You are going to Korea for hernia surgery???????
01/14/2023 at 3:23 pm #33452ChuckParticipant
When I mention to my family that I am considering going to korea to have Dr. Kang fix a possible new hernia…everyone i know is in disbelief. That’s crazy! Dont do it! What if something goes wrong??? Well I can tell you that the best way for something to go wrong is to go to a US surgeon. I thought a comparison of my experience so far with Dr. Kang vs US surgeons might be pertinent. Dr. Kang recently reached out to me through Stephen Kwon…because he saw me posting that i might just go to korea for a diagnosis on Hernia Talk. I was stunned that this busy surgeon would take time out of his day to reach out. He reassured me that he could give me a good diagnosis but expressed concern about me traveling all that way and maybe coming up empty. Dr. Kang and Stephen have been extremely responsive..I asked whether Dr. Kang needed CT scan or MRI to diagnose a hernia…I was quickly advised it was unnecessary–Dr. Kang can diagnose with the help of ultrasound and his vast experience. Compare to the following:
Dr. Krpata – Called to ask if he could remove mesh robotically. Was told i Had to book an $1,500 dollar appointment to find out. Further discussion refused. Sorry no exceptions.
Dr. Yunis – Called to ask if Dr. Yunis could do a tissue repair over skin that had had mesh removed. Was told i had to book a $250 telehealth.
Called Dr. Kang to see when I could get in to see him Stephen promptly responded tomorrow if you can get to Korea…Can you believe these guys?
Called Dr. Towfighs office to see when i could get a consult…I will say her assistant was very nice and helpful…but i was told send in all your info and an MRI then you gotta wait..maybe weeks to months for an email only consultation.
When my surgeon Sam Carvajal butchered me…he wouldnt take my calls. Several folks have told me privately that they received the same treatment from Dr. Yunis…who i found to be very caring in my consult…but makes me wonder. Kevin Peterson—forget about it…takes no calls for anyone after screwing them up. There is tons online about this.
Compare to Dr. Kang…when called concerning a recurrance—Come to korea and I will fix it again for FREE!
Stephen Kwon responds promptly to any email…even about issues such as vaccine requirements…quarantine requirements…ask away stephen will answer. Compare to Peterson…who never showed up for my first consult…showed up two hours late for my second consult…then cut off my questions because he was late.
Compare to Grishkan who rushed to the phone to take me call when he thought i needed hernia surgery…when i told him i had already had surgery and was looking at removal options. Promptly said I can’t help you and hung up. No pleasantries…no helpful recommendations he just hung up immediately…He couldnt have care less!
So when folks express surprise I am going to korea…its easy to explain.
01/14/2023 at 8:02 pm #33453
I noticed the same contrast between German surgeons and US surgeons. I had multiple consultations with German surgeons, and they were wonderful. The contrast was shocking, a completely different culture, and a completely different quality of interaction with the patient.
The question of “what if something goes wrong” is a legitimate question, though. In most cases, nothing goes wrong. However, bad things do sometimes happen with surgery. Being stuck in a foreign country in such cases can be a big problem, and may lead to problematic follow-up care, or push you to make decisions about care which are driven by the circumstances rather than what really needs to be done.
This probably shouldn’t be the deciding factor, but it’s a factor. If you decide to do it, it’s worth thinking about how you would handle complications if they happen. Get additional care at Kang’s hospital, get admitted to some other Korean hospital, come back to the US instead of all that (what if you’re in no shape to travel?), wait in Korea to see if the problem goes away, etc.?
Not saying you should be overly paranoid about this for what seems like a “simple” hernia surgery, but give it at least some thought. At the very least, I think it’s important to have a family member or a trusted good friend with you. Based on my experience, the drug cocktail they give you during surgery impairs you to some extent for a while, and you may not be in the best shape even to make decisions about what to do in case of a complication.
01/14/2023 at 11:40 pm #33454
By the way, among the surgeons you mentioned, I did talk to Dr. Yunis, and he was pleasant, spent enough time, and answered my questions. I was seriously considering having him do the surgery, but ultimately wanted someone with more Shouldice procedures under their belt. Also, I wasn’t quite sure what he would do in my case: Shouldice, Desarda, or mesh.
