[Chaunce123]

Inguinal hernia repair without mesh. Desarda?

caidanfire, did you hear back about the Desarda repair? Any update?

[Chaunce123]

Umbilical Hernia question

I think there is nothing wrong with getting a second opinion, particularly if you feel you might be getting more symptomatic from the hernia. I’m just a patient though, I don’t know what doctors think of additional opinions and if they’re helpful or not.

If your username is suggestive of your location (NYC) then you have a lot of great hernia specialists nearby, one that is frequently mentioned on these forums in Dr Brian Jacob in NYC. Further upstate in Albany NY is Dr Steven Goldstein.

[Chaunce123]

Inguinal hernia mesh removal

I am sorry to hear that you’re in pain. Did the original surgeon try anything to help your pain? Does anything help to reduce the pain or eliminate it? Did you have open or laparoscopic surgery? Did you have pain prior to surgery?

Try to document your symptoms and experience, what helps, what makes it worse, etc for your next appointment. Be as prepared as possible and seek out an expert in the field if you can, re-do surgery is very specialized.

The surgeon who did the initial surgery should be able to explain why they used mesh after removing the cord lipoma. There have been a few threads on the topic on these forums which could be useful to review as well, since cord lipoma is a really common finding:

http://www.herniatalk.com/hernia-discussion/978-importance-of-lipoma-of-the-cord.html

http://www.herniatalk.com/hernia-discussion/1077-fat-in-inguinal-canal-vs-hernia-vs-cord-lipoma.html

From the sounds of it, (and I’m not a doctor, so this could be wrong) the repair is basically the same.

http://www.ncbi.nlm.nih.gov/pubmed/15105999

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1422475/

A good starting point is to find an experienced doctor with a lot of knowledge of hernia re-do surgeries and the complexities of them. You may have to travel depending on the state and city you’re located in as Beenthere suggests.

Good luck and keep us updated on your decisions and progress.

[Chaunce123]

Inguinal hernia repair without mesh. Desarda?

A surgeon with experience in both would be much better at explaining and describing this, but to simplify tremendously based on my own understanding of the two different repairs types:

Desarda repair – uses a detached piece of the patients own nearby muscle tissue to cover the hernia hole

Shouldice repair – uses a multi-layer reconstruction of the patients own tissue to stitch the hernia hole closed

I’m sure that is very over simplified, but it should give you a general idea.

Please keep us all updated about your decision making, and what surgery type and where you end up going. Follow up is always good, and very helpful to other patients!

[Chaunce123]

Inguinal hernia repair without mesh. Desarda?

After a little internet research it does look like Dr Bob Burns will perform the Desarda procedure sometimes on request, as Dr Towfigh suggested. Desarda is a new repair type though and I don’t think there is as much research and longterm followup for it, whereas something like the Shouldice repair has a lot of substantial history behind it.

As for insurance and who takes what plan, your best bet is to call the billing offices of each clinic and ask directly. Typically they know immediately, or they will research and call you back. This list may help, it shows their clinics and contact information:

Dr Towfigh – http://www.beverlyhillsherniacenter.com/office-address-and-hours.html

Dr Chen – https://www.uclahealth.org/provider/david-chen-md

Dr Johnson – http://www.desertsurgeons.com/Surgical-Care-About-Us-Palm-Springs-CA.html

Dr Burns – https://www.hoag.org/find-a-doctor/b/robert-g-burns-md/

Dr Philips – http://bio.csmc.edu/view/3815/Edward-H-Phillips.aspx

Good luck, keep us updated on your case.

[Chaunce123]

Positive Cough impulse but negative ultrasound

Hey Paul, sorry you’re going through this and had the unnecessary surgery, that sounds really awful. I can relate to some of your other story however, with ambiguous ultrasound and cough impulse findings, groin pain, misdiagnosis, the works… so I can relay what I have learned.

– Hernias are routinely overlooked on imaging, particularly if they are small. You might want to have another radiologist or hernia expert look at the actual images, CT or MRI results, not just the paper report.

– Was your ultrasound done dynamic with valsava? Was it done standing up or laying down? Make sure you get one with valsava so that a valid picture can be seen when pressure is going on.

Another option would be to consider a surgical laparoscopic exploration, but that has it’s own risks as well as potential benefits if they find something. You’d want to talk to a surgeon about this and only do it if there was genuine suspicion that it was worth pursuing.

I am puzzled that you had a faint cough impulse though, and I wonder if that is suggestive of anything. Do you play soccer (football) or other sports? Are you physically active and fit physically? I ask because there are groin pulls, muscle tears, hip issues, and sports injuries that can mimic some hernia symptoms but without the typical workup.

If you’re in the UK, you could consider going to The Gilmore Groin & Hernia Clinic.

http://www.thegilmoregroinandherniaclinic.co.uk/

Also sometimes in London, Dr Muschaweck does surgery there, but she is primarily based out of Munich Germany.

http://www.leistenbruch.de/english/index.html

Both of these clinics should be able to workup a hernia, a tiny hernia, a groin muscle tear, groin nerve entrapment, or related conditions. Personally if I was in Europe and had an ambiguous groin case, I would see Dr Muschaweck for a workup and testing, she is extremely well regarded in athletic communities.

Best of luck to you, keep us updated on your progress, diagnosis, and plans.

