drtowfigh
Forum Replies Created
-
Going back in open, after prior open repair, is asking for trouble. There are nerves that risk being injured as they are already involved in scar tissue.
Laparoscopic repair would be safer and more effective. Not sure why laparoscopic surgery scares you. If done by a specialist, it would be the best option.
-
– seek a specialist to figure out the cause of pain
– if it’s a hernia recurrence, wear a truss or compression underwear. Ice packs help.
-
Yes. Ilioinguinal Neurectomy performed electively during open inguinal hernia repair is a commonly performed procedure claiming to reduce chronic postoperative pain.
I don’t like it. And I don’t do it. There are risks with neurectomy, including neuroma and chronic pain. Many don’t do the neurectomy correcfly. this practice ignores the many other reasons for chronic pain after open inguinal hernia repair besides ilioinguinal nerve injury.
If you really want to reduce chronic pain, a) make sure a hernia specialist performs your hernia repair and b) consider a preperitoneal (usually laparoscopic) repair.
That’s my thought on the issue.
-
I recommend you travel to Hershey. dr Eric Pauli.
-
– highly unlikely and unexpected to have any intraperitoneal injury with an open tissue repair
– even with laparoscopic repair, adhesions are uncommon
-
You’re so right. We have little data for women.
We do know that women are more likely to have femoral hernias and watchful waiting is not safe for that type of hernia. So make sure you rule that out with the ultrasound evaluation.
As a power lifter, I would recommend laparoscopic repair with mesh. But of course you have options.
The prior surgery did not cause the hernia.
-
Not sure if Dr Hari Kumar Ondiveeran could see you. He’s in Ontario, I believe.
-
Congratulations on your successful repair. Thank you for sharing.
Also, a two layer repair is technically not a Shouldice. It may be a Bassini or another type of two layer tissue repair.
-
Sounds like you had the best repairs possible based on the circumstances.
If they truly did a Shouldice repair, then that’s great and it doesn’t make sense that they said you had a temporary repair. Sometimes surgeons do a tissue repair and I correctly call it a Shouldice. Those pseudo-Shouldice repairs are not well studied and it’s unclear how many of them fail.
-
Good to see your surgeon about this. Imaging may help. You may have a seroma or hematoma. Massaging the area may also help. In some situations, the new symptoms are a result of the mesh shrinkage taking into effect.
-
Consider Dr Jan Kukleta in Switzerland. I’ll bring him on as a guest for HerniaTalk LIVE episode soon.
-
all true hernia specialists should be able to treat a Spigelian hernia.
-
The standard for most hernia repairs is not to touch or cut any nerves. With the modified Shouldice repair by the Shouldice Clinic, they have considered cremaster muscle resection (to reduce the hernia recurrence from the originally described Shouldice technique) and thus genital branch neurectomy as their common practice. With other open operations, many surgeons commonly cut the ilioinguinal nerve.
-
yup. which is why I teach all my residents in the OR and also show up to the Morbidity and Mortality conference to educate the rest of the Department and remind them of the tissue repair options and how to best do them.
-
See a hernia specialist.
Here are two in Houston I’ve interviewed on HerniaTalk LIVE. You can search more on this site
-
– everyone gets the initial swelling at the groin incision. It’s called a healing ridge. It eventually flattens out.
– not sure what exactly they mean by funicolysis. It may mean they narrowed the internal ring. Most of us prefer not to do that. It causes pain and tearing. Funicolysis may also mean the cremaster muscle was circumferential cut. That’s seen more with open tissue repairs such as Shouldice.
-
Search this site for North Carolina. We have interviewed many great surgeons from there on HerniaTalk live.
-
Mesh and non-mesh options should be discussed and you and your surgeon can review what’s best for you.
I assume you’ve had surgery already. Wishing for a rapid recovery.
-
Sounds like you may have a neuroma due to iliohypogastric nerve damage during the Csection.
If so, this is very treatable.
-
Blood tests will typically be normal. That’s not a reason not to act. Symptoms and your history are the most important. Imaging can also help.