[ajm222]

Thanks, GI. I appreciate the encouragement. It’s odd that some weeks I feel good and others not good at all. And no real rhyme or reason in terms of activity or rest. At any rate, I had thought you were feeling quite good a couple of years ago and had mostly gotten back to feeling like you could do most anything. But it seems like maybe you weren’t in fact quite there yet. I don’t doubt that healing takes a long time, but of course it’s always frustrating when most say after a couple of months they’re basically back to normal, even if there are tiny things here and there that they may feel. But it doesn’t disrupt their life. The way I’m feeling now is definitely disruptive. I do have a suspicion I may have some sort of issue with subconscious tension causing a lot of the soreness. That’s why I really should try and get on maybe a temporary medication to allow myself to relax. Worked for me in the past in a similar situation, also involving something in the pelvic area.

[ajm222]

Hey GI –

I never ran that much. I was at times running about 15 miles per week. But since the tissue repair, with a few exceptions, I no longer run at all. I try and find that balance, and I’ve had good weeks and bad. But most of my exercise now is either walking or doing yard work. Too afraid to run much anymore, and it’s not very pleasant.

[ajm222]

Thanks for the update. That’s encouraging. I had a modified Bassini-type repair from Dr. Belyansky in February and I’ve had similar discomfort, though I also had mesh removal a couple years prior to that. The symptoms are somewhat similar to the feelings I had prior to the tissue repair so much of it may be a carry over. But I’ve also had some improvement over time even with those. Hoping another 6 months will see even more. Given my circumstances I have no expectations of ever being the same, and currently just glad to be able to get around and still live my life to a decent degree. We’ll see. Still have some fullness in that area, and some testicular sensitivity, along with the on and off soreness. Anyway, glad to hear you’re doing better. It definitely can take some time for many of us.

[ajm222]

depends on who you ask and what study you look at and how it’s removed. i think the bulk of studies show lap is actually lower for chronic pain and, given a surgeon who is experienced with the robot, less difficult to remove. openly placed mesh is a bit precarious because of all of the nerves involved, both in terms of the mesh potentially adhering to those nerves and other critical structures, and in the case of removal having to get around those nerves and other structures to get to the mesh. which also could arguably explain some studies showing higher rates of chronic pain. i am guessing lap vs open are roughly equal though when all things are considered. finding a surgeon who is comfortable with one or the other will likely result in very similar rates of pain and similar rates of mesh removal success.

[ajm222]

Makes sense. Thanks, GI.

[ajm222]

Hi GI,

So that’s your surgical report? Suggests there are indirect hernias after removal on both sides? I had thought you said there were no hernias after removal and you haven’t had any recurrence yet.

Thanks

[ajm222]

makes sense tissue repair would take a little longer, but two years still seems excessive. and if this is a mesh doc, what does he mean the tissue can fail? doesn’t sound like a particularly reputable source. most mesh surgeons will say a mesh repair is fine almost immediately after surgery, and there are no restrictions at all, particularly as time goes on. but they will often say you just may feel twinges here and there for up to a year. tissue repair surgeons tend to suggest they need several months to get stronger but rarely do they suggest limiting activity once healed.

i’m here at 4 months since a tissue repair with a terrible cough and sneezing from a cold and really hoping it’s strong enough now, lol. but i also had absorbable sutures, which have mixed reviews.

[ajm222]

Dr. Belyansky has a reputation for being able to see things on CT that others can’t. He read mine and didn’t see the hernia. And of course all the other imaging I’d had in the past when I was having issues with the mesh repair showed nothing at all. I just think the imaging is very limited, particularly if it’s not dynamic. And it’s expensive, and somewhat dangerous in the case of CT. So it doesn’t seem worth it to me most of the time. Dynamic ultrasound seems like the best option, but very few seem to bother using that method.

[ajm222]

I don’t think CT (or any imaging) is great for detecting hernias. I had removal and then started having another decent sized lump in my groin that was obviously a recurrence. Got a CT scan that said everything looked awesome. Had a tissue repair anyway and I definitely ended up having a hernia when the surgeon went in. It was obvious. That’s not to say you have a recurrence, but you might. After mesh problems plus removal, you may have all kinds of strange sensations. Look for any bump/lump. Eventually, if it is a recurrence, it should be obvious.

