[DrBrown]

@colt
You will get an inflammatory response to any mesh that is implanted. That could aggravate the Crohns. I advise you to have a non mesh repair. Depending on the type of inguinal hernia there are many options for the suture repairs.
Regards.
Bill Brown MD

[DrBrown]

@cshelter
The lap repair requires the use of mesh which can be a source of chronic pain.
The open pure tissue repairs allow the surgeon to visualize all the important structures such as nerves and blood vessels. It is the operation that I advise for all my patients.
Regards.
Bill Brown MD

[DrBrown]

@colt
Shouldice is an excellent method for hernia repair.
A 6cm incision is made over the defect. It is less invasive than laparoscopic repairs.
If it fails, then mesh can be used.
Regards.
Bill Brown MD

[DrBrown]

@good-intentions
You are correct. The design of the plug with the multiple leaves makes it prone to becoming a meshoma. Being lightweight is not going to make and difference. It is only going to give me more work to do.
The mesh plugs are the most common type of mesh that I remove.
Regards
Bill Brown MD

[DrBrown]

@alephy
Worry more about symptoms.
If the hernia is not causing any trouble, it does not need repair.
Also, work on getting the body in shape. Stop smoking. Get Skinny.
Regards
Bill Brown MD

[DrBrown]

@dh305
Consider a diagnostic injection. Inject the mesh with a local anesthetic. If you feel better that would be evidence that the mesh is the source of the pain.
Also, consider a nerve block. The nerves are often involved.
A standing ultrasound with Valsalva would help determine if you have a recurrent hernia.
Regards.
Bill Brown MD

[DrBrown]

@colt
Do you have a direct or indirect hernia?
Look for a surgeon who is at least 60 years old.
He/she would have been trained before mesh became available.
The prolene would be a good choice for sutures. It is monofilament. Infection rate is low.
Regards.
Bill Brown MD

[DrBrown]

@scaredtodeath
Those products promote healing, but would not close a hernia.
Regards.
Bill Brown MD

[DrBrown]

@good-intentions
Dear Good.
The hernia repairs that do not use mesh are considered pure tissue repairs. But I agree with you that it is a misnomer.
I use sutures that do dissolve.
regards.
Bill Brown MD

[DrBrown]

@inguinalpete
Imaging does not see the mesh very often.
It can be helpful to rule out other problems.
the mesh can be injected with local anesthetic. If you feel better that is strong evidence that the mesh is the source of the trouble.
In a skinny person, the mesh is often palpable.
regards.
Bill Brown MD

[DrBrown]

@alephy
Marcy with a ringplasy.
With a desarda to reinforce.
Regards.
Bill Brown MD

[DrBrown]

@newagehernia
Also, remember to consider a pure tissue hernia repair.
This option avoids the use of mesh and the recurrence rate for indirect hernia is about the same as mesh repairs.
Regards
Bill Brown MD

[DrBrown]

Dear Steve
Be patient. Vague pains, tightness, buring, stiffness will be common for the first 8 weeks.
If you have trouble beyond that time, consult with your surgeon.
Regards.
Bill Brown MD

[DrBrown]

@cshelter
A nerve ablation only disrupts the nerve at one location. Since the nerves interconnect pain sensation can still back to the brain through these interconnections.
A nervectomy involves removing the nerve. This cuts the interconnections so has a better chance of treating the pain. But it is a major operation.
Regards.
Bill Brown MD

[DrBrown]

@deeoeraclea
The best repair depends on whether the hernia is direct or indirect and the health of the patient.
For example, A Shouldice would be overkill for an indirect hernia in a teenager.
And none of the repairs will work with an obese smoker.
Regards.
Bill Brown MD

[DrBrown]

@cshelter
The open techniques require that the external oblique muscle to be split to allow adequate exposure.
The laparoscopic techniques do not.
Regards.
Bill Brown MD

[DrBrown]

@alephy
Dear Alephy.
Consult with your surgeon about when and how to exercise.
He or she will best know about how strong your repair was.
Regards.
Bill Brown MD

[DrBrown]

@alephy
The open pure tissue repair has the least risk for nerve damage.
The nerves can be visualized and protected.
Regards.
Bill Brown MD

[DrBrown]

@cshelter
A steroid can be added to the local anesthetic to make it last longer.
The next step would be a nerve ablation.
The last resort would be a neurectomy.
If you have mesh, consider removing the mesh.
Regards.
Bill Brown MD

[DrBrown]

@alephy
The recurrence rate is dependent on multiple factors.
A young healthy male has a low recurrence rate:
https://www.ncbi.nlm.nih.gov/pubmed/27522362
But if you operate on an obese, smoker, on steroids the hernia will recur no matter what operation is done.
regards.
Bill Brown MD