drtowfigh

That’s an incorrect interpretation of the study and not the purpose of the manuscript.

This is not a population study of all patients undergoing hernia repair. Thus it is incorrect to say that ⅔ of patients are unhappy with their repair.

The research study compares the different values and outcomes of those happy vs unhappy with their rep…[Read more]

Yup. A lot of ways to analyze the pros/cons of robotic inguinal hernia repair.

It’s certainly never been show to be cost effective purely from the surgery/Hospital utilization standpoint. But it the technology has made it so that more surgeons are offering minimally invasive inguinal hernia repairs, which is a good thing, as the alternative w…[Read more]

1) still have to dissect out the cord, as it lays on top of the direct hernia and prevents you from repairing it if not dissected out
2) for direct hernias it’s a weakness not a tear of the transversalis fascia
3) for direct hernias, the weakness
should be plicated prior to mesh placement. Most surgeons are unaware of this important step for o…[Read more]

In general, incisional hernias are best repaired with mesh. Studies show 50-60% recurrence when repaired without mesh.

Incisional hernia in the midline of up to 2cm can be considered reparable without mesh if combined with a fascial plication.

A multiply recurrent incisional herniaeasuring 7cm requires some amount of fascial components…[Read more]

@ajm222
– I don’t trust imaging reports. I look at the imaging myself and based on our own published study, 3 out of 4 times the imaging report is incorrect. So, I do not rely on a radiology report to determine my plan of care. Also, CT scan is not sensitive enough for small hernias which may be symptomatic. Also, the technique of the imaging…[Read more]

@ajm222

I don’t know the specifics of your situation since you’re not my patient, but based on what you’ve shared, it sounds pretty convincing to me that you have a hernia recurrence. A) you have a bulge, B) you have symptoms, C) CT scan shows a hernia via the cord lipoma/retroperitoneal fat, D) you had no hernia repair once the mesh was remov…[Read more]

@ajm222

I don’t know the specifics of your situation since you’re not my patient, but based on what you’ve shared, it sounds pretty convincing to me that you have a hernia recurrence. A) you have a bulge, B) you have symptoms, C) CT scan shows a hernia via the cord lipoma/retroperitoneal fat, D) you had no hernia repair once the mesh was remov…[Read more]

Shouldice, etc are for inguinal hernias. If you have a ventral hernia, first it’s important to know if you are eligible for a non-mesh repair. It is not as easy or reliable to not use mesh if the hernia is large. Dr. Beanes is a good resource to ask this question for ventral hernias.

Regarding first line of care for those with allergies and urticaria, it depends on the extent of and details of that. It also depends on the hernia.

Will ask her!

The Marcy repair is a great option for children and women with very small inguinal hernias. It’s an old technique that has been around for over 50 years. I use it in specifically those situations. It is not appropriate for direct inguinal hernias or in most male hernias.

I believe Dr Kang’s repair for indirect inguinal hernias is a mod…[Read more]

Happy to help:

1- bulging in the groin during pregnancy can be inguinal hernia, femoral hernia, or round ligament varices (varicose veins). Does the bulging go away when lying flat? A simple hernia ultrasound performed to help find the answer.

2- Pregnancy rarely causes hernia emergencies. Also, delivery rarely causes hernia emergencies.…[Read more]

Not a fair statement, in my opinion.

Dr Felix was the first to introduce the TEP laparoscopic inguinal hernia repair. He was trained under Dr Nyhus, who performed a similar repair in open fashion.

Drs Felix & Daes wrote the initial paper in 2017, discussing the importance of defining the critical view for laparoscopic or robotic inguinal…[Read more]

Not a fair statement, in my opinion.

Dr Felix was the first to introduce the TEP laparoscopic inguinal hernia repair. He was trained under Dr Nyhus, who performed a similar repair in open fashion.

Drs Felix & Daes wrote the initial paper in 2017, discussing the importance of defining the critical view for laparoscopic or robotic inguinal…[Read more]