[ajm222]

you have remarkably little swelling. i had a large lump for quite a while. externally at least it appears good.

[ajm222]

Thank you!

[ajm222]

Good suggestion. Maybe I’ll start there. Thanks.

[ajm222]

Very interesting. Hopefully something similar will happen to me. I’ve got about three months left until I hit two years. I expect if I’m lucky it’ll take a little longer in my case at least. I do worry more surgery is just as likely to complicate matters. Thanks.

[ajm222]

Hey there! I haven’t anything since the tissue repair except an exam by the surgeon a month or two after. But most of the symptoms pre-dated the most recent surgery. I don’t think the deep soreness is a hernia. That has been a constant since the original mesh surgery. In fact, the most relief I had from that ironically was when I re-herniated a year and a half after the removal surgery! That’s why I am thinking scar tissue and some sort of neuropathy. Though again it’s not sharp pain but tenderness and soreness.

That’s very encouraging to hear both your story and GI’s about improvements many years later. I do think that eventually pain and discomfort fade over time even when physically not much else changes. I think some people because of anxiety or other predispositions can sort of keep the pain response active much longer than the average person. I have certainly experienced this in other parts of my life, and I definitely have the personality type.

I guess I was curious because I’ve heard of some success with scar tissue removal in some cases of pain or sort of a cleaning up of a surgical area. But again, any time you go under the knife anything is possible, and if you are predisposed to being more sensitive to pain, it may in fact improve the scarring but create new pain.

[ajm222]

where did dr. kang verify his identity?

[ajm222]

Thanks, Dr. Towfigh. That makes sense. It would certainly be disappointing to think my trusted surgeon used inferior materials for my repair and that it was likely destined to fail. But I suppose there are often professional disagreements in terms of the best materials and methods. And each individual case is unique.

It looks like that article was written by the famed Dr. Desarda himself. I wonder why he didn’t publish it in a surgical journal.

• This reply was modified 1 year, 4 months ago by  ajm222.

[ajm222]

sock puppet alert? 😉

[ajm222]

My only concern is whether or not the regular short-term absorbable sutures hold strongly enough to provide adequate time for the repair to get strong. I probably should ask which specifically were used in my case but I think it was the ones that immediately start dissolving and lose much of their strength after 4-6 weeks and are mostly gone in 6 months.

[ajm222]

Hey Larry – the shouldice surgeon (Samer Sbayi) would probably be worth visiting despite the distance. He has a great reputation. There are likely some older surgeons in your area that have done tissue repairs if you don’t want mesh. You may need to just call around. But ideally you’ll want to go to the most reputable tissue repair surgeon you can find even if it involves some travel. If nothing else, Dr. Sbayi’s office may be able to give you some names. And Dr. Towfigh sometimes chimes in with recommendations. You may also be able to use the search tool in this forum to look for surgeons in upstate NY that will do tissue repairs. Any idea what type of repair was done specifically during your first go ’round? How was the recovery? Seems it was extremely successful. Not uncommon for those older repairs. Still not 100% sure why they have mostly gone away and switched to mesh. Seems unnecessary when all things are considered.

[ajm222]

My surgeon used absorbable sutures, and he has a great reputation. H thought for my indirect inguinal hernia it would be effective given my health and age, providing sufficient scar tissue was created. I do think he also was concerned though because he removed my old mesh and probably worried there was a small chance I could have issues with the permanent sutures.

I also know that Dr. Kang used to primarily use absorbable sutures with great success. He did apparently recently switch to non-absorbable sutures because he did have some cases of recurrence, and started to believe that very few patients had issues with the non-absorbable sutures, so on balance I guess decided to make the change. But the difference in recurrence rates was small – something like 1.5% vs. 3.5% (just a guess, can’t remember, but roughly close). And the recurrences were probably mostly folks with unique situations involving age, weight, hernia type, etc.

I don’t personally know how absorbable sutures would be able to hold a repair together, but frankly I don’t even know how non-absorbable sutures would be able to hold a repair together. Or even mesh. None of the techniques seem to make a lot of sense to me.