Surgical Approach for Active Adult – Modified Bassini
I’ve read read so many posts and they’ve been very helpful. Thank you to all who have contributed! My question concerns returning to activity based on surgical approach.
I had a direct inguinal hernia repaired a week ago. My body bounced back really fast. I’m in almost no pain and definitely feel as though I could run. But I won’t run until a meet with my surgeon for a 10 day followup and get clearance. I do have considerable swelling.
My question concerns surgical approach. I told my surgeon I was very active and run a lot at the evaluation appointment. But he didn’t say which approach he’d take with the repair. From hours of research over the last week, I’ve discovered there are multiple repair approaches to the abdominal defect.
The surgery can be open or laparoscopic and the repair can be with or without mesh. From reading dozens of journal articles and even a hernia textbook, I discovered that surgery with mesh is by far the most common. The Lichtenstein Repair is extremely common as an open repair and sometimes stated as the gold standard. There is also the Shouldice repair which is highly regarded by some.
I found out after the surgery that my surgeon performed a Modified Bassini repair. I have the post-op report. As I understand it, this repair just stitches the defect back together without mesh. From what I’ve read, this approach has a high rate of recurrence. I live in a large metropolitan area, have great insurance, and the surgeon is extremely highly regarded in the city. It was an elective surgery and there was no heightened risk of infection.
Why would he choose a Modified Bassini for someone like me who is extremely active? I called his office and apparently he performs this type of repair in almost all cases. He reserves mesh for large or complicated repairs. Up to Date even says tissue approximation repairs like Bassini have a prolonged return to activity because the tissue has to repair itself.
One article says Bassini is reserved for children and older, inactive people or where cost is at issue. With mesh repairs, I’ve read of people running extremely soon after surgery. Some hernia centers even boast returning to activity with only pain being the guide; almost claiming you can’t cause a recurrence from activity, the mesh repair is completely strong immediately after placed. My repair was sutured with 3-0 Vicryl.
So I am very disappointed that I wasn’t guided toward a repair that would work best for my extremely active lifestyle. I take some blame for not asking more questions, but I trusted the surgeon. He’s one of the most well known general surgeons in a top 10 U.S. city.
Anyone else have a Modified Bassini or anyone have any anecdotes about what repair they had and what returning to activity looked like? Am I overreacting and the Modified Bassini is really a perfectly appropriate technique for an active person. Not running is torture and I’m ready to get back out there. And I’m practically pain free and could certainly slow jog. Thanks!
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