drtowfigh
Forum Replies Created
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Marcy is not a reconstruction, rather a simple closure of a hole. It is considered a valid repair only for indirect hernias and only in children and some women, but not adult males. The repair depends on tissue integrity, which has clearly failed if you have an enlarging indirect inguinal hernia. Patients, in particular males, with inguinal hernias are considered to have abnormal tissue integrity (eg, collagen, MMP, etc) and require a reconstruction of the groin to release tension in the area and redistribute it.
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Can’t cherry pick one study. The size of hernia, your anatomy, your medical history and risk factors, surgeon experience, etc, all factor in on what is considered best repair for you.
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The Marcy repair is not indicated for adult males.
I recommend you find a surgeon who can perform a variety of repairs and have them guide you as to their recommendations rather than choosing a repair type that may not be suitable or appropriate for your need.
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Our hour was jam packed with expert information about mesh infections, intestinal fistula management, and how to optimize to get the best hernia repair.
If you missed it, you can watch and share from here: https://youtu.be/ypUHTX64gNM
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No. The final position of the mesh is the same. The approach for TAPP starts intra-abdominally, so bowel is visible. But the mesh placement is in exactly the same place.
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What a fun and informative session. Great stories and discussion about the history and evolution of hernia repairs.
If you missed it, watch and share YouTube: 44. HerniaTalk LIVE Q&A: History of Hernia Repairs 02/23/2021
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I have to address misinformation on this post:
There is no corporate influence on the surgical education curriculum. There is no situation in which a corporation prevents or blocks tissue-based inguinal hernia repair during residency.
In my opinion, knowing the hernia world and its players, the article is seems one-sided in its presentation of the problem.
And welcome back, Chaunce!
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To clarify: no Corporate Alliance representative runs any hernia meeting or AHS meeting or conference. The Corporate Alliance has their own Corporate Alliance meeting separate from the Society’s meetings/conference.
Also, Corporate sponsors of meetings change annually. This is true of any conference.
Also, annual medical/surgical conferences are paid for by physician dues, attendee meeting charges, and unrestricted grants which come from corporate sponsors. The amount of these grants has reduced dramatically since the Sunshine Act. All corporate sponsors are noted in the annual meeting information. There is no hiding of anything.
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We had a session packed with questions tonight. Topics we discussed included infected mesh, components separation, mesh choices, biologic mesh, laparoscopic and robotic options, hernias after Cesarean section, flank hernias, mesh reactions.
If you missed it, watch and share it from here: https://youtu.be/kxb87ni5w28
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The mesh is in the same place for both
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Fantastic episode tonight on HerniaTalk Live with Dr Nahabedian. If you’ve had a DIEP or TRAM flap and have a hernia or a bulge as a result, that requires special attention. We review all the situations.
Watch it fully here: 42. HerniaTalk LIVE Q&A: Hernia after Breast Reconstruction https://youtu.be/3PktMy_SmDw
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One study shows 18% recurrence at 3 years with ? of patients following up: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=phasix+mesh&btnG=#d=gs_qabs&u=%23p%3DNZZFiJjtnWYJ
No results published from the other study, but the data was presented last year at our meetings and I believe the recurrence was also around 20%.
The consensus is that the recurrence de rates will continue to climb. There is no perfect mesh product. Also, scar tissue typically is not strong enough to prevent recurrence, but sometimes it may be.
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Though it’s true that plug and patch repair can be performed safely and it is still among the most common repair types for inguinal hernia, it remains fraught with risks. There is no need to do an operation that has risks when there are perfectly better alternatives. If your surgeon only does open surgery, then an open Lichtenstein or laparoscopic repair is better. I would stay away from the plug and patch.
I also don’t jump out of airplanes or plan to learn to tightrope without a net under it. I know many do it and they are fine. To me it’s just not worth the risks.
It sounds like your surgeon is a general surgeon. He/she learned a particular way of doing things and has continued that for years. There has been no improvement if hernia care and also no tailoring to your particular needs.
I strongly suggest you take your health as something worth investing in. If you can’t see a second surgeon within your system (you should be able to), then seek a surgeon outside the system who actually has an interest in hernias.
Another analogy: I wouldn’t want someone who has no interest in hair color to dye my hair.
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We had a very inspiring and insightful discussion tonight on the management and repair of giant incisional hernias. Some of you may have heard terms such as loss of domain, components separation. We also discussed the use of mesh, tissue repairs, biologic mesh, and free flaps for extreme situations.
If you missed it, you can watch the entire episode here: https://youtu.be/PIvpvNfyCNg
Don’t forget to Subscribe to my YouTube channel to continue to hear about video uploads from HerniaTalk Live.
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I can also pin a post to alert others to seek the Success Stories tags.
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Good idea. Perhaps best to add the Success Stories keyword as a tag?
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Yes. This is the second time such a study has had these results. Both European population studies.
It just shows that there is no one perfect answer on how to reduce complications from hernia repair. Also, population studies don’t necessarily ask the right answers to tease out postoperative symptoms.
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Pain may be related to the repair, a tear, or a recurrence. Examination by your surgeon and then imaging will help.
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Context is important. Everyone is different. I don’t recommend haphazard mesh removal. As much as possible, every intervention must be planned based on evidence and expected outcome.
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This session was super informative. We discussed all aspects of core muscle injury, including rectus strain, adductor strain, pubic plate disruption, inguinal hernia, hip labral tear, FAI, diastasis recti, and other reasons for abdominal and pelvic pain.
If you missed it, you can watch it all here: https://youtu.be/SK3yVyseox0