drtowfigh
Forum Replies Created
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Thanks for all who participated, making this the most interactive session we have had to date. If you missed it, you can watch the Q&A session on my YouTube channel here:
https://youtu.be/x-5vJbGU2Co -
I don’t know how many of you were able to join me live, but that was an amazing two hours of insightful questions.
We discussed all types of hernias, their repairs, indications for pregnancy, online resources, exercise and PT protocols, etc.
You can watch it all here: https://www.facebook.com/141698152571123/posts/3916457325095168/?d=n on my Facebook Homepage (@Dr.Towfigh)
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We will be live soon, at 4:30 pm tonight, Pacific, on my Facebook homepage (Dr.Towfigh) and also on the Pelvic Guru homepage. If you miss it, I will send a link to the archived page.
This expert webinar about hernias will be LIVE in the #GPHAM membership Facebook group (and membership site) AND the public Pelvic Guru Facebook page AND Dr. Towfigh’s Facebook page! (Recordings too).
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I have the honor of interviewing the world renowned hernia specialist and surgeon, Dr. Shirin Towfigh, “Queen of Hernias, Fascia-nista, and Hernia Whisperer.” 🎉🎉🎉Over the years, she’s also been a wonderful resource for information and help. .
Some of the questions/topics:
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🔥 Hernia basics and anatomy – What is it? What types and are some hidden?
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🔥 Can all people get them? Can they happen in #pregnancy?If someone had one as a baby/child, are they more likely to have more issues as an adult?
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🔥 How accurate is imaging for them?
What is the best imaging?
Who should read the imaging?
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🔥 For health & fitness professionals:
* What signs should we be looking for to suspect a hernia * How would this differ in people with female anatomy vs male?
* Are there quick screening tests we can do as physical therapists?
* If there is a #herniasurgery always recommended or are there conservative things you recommend health professionals do to help with symptoms?
* Hernias related to abdominal or pelvic pain – are there types of pain presentations or genital issues related to #hernias – suprapubic discomfort, testicles drawing up, abdominal pain specific to eating, etc?
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🔥 Mesh.
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* When is mesh needed?
* Is all mesh bad
* I know you see a lot of complications with #mesh. Is there a way to avoid this – based on surgeon skill or some people can just have this happen?
* What is mesh-less surgery and is it effective or only for certain types of hernias?
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🔥 What is a #sportshernia & how is it treated differently than other hernias?
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So, drop in and join us tomorrow, Tuesday, June 2! 🎉🔥❤️.
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#pelvicguru #gpham #herniarepair #herniasurgeon #pelvicpt #pelvicpain #endometriosis #surgery #pelvichealth #pelvicfloor #herniatalk -
The AHSQC is unrelated to this survey. This was made by one of my Czech colleagues. She is trying to figure out what issues are important to patients and this how surgeons can better discuss and inform their patients.
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You can watch this episode on my YouTube channel here:
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I should have clarified: for OPEN inguinal mesh removal.
For laparoscopic, we rarely have to do a neurectomy, as the nerves are not exposed.
In my opinion, mesh removal should always be done by a specialist, as the risk of complications is not low.
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Dr. Ramshaw has written about his experience with prehabilitation. Here is a sample article:
https://link.springer.com/article/10.1007/s00464-019-07082-5
Also, you can read more about it in the book:
https://www.sages.org/publications/sages-manuals/the-sages-manual-of-hernia-surgery/
Plus if you google Dr. Ramshaw and Prehabilitation, there are multiple articles discussing the topic.
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For inguinal hernia mesh removal, nerve damage from the mesh removal process is likely. Not all nerves may be at risk, but typically at least one may be. So, the surgeon should consider neurectomy at that time. If neurectomy is not performed, the risk of chronic nerve pain, neuroma is high and can be quite life-altering. And treatment afterwards may not be successful without another operation.
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You can watch the entirety of this HerniaTalk **LIVE** episode here:
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This is not a paper on tissue repair. It simply discusses what many of us already do for laparoscopic repair of direct inguinal hernias: we close the direct defect or imbricate the transversalis fascia prior to mesh placement. It reduces seroma formation and also, I believe, reduces eventration (pseudo-herniation) of mesh into the direct defect.
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You can watch this HerniaTalk **LIVE** session here: https://youtu.be/6wQzS1hIU74
We discussed sports hernias/athletic pubalgia, tummy tuck, watchful waiting, and the future of hernia surgery.
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Depends on the level of the neurectomies. Most neurectomies for groin pain do not result in functional deficits. If there is pain or neuroma or a hernia-related problem, usually those can be treated, though for sure it is a challenging problem.
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If you missed this session, you can watch the full hour on my YouTube channel here: https://youtu.be/cvmLowkvg3Y
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I recommend CT scan, since you have scar and mesh that can cause artifact with typical ultrasonography.
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This may be where your component separation occurred. Usually there isn’t pain associated with that unless the separation was made too deep and so you get a laxity in that region.
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Dr Goodyear has Retired. He was an amazing resource and actually started the first hernia online discussion forum.
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If anyone missed this LIVE, you can watch it on my YouTube channel here:
https://youtu.be/UQvBs0WzPzo -
Yes. Please contact my friend and colleague Dr Macky Faylona.
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As for reconnection: the answer is no.
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@julian your situation needs careful evaluation. Sounds like you’ve had multiple operations plus neurectomies. Imaging and a careful history can help figure out what the underlying cause of your symptoms may be.