Watchful – FYI – this is why kang is the only option…

[William Bryant]

That’s how I put it, when it works it’s brilliant but if it goes wrong it’s disastrous.

It didn’t help tje conversation was heard by me partner who already tells me about work colleague who had two mesh repairs and is all ok, it’s because a tissue repair would be quite an expense for us but I’m reluctant to contemplate mesh despite that.

[David M]

Watchful, would you still do it the same way if you had it to do over? How is it currently feeling?

Your case is especially interesting because you were here before your surgery, whereas many come here because they already have the pain. That makes your anecdotal story somewhat more worrisome.

[William Bryant]

Hello Watchful, he’d done hundreds and the pain he referred to was a patient he had to refer to pain clinic.

I forgot about the surgeon you consulted who himself had pain after surgery.

It’s a real minefield.

I was speaking to a client on Friday and said I have a hernia and can’t carry… He’d had 3, his son 3 and his brother in law 1 – all mesh repaired, all fine.

[Watchful]

Chuck,

There are bad results with all these techniques (including Kang). It’s not true that Shouldice is particularly bad. It has its pitfalls, but so does mesh as you well know. You mentioned Lichtenstein – as I said before, I consulted with a surgeon who does this procedure, and he had a bad result (chronic pain) when it was done to him, and he needed a nurectomy. He now routinely cuts the ilioinguinal nerve.

You’re drawing conclusions from anecdotes. The only valid conclusion to draw is that there is no perfectly safe solution. You need to do your best the pick the best surgeon and technique for your case. However, you don’t know all the factors in advance, and even if you made the perfect choice, there’s still scope for trouble.

Even the best surgeons make mistakes, and medicine isn’t engineering – it’s a complicated mess of unpredictable repercussions from intervention. Evolution did not engineer the body to be friendly to surgeons (or drugs). The best of them are good at avoiding mines in this minefield, but no one and no technique can guarantee success. All you can hope to do is maximize your chances of a good outcome.

[William Bryant]

Thats interesting Chuck, the NHS consultant I saw does open repair. He said in last year he’d only had 1 case of chronic pain.

[Unknown Member]

Wachful…you went to one of the best surgeons there i trust…and still got a bad result….i bet they brought out their best for rand paul…the shouldice procedure just seems so destructive…it seems like a real set up for chronic pain. The wierd thing is lichtenstein open is supposed to be the biggest risk for pain…but i havent met a soul who had it that has even a tiny issue…my life was destroyed by allegedly safe lap surgery…

[Watchful]

This surgeon had quite a few bad reviews. He doesn’t perform surgeries there anymore.

[William Bryant]

Thats a good find Chuck, rather like a mesh register to weed out worst mesh/bad surgeons, Shouldice should do the same as some of the surgeons there sound uncaring and not the best.

Shouldice you’d think have a reputation to keep. So in their interest.

It’s a shame the blogger doesn’t say how his first hernia surgery was done or by whom.

[Watchful]

To be fair, only one pain clinic referral out of a few hundred surgeries (if true) is pretty impressive, but, still, it doesn’t give the full picture. Maybe some patients didn’t go back to him, for example, and there are those who get chronic pain which is not so severe. Another aspect is that with mesh the complications can come even years down the road.

[Watchful]

That’s the thing – patients don’t typically get referred to a pain clinic for intermittent and tolerable pain. You need to ask him how many have any level of chronic pain, and I’m pretty sure he doesn’t know and doesn’t keep track of that.

We know that most mesh surgeries for inguinal hernia turn out just fine. The problem is that the incidence of complications (including mild, moderate, and severe ones) is too high for comfort.

[Watchful]

How many has he done over the last year? Also, how does he define chronic pain? Many define it as debilitating pain, or pain that requires medication, and don’t count less severe pain.