drtowfigh
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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
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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. -
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.
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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. -
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
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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
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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.
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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 -
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.
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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
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Great discussions. If you missed this episode, watch it here: https://youtu.be/Iyauzcas6Jg
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Great discussions. If you missed this episode, watch it here: https://youtu.be/Iyauzcas6Jg
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Thanks everyone for participating! This is also available on my YouTube channel here: https://youtu.be/-rTGQ62gu-8
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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
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I got the same message while on my smart phone. We are working on it. I can check messages on my desktop now.
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Thanks to everyone who joined me for the last episode of HerniaTalk LIVE Q&A for 2021. You can watch it here: https://youtu.be/EOSViGtAccY
See you back in 2022!
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As a surgeon, it is not considered appropriate to offer an elective operation that has a 30% recurrence rate, even though to a patient that may imply 70% success rate and they are acceptable of that. We understand the implications of recurrence: more pain, more disability, larger hernia, more difficult operation the second time, more likely to recur the second time. It’s a domino effect we don’t like.
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The very very small hernias do not cause incarceration problems with femoral hernias. Anything more than that is at risk.
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Thank you!!
Suture repairs may Involve polypropylene or polyester or nylon but there are other alternatives used too. It is surgeon dependent
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I have had multiple instances where the operative report claimed the mesh was all removed and then I go in and there is all this mesh left behind.
That said, when Dr Belyansky says he removed 100% of the mesh, be assured that you have no mesh in place anymore.
Mesh remnants can be seen on MRI usually.