[Chaunce123]

Post surgery thoughts

These are great stories to share and I wish more patients did the same. Thank you for taking the time to share your experience, surgeon, before / after, etc.

[Chaunce123]

Black & Blue from Inguinal Hernia

I think it’s basically because the surgical area and activity often involves the spermatic cord, and then afterwards gravity does its job. Since the testicles descended from the abdomen there is a connection between the two, which is also part of why the indirect hernia can form in the first place, so I would bet the bruising follows the natural pathway down into the groin as well.

How did your surgery go overall? Fellow patients would likely appreciate hearing your experience, opinion, surgeon choice, etc, if you feel comfortable sharing it.

[Chaunce123]

No mesh Hernia surgeons in Portland Oregon?

Has this been confirmed? If so I will add Dr Martindale to the list of west coast non mesh repair surgeons.

Currently I know of three non mesh practitioners in California: Dr Shirin Towfigh, Dr David Johnson, Dr William Brown

[Chaunce123]

No mesh tissue repair Illinois or Wisconsin

I’m have come across a few clinics in the midwest/east, none in IL or WI that I am aware of. Somewhat nearby you have:

Toronto Canada has the famous Shouldice clinic

Cleveland Ohio has Dr Grischkan who performs a Shouldice repair

Dr Szotek in Indiana from these forums might do it too or know someone nearby

[Chaunce123]

Hernia forum

I agree there is a lot of great information in the past older forums, I hope it can be restored.

[Chaunce123]

GETTING DOCTORS TO BELIEVE YOU HAVE A HERNIA

In situations that are not certain on exam, an ultrasound, MRI, or CT scan with a “valsalva” is often the best way to determine if there is a hernia present or not.

Your best bet is probably to meet with a hernia surgeon who has experience in this type of thing.

Good luck.

[Chaunce123]

Inguinal hernia repair without mesh. Desarda?

Fellow patient here, not a doctor… so take that for whatever it is…

The only US doctor I know of who does Desarda repair is Dr Robert Tomas out of Florida.

In California I know of three doctors who do non mesh repair;

– Dr. David Johnson in Palm Springs, does Shouldice repair on select patients

– Dr William Brown in Fremont, not sure what repair type

– Dr Shirin Towfigh in Los Angeles (from these great forums), who performs non-mesh on select patients

I am sure there are others out there too, but I am personally not aware of them and haven’t seen them in my own research efforts.

Keep in mind that non mesh repair is largely patient dependent, meaning it is not always viable for all patients. Things like patient weight and tissue quality matter considerably from what I understand.

Best of luck, considering keeping the forum updated on your decision making and progress.

[Chaunce123]

Lowest risk surgery type to resolve groin pain?

That makes sense, I only wish more doctors had such a robust approach!

Would you say that laparoscopic hernia surgery is generally well tolerated and effective for male patients that have a background of groin pain?

[Chaunce123]

Looking for a Hernia Specialist near North Alabama

The prehab idea is really interesting. I would think it is fairly normal to have anxiety about surgery and especially anxiety and some frustration (or depression) if you experience chronic pain.

I have read many times that physical therapy, movement, and exercise all generally improve a surgical recovery, as does eating a lot of healthy protein and vegetables.

[Chaunce123]

4 years of hip/groin pain. Help!

How did your labrum surgery go? Did it help with your pain? Any update on the possible hernia?

I don’t know if it is helpful, but there is a well-known physical therapist in Santa Monica named Holly Silvers who knows a lot about FAI, sports hernia, etc, she works with a variety of pro-sports teams and sees a lot of the injuries in athletes, could be helpful in ruling in or out some diagnosis or rehabbing afterwards http://smsmf.org/our-team/holly-silvers

[Chaunce123]

Looking for a Hernia Specialist near North Alabama

Yes, please do post updates as you go along! Whether it is about your condition, any surgeries, and post-op experiences, it is all valuable information and insight. All too often fellow patients disappear after treatment and then their stories are not complete, but surely updates like this could be helpful for other future patients.

Out of curiosity, what is the pre-habilitation?

No need to thank me but you are very welcome anyway! I am glad to hear you had a good experience with Dr Ramshaw, best of luck going forward and you are in great hands! 🙂

[Chaunce123]

Diagnostic laparoscopy as the definitive means of hernia detection?

The idea of a laparoscopic repair without mesh sounds intriguing. Is there some cases where this is more suitable than others? Does this have a good outcome based on existing experience and data?

[Chaunce123]

Looking for a Hernia Specialist near North Alabama

How did your appointment go? Any update?

[Chaunce123]

Pulsed Radio Frequency ablation treatment?

I have an interest in this as well, and I also get mixed opinions or advice.

I often dig through medical studies to get a better idea of these things, but there does not appear to be a widespread study on PRF and thus no wide consensus on efficacy. You will find that some of the smaller studies suggest it offers short-term relief of a year or so but then repeat PRF is necessary again.

http://pubs.rsna.org/doi/full/10.1148/radiol.11110727

http://www.goldjournal.net/article/S0090-4295(02)02423-8/abstract

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2914602/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045265/

NIH has many articles on PRF in general

http://www.ncbi.nlm.nih.gov/pmc/?term=Pulsed+radiofrequency

Perhaps Dr Towfigh has experience with this procedure?