drtowfigh

Thanks, everyone for helping make another very exciting HerniaTalk LIVE session. We hoped most all your questions were answered about what core exercises are safe to perform and why you may be having pain when doing some of them.

If you missed it, watch and share from here: https://youtu.be/DQFN99yowjA

Watchful waiting is appropriate for a lot of patients with a symptomatic or minimally symptomatic inguinal hernias. I recommend it all the time.

I also recommend that they consider repair if the hernia is starting to get larger. All hernias have the potential to increase in size over time. But they don’t all get bigger rapidly. The process m…[Read more]

I’ve also had HerniaTalk LIVE sessions with some of them. You can watch and see if you feel like their expertise meets your needs.

Maybe one day. Not today.

The US has multiple hernia surgery training centers. Many are imbedded within accredited laparoscopic surgery training center. Official accreditation for a hernia-only training center has been discussed but is not yet reality. Nevertheless, we do have a couple of US training centers for hernias only.

This session was jam-packed with your questions. I amswered all of them!

Watch and share them from here: https://youtu.be/Tck5du5AjvY

There are many issues with this manuscript.

First, mesh migration implies the mesh has moved from its originally intended placement. This has been seen with the plugs for inguinal hernias, though it’s not common and likely is related to surgical technique.

Mesh migration is not a major reason for recurrences or mesh related complications.…[Read more]

Its possible the MRI is not correctly interpreted. Get a second opinion if you’d like.

Multiple posts about Florida on this forum. Use the search function to help you

I’d wonder if the mesh removal were complete. The densest area of mesh adherence is at the pubic tubercle. Also, I’ve seen a lot of situations where patients were told the mesh was removed and I go in and there is still a lot of mesh that remains.

Scar tissue can entrap nerves or cause intestinal adhesions but in and of itself is usually not…[Read more]

Xenmatrix is yet another biologic absorbable mesh among a cadre of similar mesh products. As far as I am aware, it is more processed than many of its competitors, so it tends to act more like a foreign body and a synthetic than a pure biologic.

4×6 inches is not a large piece of mesh. I don’t understand what you mean by shrinking.

Sounds like a good plan.

All of these are great suggestions. It is uncommon to have nerve damage with lap TEP, but it can happen. Did you have tacks? Why did you have 2 meshes on one side?

I wonder if the needle from the steroid injection caused bleeding. And thus your symptoms and signs were related to a small bleeding episode.

Imaging and details of your history…[Read more]

This sounds like it is likely the Bard Perfix plug and patch, in size medium.

Thanks to all who participated. Stephanie Prendergast, MPT, did an amazing job answering all your questions about PT, pelvic floor disorders, pelvic pain, and how they relate to hernias. We discussed different exercises and when they are safe to perform them.

If you missed it, WATCH and SHARE from Youtube here: https://youtu.be/88aRacf_rQM

If the mesh was placed laparoscopically, then the mesh removal should be done lap or robotically.

I do both sides at the same time. The scars are the same. The OR time is longer but less than double the time of only doing one side. Extra anesthesia time in an otherwise healthy patient is not an issue. The recovery is better with both sides…[Read more]

@richarda When I see patients with postoperative chronic pain after hernia repair, the evaluation is quite complete so that at the end you have a better idea of what exactly is causing your pain and what is the plan of care. The details of your symptoms are important in determining this as well as results from imaging, examination, and possibly…[Read more]

If 100% of the pain is from the nerve, there is no need for mesh removal, usually.