News Feed Discussions Thinking about "proper" evaluation: Chicago specialists?

  • Thinking about "proper" evaluation: Chicago specialists?

    Posted by UhOh! on March 4, 2018 at 11:10 pm

    I’m finally coming around to getting a real evaluation, by a specialist surgeon, to determine whether or not to consider surgical repair. I live in Chicago, and want to stay local. Specifically, I am looking for surgeons who:

    Specialize in open, tissue repair techniques
    Do them under local anesthesia
    Are willing to confirm specific diagnosis (hernia or not; direct or indirect) with imaging
    Will not fight me on the fact that I will not consent to residents participating in the surgery (if a teaching institution)

    Would appreciate any thoughts/recs. Thanks in advance.

    Tino_7 replied 4 years, 7 months ago 7 Members · 14 Replies
  • 14 Replies
  • Tino_7

    Member
    August 27, 2019 at 3:05 pm
    quote UhOh!:

    The surest way is to strike that section of the consent form. There’s also a difference between “hold this” and “cut here.” But in reality I think it is imperative to have an honest discussion with the treating physician beforehand, to let them know what you are and are not comfortable with.

    You can do that and verbally request to the surgeon that you do not want residents involved in critical points of the surgery. Legally, that should bind them (must be in writing), but once you’re under sedation, what do you really know?

    Major teaching hospitals offer the best of care, whether Mayo or Cleveland Clinic or UCLA or Mass General, etc. – but these are teaching hospitals and in surgery, one should expect that the classroom training extends there.

    Get it in writing and hand mark the consent form and request a copy of the marked up copy with your signature and date prior to surgery.

  • Tino_7

    Member
    August 27, 2019 at 2:52 pm
    quote UhOh!:

    I did a consult with a surgeon in Chicago who says he can do non-mesh but thinks mesh has a better outcome and hasn’t done a non-mesh in about three years (as of last fall). Ultimately I haven’t done anything; mine is still reducible, contains only fat and rarely if ever bothers me. So I’ve left it alone.

    Thank you and thanks for the PM.

    I’m going to consult with the Chicago surgeon soon.

    Also, I consulted with Dr. David Grischkan, Cleveland, last month. He can do open suture repair. On the plus side, he’s done over 20,000 operations and this is all he does, and he has no residents to assist. He is the only surgeon in the room to work on you. On the down side, he’s 9 hours away by car.

    The choices in the upper Midwest are few. I don’t know of any surgeon at major medical centers such as UM Ann Arbor, Cleveland Clinic, RUSH University Med Center in Chicago who do non mesh repairs.

    A doctor in central Indiana (Greencastle and Indianapolis), Paul Szotek, does different types of repair including open non mesh and robotic mesh.

    I don’t know enough to choose between the two. I know someone who had robotic laprascopic with mesh in Chicago and is doing great. I know someone who had the same in Raleigh, N.C., who five years later still has issues. I guess with robotic, you bounce back faster. With open, you don’t have to worry about mesh migration or immune response-rejection.

    Dr Grischkan reports a failure rate of < 1% and says his method is superior.

    On a side note…..

    I want to start a new thread here, but cannot find anyplace on the forum to begin a new topic. How do I do that?

    Thanks!

  • UhOh!

    Member
    August 26, 2019 at 2:14 am
    quote tenreasy:

    I live in Chicago and I do not think that anyone does open tissue repair. They all use mesh. As far as not letting residents participate not sure how you could enforce. My doctor performed the main surgery and was assisted with residents. Maybe doctors could chime in.

    The surest way is to strike that section of the consent form. There’s also a difference between “hold this” and “cut here.” But in reality I think it is imperative to have an honest discussion with the treating physician beforehand, to let them know what you are and are not comfortable with.

  • tenreasy

    Member
    August 25, 2019 at 3:15 pm

    I live in Chicago and I do not think that anyone does open tissue repair. They all use mesh. As far as not letting residents participate not sure how you could enforce. My doctor performed the main surgery and was assisted with residents. Maybe doctors could chime in.

  • UhOh!

    Member
    August 22, 2019 at 1:59 am
    quote Dill:

    Oh. I didn’t even know that was a possibility. I wouldn’t have wanted that either. Hope I didn’t sign on that. I’ll ask on the follow-up.

    I’m just assuming that any resident would be entirely unfamiliar with the procedure (other than, perhaps, a textbook) because nobody seems to teach it these days, and virtually all of the doctors who do it are doing it by request only, not as their standard of care (meaning the opportunities to observe them doing it are seldom).

  • Dill

    Member
    August 20, 2019 at 11:21 am

    Oh. I didn’t even know that was a possibility. I wouldn’t have wanted that either. Hope I didn’t sign on that. I’ll ask on the follow-up.

  • UhOh!

