[drtowfigh]

Inspiring hour with Sue Blackwell, her struggles with parastomal hernia recurrences, and how she used her experience to become a patient advocate.

If you missed it, watch it all here on my YouTube channel: https://youtu.be/pV6fUomSWsk

[drtowfigh]

This is a population based study. They don’t have data collection regarding type of mesh used

[drtowfigh]

Amazing details shared by musculoskeletal radiology and nerve imaging specialist at NYU Langone. You can listen to it all here: 93. HerniaTalk LIVE Q&A: Imaging for Peripheral Nerve Disorders and Chronic Pain
https://youtu.be/JWpPeLzqVc8

[drtowfigh]

The IHC is not for patients. It is intended for physicians to talk freely about their patient cases so that they can learn from each other. The transparency is within-group. It is not a public forum. And it is the only one of its kind, outside of an institution’s Morbidity and Mortality conference (which is also closed) where doctors freely discuss their clinical situations and learn from them.

[drtowfigh]

Here is the link to watch the HerniaTalk session https://youtu.be/HrGl8eNchtA

[drtowfigh]

Thanks for highlighting the IHC. It is an online international group of over 13K surgeons who discuss hernia-related topics. As part of our mission, we choose one country a year to take expert surgeons to to provide high level hernia education to the local region. The goal is to help as many surgeons as possible have direct access to hernia specialists and learn from them, regardless of their socioeconomic status. We have been to Armenia, India, and now will be in Costa Rica.

The hernia meetings since their inception have never had DoD or any other governmental funding. As far as I know, none of the surgical meetings have ever had any governmental funding. Industry has always helped support surgical education and though this funding is dwindling and limited due to the Sunshine Act, most meetings remain very much dependent on industry funding.

Meanwhile, we surgeons donate our time and effort to help other surgeons learn from us. The IHC in particular has had the largest positive impact in educating surgeons about hernias in order to provide the best care for their patients.

[drtowfigh]

Thanks to everyone for making this session of HerniaTalk LIVE Q&A one of the most interactive and personal sessions we have had.

If you missed it, you can watch it on my YouTube channel here: https://youtu.be/TSNLaf1tLvw

[drtowfigh]

The 2003 study is terribly flawed.

– It was performed at a time when surgeons were not skilled in laparoscopic repair. In this study, the surgeons only had to do 10 laparoscopic cases before entering patients. My residents have done more than that in their first few years of training. That number is way below the number needed to get beyond your learning curve. Meanwhile, the surgeons were already experts in the Shouldice tissue repair
– nevertheless, the findings still show no statistically significant difference between lap TEP and the Shouldice. P>0.05. They only compared 130 patients in each arm, so possibly a larger study may have teased out differences in outcome.
– To interpret that the study did show a difference (Eg higher recurrence with TEP) is statistically incorrect.
– to claim the study nefariously promotes mesh based repairs is also not fair for this prospective randomized trial.
– sensibility means sensation.

[drtowfigh]

Usually there is a 1-2 year delay from presentation to publication.

Many of the papers on P4HB are already published by Dr Scott Roth and others. The Ovitex prospective study is also published.

[drtowfigh]

Here are my thoughts:
– I do prefer watchful waiting if your inguinal hernia is not affecting your daily activities
– If you are fit and healthy, the laparoscopic with mesh is the best overall repair, if performed by a specialist: short recovery, low recurrence rate, lowest chronic pain risk. Otherwise, an open repair is best.
– If you have a direct inguinal hernia, the tissue repair is not your friend. It may be too tight and cause more chronic pain than any other repair option.
– The open preperitoneal mesh repair is worst of both worlds. I would only recommend that technique if you have a recurrence from an open anterior repair AND you cannot get anesthesia. It is not considered the best option for primary inguinal hernias.

[drtowfigh]

Just wow! That was a packed session. I wished it went on forever. The discussion was fluid and your questions were amazing. There were so many we didn’t get to.

If you missed it, catch the session here: https://youtu.be/_wdB-QfJDKc

[drtowfigh]

What a fantastic session on Hiatal Hernia Repairs. Dr Houghton is a robotic surgery specialist and foregut surgery specialist. The surgical treatment of hiatal hernias can be tricky.

If you missed this episode, you can watch it here: https://youtu.be/6-7jRUO1GUg

[drtowfigh]

If you go to my Facebook page, you can choose to participate there, live. The link you provided is correct. The Zoom link also works.

All HerniaTalk **LIVE** Q&A sessions are collected on my YouTube channel. You can peruse that at any time. I always post the direct link to it right here on HerniaTalk.com to help you all.

Thanks for the input on topics to cover with Dr Heniford.

I did interview Dr Todd Ponsky a year ago. You can search for it here or on my YouTube channel to listen/watch.

[drtowfigh]

Thanks to everyone who joined. We had such an amazing series of questions that we answered about robotic surgery with Dr. Pakula. She is really great with them.

If you missed it, you can watch and share on my YouTube channel here: Video link
https://youtu.be/E14VmoCHPfw

[drtowfigh]

Charges are highly variable and I agree with the ranges provided.

Just fyi: although it is more costly to the hospital to do operations robotically or laparoscopically, billing is based on codes. The codes are similar depending on the approach, so insurance reimbursement should be similar regardless of the approach.

[drtowfigh]

We ran through so many great questions tonight. If you missed it, watch and share from you Youtube channel here: https://youtu.be/Y9e55v-n_2o

[drtowfigh]

Great discussions. If you missed this episode, watch it here: https://youtu.be/Iyauzcas6Jg

[drtowfigh]

Great discussions. If you missed this episode, watch it here: https://youtu.be/Iyauzcas6Jg

[drtowfigh]

Thanks everyone for participating! This is also available on my YouTube channel here: https://youtu.be/-rTGQ62gu-8

[drtowfigh]

We had a blast, discussing setting your expectations as you navigate through various phases of your hernia repair.

If you missed it, watch and share from my YouTube channel: https://youtu.be/1pIEDOpFuKE