Tagged: Tailored Approach
02/17/2020 at 7:19 pm #21866
I am trying to put together a resource listing of premier “tailored approach” surgeons that do non-mesh tissue repairs as an option when the case permits. ( @alephy we were just discussing this 🙂
I am pretty sure @drtowfigh and Dr Conze in Munich do this.. I know there are others I am missing, can someone please advise? Does @drkang and @drbrown? I see both very highly regarded here. I searched for this specifically here, but didn’t see any sort of listing. Any help is much appreciated.
02/18/2020 at 3:49 am #21869ColtParticipant
I wonder if all the surgeons that make contributions for information to this website, use a tailored approach when looking at patient for hernia repair
Seems like to me most of the surgeons that do hernia repair especially the
Younger ones say under 50 really push hard to do mesh only, at least that’s what I have run into in my area of the country which is rural southeast
I even contacted one surgeon that is a member of the American hernia society
Point blank told open tissue repair was a an inferior repair and he wasn’t aware of anyone around now that did open tissue repair, I might have put this post in wrong area sorry if I did, I don’t remember how to start a new topic, but was also going to ask is it better to use a surgeon that’s a member of the American hernia society than not, seems like most general surgeons are not
02/18/2020 at 9:56 am #21871
@colt I sort of assumed they all do, but just wanted to check. Any of the doctors can confirm maybe?
Not to digress, but well actually, it’s actually pretty related to what you said so…
The only Dr. that I know of that did not use a tailored approach, and does full tissue repair, and I earned the right to say it because I was a direct recipient of the method, is the one that does Desarda, in FL.
And it’s an interesting example of that for a couple of reasons in my view.
Based on my experience, you might be lucky if you get diagnosed correctly, via a physical exam, ie, palpated at all. Again I can say that because my experience was eyeballed, thus incorrectly noted as reducible, which would generally indicate direct. Then I was told it was actually a small indirect one, at the 3 or 4 day post op meeting. Wish he would have stopped, sewn me up, and said I’m not going to do all this to you my friend, for that. But there may be a reason for that…
As the meeting ended, I received a plea to leave a review. Before there was any way to know what the surgery outcome ultimately would be? I thought that’s just odd..so I didn’t do it. But there may be a reason for that…
Search “hernia” in Google, and you’ll see a clinic runs a ton Adwords Google Ads that pop up at the top the page, on that technique.
They are expensive ads. We deal with these for a living. A Google Adwords based customer acquisition model, even a partial one, requires maximizing your Return on Investment to Ad Spend. Which means you focus on maximizing your “leads-to-sales”. So you might have staff that follows up to try to get people to commit to buy, like a car dealership does… just in this case it’s a hernia surgery. And, they did call in this manner to try to book me in.
As Adwords and Google Product Listing Ads experts, also known as PLA ads — we have been doing it and dealing directly with Google for 15+ years. This is an expensive business model dependent on high enough ROI to advertising costs (lead to sale) and moving a lot of those through your sales channel, quickly. It works great for some industries where that’s ok. The irony is this didn’t occur to consider, perhaps being too close to it, it felt normal, and treating our customers with a very high level of respect affected our thinking.
That system is different from putting the care of the individual first, gaining word of mouth referrals, taking time as needed, plus using other more traditional channels that don’t impact a health-first approach.
About them being more delicate, I’ve seen it noted here. I can say the pure tissue repair I had needed longer than it was, I feel, implied to heal. For whatever reason, they said go ahead and jog in two weeks. And really oddly, specifically not to call them if there is more pain in 4 or so weeks. There was.
I walked a few miles a day on flat terrain (trade show etc) for 10 days, a full 12 weeks post op, figured should be OK since hey they said I could jog in 2 weeks… and it seemed to rapidly go downhill in the last couple days. Then more things happened after that when I got back.
All in all, what I have read since says, to my thinking, that a tailored approach is critical, and just as much is the surgeon! And mesh is not bad in and of itself. And tissue repair is not good in and of itself.
02/18/2020 at 10:04 am #21872
Edit / add — having a lot of reviews, no matter if they are sort of meaningless as to representing ultimate outcome because people don’t really consider that aspect, they see stars, is also critical when running Adwords.
02/18/2020 at 2:48 pm #21876ColtParticipant
Send me a chat when you get a chance
02/18/2020 at 3:46 pm #21880
02/19/2020 at 11:55 am #21889kaspaParticipant
There are very good doctors that can do a tailored approach and you can discuss that in detail beforehand. However, if you’re not lucky a tailored approach may only mean that you leave operating table with a mesh, and that’s all, as I’ve heard in some [dramatic] stories.
02/19/2020 at 1:14 pm #21894idoncovParticipant
I agree with kaspa’s last statement. With all the comments left here about repair issues by numerous surgeons why would you go to a physician and tell him to do as he sees it. That is essentially a tailored repair. A tailored repair takes all the power you have as a patient and gives it to them. The best approach is to really become familiar with all methods of repair and go to physician who is best at doing your repair. That’s from my personal experience.
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