    Member
    August 20, 2019 at 5:00 am
    quote Dill:

    [USER=”1218″]Beenthere[/USER] what is a ghost surgery? [USER=”1391″]UhOh![/USER] I was asked to sign if I would mind students in the surgery (I haven’t found out if there were) and I said sure because I actually want younger people to know how to do the surgery without mesh, however it seemed like it would have been fine with them if I said no.

    Observing, sure, but not operating. Chances are that this would be the first time they’d even seen a pure tissue repair done, so to me the risk is too high letting them actually cut. I might feel differently about a fellow, who is already a board certified surgeon but continuing t do specialized training.

  • Dill

    Member
    August 20, 2019 at 1:21 am

    [USER=”1218″]Beenthere[/USER] what is a ghost surgery? [USER=”1391″]UhOh![/USER] I was asked to sign if I would mind students in the surgery (I haven’t found out if there were) and I said sure because I actually want younger people to know how to do the surgery without mesh, however it seemed like it would have been fine with them if I said no.

  • Tino_7

    Member
    August 19, 2019 at 4:52 pm
    quote UhOh!:

    I did a consult with a surgeon in Chicago who says he can do non-mesh but thinks mesh has a better outcome and hasn’t done a non-mesh in about three years (as of last fall). Ultimately I haven’t done anything; mine is still reducible, contains only fat and rarely if ever bothers me. So I’ve left it alone.

    Ok, thanks. Can you PM me the name of the Chicago surgeon? Glad your hernia isn’t any worse.

  • UhOh!

    Member
    August 15, 2019 at 8:51 pm
    quote Tino_7:

    I realize it’s been 3 years but what did you decide on?

    I’m near Chicago too but could find no surgeon who does non mesh repairs. Kind of frustrating considering Chicago is home to several outstanding hospitals and medical schools.

    I can get to Chicago much easier than Cleveland or Knoxville or Indianapolis.

    Since Drs. Szotek and Grischkan are closest, I will look into them.

    Dr. Reinhorn in Boston would be a great choice if I were nearby.

    I have other issues that make air travel difficult, and so I have to select a surgeon that is a reasonable (< 8 hr) drive.

    Very interested to know which surgeon you selected and how your surgery went.

    thanks.

    I did a consult with a surgeon in Chicago who says he can do non-mesh but thinks mesh has a better outcome and hasn’t done a non-mesh in about three years (as of last fall). Ultimately I haven’t done anything; mine is still reducible, contains only fat and rarely if ever bothers me. So I’ve left it alone.

  • Tino_7

    Member
    August 15, 2019 at 3:52 pm
    quote UhOh!:

    I’m finally coming around to getting a real evaluation, by a specialist surgeon, to determine whether or not to consider surgical repair. I live in Chicago, and want to stay local. Specifically, I am looking for surgeons who:

    Specialize in open, tissue repair techniques
    Do them under local anesthesia
    Are willing to confirm specific diagnosis (hernia or not; direct or indirect) with imaging
    Will not fight me on the fact that I will not consent to residents participating in the surgery (if a teaching institution)

    Would appreciate any thoughts/recs. Thanks in advance.

    I realize it’s been 3 years but what did you decide on?

    I’m near Chicago too but could find no surgeon who does non mesh repairs. Kind of frustrating considering Chicago is home to several outstanding hospitals and medical schools.

    I can get to Chicago much easier than Cleveland or Knoxville or Indianapolis.

    Since Drs. Szotek and Grischkan are closest, I will look into them.

    Dr. Reinhorn in Boston would be a great choice if I were nearby.

    I have other issues that make air travel difficult, and so I have to select a surgeon that is a reasonable (< 8 hr) drive.

    Very interested to know which surgeon you selected and how your surgery went.

    thanks.

  • Chaunce1234

    Member
    May 9, 2018 at 4:13 am

    Not in Chicago, but this may be helpful:

    – Dr David Grischkan in Cleveland, Ohio

    – Dr Paul Szotek in Indianapolis, IN

    – Dr Bruce Ramshaw in Knoxville, TN

    – Shouldice clinic in Toronto Canada is somewhat nearby

  • jasermd

    Member
    May 7, 2018 at 5:20 pm

    UhOh! any luck finding anyone in Chicago?

  • Beenthere

    Member
    March 9, 2018 at 3:34 pm

    UhOh,

    My problems started in 2010, surgery 2011 if you call it that. It took me 2 years to find a surgeon that I felt I could trust to fix the first surgeons damage.

    I live about 2 hours from Chicago and it has been awhile so my information might be out of date. I could find no surgeon that was truly a specialist in the Midwest for hernia surgeries except for Ramshaw who was I think in St Louis at the time but moving to FL. I have heard that (I think it is Goldbeilt? not sure on the spelling) in Milwaukee is very good but it is a teaching hospital.

    My original surgery was at a large teaching hospital and the surgeon stated he would do the entire surgery but in follow up visits he could not answer any questions about the surgery and I found out later that it was common for ghost surgeries to be performed at this facility. Again I recommend the book Unaccountable to read before having any surgery.

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