Being an inguinal hernia patient is a tough spot to be in… Do you go to a surgeon who performs multiple different techniques such as Dr. Yunis, Dr. Towfigh, or a number of German surgeons? Do you go to someone who does one technique such as Dr. Tomas, Dr. Kang, the Shouldice Hospital, or the local open/lap/robotic mesh surgeon? If you choose a single-technique surgeon, you’re basically acting as your own doctor by picking the procedure by picking the surgeon. If you choose a surgeon capable of multiple techniques, you never know if they decide on the procedure based on what’s best for you, or what they happen to be most comfortable with, or most interested in practicing now.
I actually also went to the best lap mesh surgeon in my area. Even with him, it wasn’t clear what was going to happen. He told me that my hernia was so large that he wouldn’t have been able to do it laparoscopically a few years ago, but he now has the experience and confidence to do it. Still, he said there’s only an 80% chance that he would be successful, and a 20% chance that he would need to convert to open during the surgery. Of course, he hasn’t done open much… Sounded pretty scary where I could end up with an aborted lap surgery as well as an open surgery done by someone who doesn’t do it normally.
- This reply was modified 1 week, 4 days ago by Watchful.
01/14/2023 at 11:57 pm #33457William BryantParticipant
I’ve had that what if something goes wrong from people Chuck and it is a concern that’s why I wouldn’t stint on insurance when I come to do it.
It sounds as though the USA is driven mainly by money, Germany to a lesser extent and Korea possibly far less so.
01/15/2023 at 11:05 am #33463ChuckParticipant
Watchful. Thanks as always for your input. The best on the page. I am in kind of a mess. Having had double mesh removal makes things worse. I have a bad dull ache on the right side where carvajal found a small direct hernia. I had pain there prior to surgery and it went away after mesh. With mesh removed it’s back. So I suspect the hernia is back. There was no bulge before and there is not one now. Just pain. Worse than it was before it was “fixed”. I am going to try to get an ultra sound. The one weakness with DR Kang is that you can’t consult with him from overseas like you can with the Germans. But I am not sure that he is limited to one technique. He seems to be very innovative and at one time was a mesh surgeon. So I think he had a broader range of experience than you suggest. My indirect hernia was large and moving into the testicle. Carvajal fixed it lap. But that’s all he does. So maybe it should have been done open. Who knows. I studied this hard but it turns out I missed so much. It’s sad that a hernia way well end my useful life. Other guys had much worse removals than me and appear to be fine. I only had the junk in a year. Would still love to chat offline as you are smarter than most docs. Happy to pay you for your time. Will do you
01/15/2023 at 1:43 pm #33465William BryantParticipant
Chuck have you asked Dr Kang if you can send him your ultrasound? What I mean is are you just assuming he doesn’t do that? As I’ve found him always ready to help. Maybe just email him and ask?
01/15/2023 at 6:51 pm #33467David MParticipant
Watchful, you said something that seemed counter to what I expected. I think I have a fairly large direct hernia and I’m trying to decide which type of surgery would be required. I assumed that the for a large hernia that lap would be better than open and that open mesh would be better than tissue, but the lap doctor’s assessment and your final decision seem at odds with this. What do you think the correct relationship is?
01/15/2023 at 8:39 pm #33468
Here’s my understanding based on my discussions with surgeons – I’m not a surgeon myself. The relevant challenge is in reducing the large hernia, and dealing with possible adhesions. For example, I had a large indirect hernia with a scrotal component. Reducing that to enable the laparoscopic insertion of a mesh could be challenging. When you go open (mesh or tissue), you can deal with that mess much more easily – it’s all right there for you to manipulate. There may be other aspects – I never went into it in much detail with them.
This may be different for a direct hernia – I didn’t have that, and didn’t research that.
As to tissue vs open mesh for large hernias… It’s possible to fix large inguinal hernias with tissue repair. They do it at the Shouldice Hospital, Dr. Kang does it, and so does Dr. Tomas. Some others won’t do it on large hernias. A more important factor for tissue repair is the tissue quality. They all rely on some decent-quality tissue. Another factor is the anatomy. A deeper anatomy makes some types of repair (such as Shouldice) more difficult.
01/16/2023 at 3:04 am #33471David MParticipant
Thanks Watchful. That the reduction of a large indirect hernia would be more difficult from the inside does make sense. The adhesion question does sound concerning for direct, as well, to me, given that the intestines, etc. have had such of a tendency to push outward. More to think about.
- You must be logged in to reply to this topic.