drtowfigh
Forum Replies Created
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Watchful waiting is considered safe for umbilical hernia that are asymptomatic. However, once it is symptomatic, as you are describing, then repair is indicated
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It’s a struggle with these spammers.
Thanks for helping keep the Forum active!
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Looks like your post is in the Discussion. Any other issues?
We are manually getting rid of the spammers that eek around the security system that is already blocking thousands! Looks like HerniaTalk.com is popular.
Also, please report any fishy or spammy posts when you see them, thanks.
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Bienvenue to our Forum.
– the short stitch trial is relevant to abdominal wall hernias, not inguinal
– tissue based repairs are an excellent option for you based on your need to remain extremely flexible
– absorbable mesh for inguinal hernias is not standard and has a high risk of recurrence.
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Femoral hernia repair is part of the laparoscopic repair. The mesh covers the femoral space. It would be odd to have a new femoral hernia unless it was completely missed and not taken down during the operation. That said, if it were missed, the mesh would entrap it, so it shouldn’t reduce easily. The story doesn’t sound right. Unless the mesh is not appropriately covering the area from the start.
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It’s not expected to have a lump within hours after surgery. Usually seroma/hematoma takes at least some hours to develop. So, the differential diagnosis for a lump can be retained spermatic cord lipoma. Missed femoral hernia is less common for laparoscopic repairs and in males.
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That was a good video.
He has a hernia recurrence. So mesh removal would not be the typical first choice.
The ulcerative colitis diagnosis is an interesting twist to the story. I’d be curious when he was diagnosed and how it’s being managed.
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Thanks.
I keep an open mind. I’m also evidence based and use logic as much as possible in what I do.
I do not consider Desarda equivalent to the Shouldice. It is another tool in the toolbox. I haven’t seen a situation among my patients yet to use Desarda vs another more vetted technique.
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I’ve seen patients of Dr Repta. They were all open and mostly abdominal wall, not inguinal patients. He’s helped a lot of patients.
I viewed the videos you mentioned. The 3 layer repair he mentions seems to be a 2 layer repair plus the external oblique aponeurosis closure. It’s unclear what technique he’s using for the repair. It’s not a Shouldice or Bassini. I did not see any opening of the floor, identification of nerves or fascial release. Also, one of the mesh removals was partial and neither of them identified the nerves.
I need to invite him to this forum to help answer some questions 😄
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👍🏻
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The more inguinal surgery is done through one wound, especially open, the greater the risk of reduced blood flow to the testicle.
That number varies based on the amount of tissue trauma incurred by the procedure, thereby affecting the blood vessels.
I perform a lot of revisional inguinal surgery. My personal rate of testicle loss is less than 1%. In my 20 year career I’ve had only 2 patients who required orchiectomy. I don’t know where Dr Sbayi got his 25% number. It sounds very high. But perhaps that’s his experience.
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Not many that I know. I am now on the community surgeon list because there is a paucity of hernia specialists including those who do non mesh repair or that remove mesh.
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Retromuscular mesh placement is the best choice.
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This is great. Thanks for volunteering. More and more surgeon groups are understanding the importance of patient representation in what they do.
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1. no
2. Depends on the technique
3. No
4. weeks to months
5. Lifetime
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I’ll repeat what I said in the last post and prior posts:
Direct hernias do better with mesh than non mesh. But that doesn’t mean you can’t or shouldn’t have a tissue repair for a direct hernia. Every situation is different.
That’s why you should pick your surgeon and follow their personalized advice.
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It’s a great program. It promotes funding to surgeons who find there is a problem that they can help solve with innovation. It’s surgeon-centric and therefore patient-centric.
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It would be great if Dr. Kang would publish his study.
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Please contact my office directly if you would like a consultation. info@beverlyhillsherniacenter.com
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I’d like to see more evidence via clinical trials and outcomes based on real use databases. It’s important to note the strengths and weaknesses of a technique so its use it tailored to those patients that would most benefit