodeling by injection? Prolotherapy?
It seems like Dr Towfigh might be on the forefront in regard to alternatives.

I know this was multifaceted but any replies are appreciated.
Thanks!
Jeremy

[LeviProcter]

Desarda repair is straightforward tissue repair also.

Yoire going to likely have to travel for the type of repairs you seek.

[Jeremy B]

Would there be a reason to go Desarda vs Shouldice?

What type of tissue repair is done with Dr Towfigh’s robotic system?

[LeviProcter]

Desarda is a tension free tissue repair. If I was having a tissue based inguinal repair I would personally (my opinion only) favor a Desarda over a Shouldice.

I would have to let Dr. Towfigh comment on robotic tissue repair as I currently don’t perform that type at present. They’re typically repairs involving suture/stitches to close the hernia without mesh.

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