drtowfigh
Forum Replies Created
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FDA is seriously looking into ways they can be involved in improving hernia care. I know there were plans for them to meet with me as a followup, but it seems that may have been on hold due to pandemic, etc.
Meanwhile, The ACHQC has a close relationship with the FDA. It is the only hernia database we have in the US that is broad and follows patients prospectively. As part of their efforts, they have developed a patient advocacy arm that includes patient representatives who can help improve care.
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It’s hard to do. Best if you engage your abdominal muscles in preparation for any cough or sneezing.
Spirometry induces cough. If it’s necessary for your lung function, fine. That may be more important than preventing a hernia
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No harm
Really only useful if have hernia symptoms.
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The ACHQC is the only national database in the US that tracks hernia patients and their outcomes. It’s not a database that is mandatory and most surgeons performing hernia repair are not members. For those of us who are, it’s the only tool we have to look at hernia and outcomes trends, understanding that
1) the surgeons entering this data from their practice may not represent the whole of US surgeons
2) the majority of patients whose data is entered by the surgeon do not enter their followup long term data re how they’re doing.So, though in the perfect world we would have crisp data for everyone to munch on about hernia repair and their outcomes, in the US we don’t.
That said, the 15% number describes the % of patients that have ANY symptoms at 3 months postoperatively. This number significantly reduces to single digits at 1 year postoperatively. This number also does not reflect symptoms that affect quality of life. That number is also in the single digits. Finally, that % is reflective of inguinal hernias only. It is much less for ventral hernias.
Meanwhile, more surgeons in the US are offering minimally invasive hernia repairs nowadays. Almost all studies show the chronic pain rate after laparoscopic and robotic inguinal hernia repair is significantly lower than the open repair.
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yes. sneezing is a lot of abdominal pressure.
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Thank you to all who participated on this Episode of HerniaTalk LIVE. I shared every detail I could think of on how to best prepare for your hernia surgery, to optimize your outcome. It is a great episode to listen to over and over.
If you missed it, you can watch and share from Youtube here: https://youtu.be/6hEQu_iI0xQ
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Sounds like it’s a small hematoma. It should go away. Massaging it can help. This is something you should review with your surgeon.
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Sounds like it’s a small hematoma. It should go away. Massaging it can help. This is something you should review with your surgeon.
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Wishing everyone a Happy Thanksgiving. I am so thankful to all of you who participate on HerniaTalk and HerniaTalk LIVE.
To watch this week’s episode, go here: https://youtu.be/sqi0AQBUDfY
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FYI, as of 1 month ago, Dr. Malcher has moved to NYU Langone.
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Thanks to all who participated. Dr. Malcher is a very knowledgeable surgeon and it is so enjoyable and fun to discuss hernia surgery with him.
If you missed this session, you can WATCH and SHARE here: https://youtu.be/atq5–X_Dso
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Dr. Horne was a wealth of information. I so much agree with her thoughtful analysis.
If you missed this session about mesh, you can VIEW and SHARE from here: https://youtu.be/0B3F3Q0TJJg
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Thanks to Dr. Coker for diligently and expertly answering all your questions about robotic surgery
If you missed it, you can catch up on my YouTube channel. This episode can be found here: https://youtu.be/C0CpPgzBIgM
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Not all doctors and surgeons say that. It’s incumbent on patients to find doctors and surgeons who can help us. Meanwhile, we surgeons are educating more and more surgeons about meshomas, etc.
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It’s not a secret that I am no fan of insurance companies. They try their hardest to prevent care for my patients. I got a bit heated tonight on HerniaTalk LIVE Q&A.
If you missed it, you can watch it here: https://youtu.be/O9a2JXN7cKM
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We reviewed a wide range of orthopedic topics. However, we did not answer nearly as many questions as were proposed. I plan to revisit this topic in the future.
Watch and Share this session here: https://youtu.be/xNZNNaHtHvw
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Hi everyone.
We had a successful session discussing When to Remove a Mesh. This topic was inspired by a talk I just gave at the European Hernia Society in Denmark.
You can watch, LIKE, and SHARE this session here: https://youtu.be/JAT5vevhHfE
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@bryanBryant I wish I knew the answer to this. We can just surmise that you have a nickel allergy, at the least. So, if you have any surgery, sometimes we use clips and tackers and coils that contain nickel. Nest to prevent their use.
As for mesh allergy: it does not seem to be among those with nickel allergies. But there is no hard science behind what I am saying: just personal experience.
If you are worried, AND your hernia is amenable to non-mesh repair, then you should consider that option. If non-mesh is not feasible, or not practical, then I tend to choose hybrid meshes for my patients. Again, no hard data, but in my experience it has had the best tolerance and least reactions among patients with sensitivities.
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Yes. You are at higher risk than average patient to have an implant illness. In my practice, I would likely recommend non mesh based repair for you as much as possible. That said, we don’t know what that “higher” risk potential is. It’s not 100%. It may be 5 or 10%. We just don’t know yet.
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Thanks @cautious.
Yes. Anesthesia can have a deleterious effect on patients with dementia or vascular disorders of the brain. It would not necessarily be an implant issue.