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HerniaTalk celebrated its 1-year anniversary tonight, on the 50th episode.

Thanks to everyone for participating with non-stop Q&A. I also shared details of what pitfalls I see in surgery when I repair hernia complications.

If you missed it, you can watch it on my YouTube channel here: https://youtu.be/AsEjxnZ7VC4

Most likely this is a fluid collection from the surgery, seroma or hematoma, and not a hernia recurrence. A simple ultrasound can diagnose this. It is extremely rare to have such an early recurrence.

Most patients who have symptoms 1+ years after an otherwise fine hernia repair or recovery have a hernia recurrence as the cause of their symptoms. The next step is accurate imaging to identify the hernia repair and look for recurrences.

If you saw me, I would order an MRI. Every surgeon handles this differently.

Most mesh-related chronic…[Read more]

I just read the Opinion piece by Dr. Ramshaw. From a surgeon’s perspective, I can totally relate.

Like Dr. Ramshaw, I left the volume-based practice that is imposed on so many of us who are (used to be) employed by an Institution. I used to be the busiest general surgeon faculty in my hospital, and I was being pushed each year to do more and…[Read more]

We do know that the recurrence rate is higher after tissue repair if using absorbable suture vs non-absorbable suture. All tissue repairs were originally described with non-absorbable suture. If you wish to have a tissue-based hernia repair with absorbable suture, then the higher recurrence risk is the reality of it. And note that once you…[Read more]

Thanks to all who joined in on HerniaTalk LIVE. The Q&A tackled all issues related to obesity and hernias. If you missed it, watch and share via this link: https://youtu.be/rTCDKsxkfgo

Depends on what was done. If no reconstruction made of the vas deferens, then can be active, including masturbation and sex immediately or within days.

Each surgeon has their own recommendations.

Depends on what was done. If no reconstruction made of the vas deferens, then can be active, including masturbation and sex immediately or within days.

Each surgeon has their own recommendations.

We had an amazing hour on HerniaTalk LIVE tonight, tackling the problem of Male Fertility and Hernia Surgery with our Guest Panelist Dr. Justin Houman, urologist and specialist in Male Fertility and Sexual Health.

If you missed it, you can watch and share from my YouTube channel here:

The saying that mesh should be removed in the way it was put in is a simplification of the recommendation and mostly pertains to inguinal mesh. The type of removal is based on many factors. Sounds like, in your situation, the mesh was placed via open incision, but it was found/placed in the intraperitoneal or extraperitoneal space. In that case, a…[Read more]

This far out, I would look into recurrence as a possibility. Why was pig (biologic) mesh used? The recurrence rate with biologic mesh is higher than all other mesh types. Alternatively, some pig biologic mesh do stiffen up and get encapsulated.

The next step is usually a CT scan to evaluate the repair.

Great!

Laparoscopically placed mesh is best removed via lap/robotic method. I strongly advise against considering an open option.

The mesh is always stuck to the epigastric vessels and also in some way stuck to or close to the external iliac vein. Dealing with that is part of the skill of removal.

I recommend seeking consultation with surgeons like…[Read more]

– no downsides to taking the supplements around the time of surgery
– I do recommend bromelain and other anti inflammatory supplements to my patients
– zinc, vitamin c have already been shown to augment wound healing. No study has been shown they clinically improve outcomes from hernia repair, ie, hernia recurrence. And this study also doesn’t s…[Read more]

Thanks for sharing your recovery experience, @ajm222. Dr Belyansky is a skilled surgeon. Your experience is what most patients should be experiencing from lap/robotic mesh removal: surgical pain that improves over time, yet resolution of preoperative symptoms.

Just know that though you had built scar tissue from the repair, and that is likely…[Read more]

@chronicpain

Lucas S,
There is no need to travel. There are wonderful surgeon options in Germany: Muschaweck, Conze, Koch.

For mesh removal during a Lichtenstein, selective neurectomy may be necessary, as the process of mesh removal itself may cause nerve injury.

I’m not an advocate of laparoscopic triple neurectomy. As @momof4 mentioned, i…[Read more]

– it’s very possible you have mesh remaining. I commonly see situations where patients were told their mesh was removed and yet there is mesh still left behind
– many of your symptoms are neuropathic (from the nerves). That includes the liquid feeling. Nerve blocks may help address those.