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Watchful – can you share more about your experience?
I didnt go to shouldice for a number of reasons:
1. They were enforcing the death shot at the time
2. I didnt like that you could not pick your surgeon
3. I didnt like that they used stainless steel sutures
4. They were cutting the cremaster.Its frustrating that it appears that some of that stuff simply isnt true any more—its very tough to get a clear picture of what the surgery involves when you have to fly to other countries. I thought hernia surgery was routine….outpatient…easy they told me. How tragically wrong i was. Did you fly there for a consult before going in for surgery or was it all one trip? Did you get to pick your surgeon? Who was it…Slater? Simmons? You have said that Conze does mostly shouldice —but his approach is less invasive than the approach used by shouldice? If must be infuriating to have done all the research that you did and still not get a good result. I don’t think i will ever get over my own mistake—i thought lap surgery was truly minimally invasive…but you saw through it and saw the obvious dangers….I don’t know how I got suckered —except that every surgeon i talked to—lap surgeons all —painted a very grim picture about tissue repairs…cutting ..sewing tissue together and hoping it holds. It seemed painful and unreliable. Never mind the nasty scar…which now i understand the scars are not even that bad. A silly painless little hernia has ruined my entire life. I did my homework and still got burned. so Seeing all these dopes just go get a lichetnstien and end up back in the gym in a week is very frustrating.,
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9 Replies
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That’s useful info. It’s great as you point out radiation can be avoided. I got disks routinely for my CT scans but not ultrasounds. It’s good to know that operators make them available.
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This reply was modified 1 year, 7 months ago by pinto.
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This reply was modified 1 year, 7 months ago by
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Ultrasound is very useful for hernias, they could tell even after my mesh was removed it was gone! It depends on who’s doing the ultrasound and how educated they are while doing it, they take pics at each part they might find something sketchy or suspicious! There are 3d ultrasounds also which people don’t know! Get your MRI, CTSCAN, ULTRASOUND DISC! And a written finding! Ultrasounds are awesome and the best for hernias as they are done throughly! No radiation just straight facts, no radiation etc but I’ve had many done with Hernias/ Hernia mesh removal, get it’s done to know the state you are healing at! Look up hernias, femoral, indirect, direct etc
Most are not to be worrisome at all but it has no radiation! -
@Watchful, you’re really balling here man. Thanks for your reply back there. Much appreciated.
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I think, Watchful, didn’t local anesthetic influence decision to a degree as well?
Never heard about deep anatomy but you’d think, or hope, they’d cover all this before the operation. Maybe it’s not possible to tell before surgery.
Another worry!
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Watchful, I appreciate your considerate answer there. Could you elaborate about your ultrasound? Can a radiologist calculate the size of a hernia? Two surgeons independently gave me the same measurement of my hernia from a CT scan. Ultrasound can provide the same data, not just an indication of an abnormality but also measure its size?
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Chuck,
I had a phone consultation before going to the Shouldice Hospital. It was with a different surgeon – not the one who did my surgery. There was another consultation the day before surgery (in person with my surgeon).
You can submit a questionnaire on their web site. If you get approved, you can ask for a phone consultation. I doubt that they will approve you because you don’t have a bulge. Their philosophy is that if you don’t have a bulge, then you either don’t have a hernia, or you have a hernia that isn’t bad-enough to justify surgery. Unless things changed there in this regard (I don’t think so), the Shouldice Hospital is irrelevant to your current situation.
Conze didn’t examine me in person. He does a thorough exam including an ultrasound before surgery. I doubt he would have done Shouldice in my case, but I don’t know for sure. My hernia was way bigger than the German guidelines for Shouldice, but I didn’t know that at the time because my ultrasound was grossly inaccurate. Your situation is different, though.
I wonder about the same thing you’re wondering about with Kang. I don’t have the answer.
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This reply was modified 1 year, 7 months ago by Watchful.
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This reply was modified 1 year, 7 months ago by
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And what did Conze say about your hernia —did he concur with Dr. Towfigh? Dr Kang says he can fix a hernia the size of a baby’s head —given that his technique is not as invasive and strong as shouldice —I wonder how that can be the case? its incredibly distressing that you did all your homework and still got screwed. Thanks for all you post here —you are saving lives
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Avoiding general anesthesia was one of the reasons I preferred to avoid lap and robotic mesh.
Lichtenstein is typically done under local anesthesia with sedation, so that would have been the same as Shouldice. From that perspective, Lichtenstein would have actually been a bit better because it’s a shorter surgery, so less time under sedation.
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Pinto,
Yes, it’s possible to measure the size of the defect as well as the hernia sac with an ultrasound. You can even get an indication of the tissue quality. Neither the technician nor the radiologist in my case had any specialization in hernia, and it didn’t seem like they knew what they were doing. The technician kept going back and forth to the radiologist in the back room to ask questions, they did only a lying-down ultrasound, etc.
The bottom line is that the measurements were very inaccurate. My actual defect size was more than twice what was specified on the ultrasound, and my actual hernia sac was about 40% larger. The defect size as measured on the ultrasound was still within the German guidelines for Shouldice, but the defect in reality was double the max in the guidelines. My internal ring was like a hula hoop 😉
Conze told me that he can get all the information he needs from the ultrasound he performs to make a decision about the procedure, and surprises during surgery are very rare. It’s a special competency that you don’t get from a generic technician and radiologist. He said they are not trained to do that.
At the Shouldice Hospital, they perform the Shouldice procedure even on very large hernias. I don’t think anyone else does that currently (not 100% sure). Who knows what it entails to do this procedure on such hernias, but based on my experience it’s a long and difficult surgery with a difficult recovery. Mine was large, but not one of those “giant” hernias with a loss of domain or anything like that. My surgeon told me that they do see hernias of this size on a weekly basis, so mine wasn’t all that rare.
Unfortunately, in addition to the large size, my anatomy was also very deep, which evidently makes this surgery even more difficult. Not sure if that’s something that can be seen in an ultrasound or other imaging. I didn’t know that this is a factor before my surgery, and I never saw it mentioned in any papers, so I didn’t know to ask any surgeons about this. If I remember correctly, Mike M mentioned that he had a deep anatomy, which made his surgery with Kang more challenging.
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