

drtowfigh
Forum Replies Created
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Most pain management specialists should be able to offer that
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drtowfigh
ModeratorFebruary 3, 2020 at 5:59 am in reply to: One side IH repair increases pressure on the other side?Yup. Unrelated.
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drtowfigh
ModeratorFebruary 3, 2020 at 5:58 am in reply to: Possible explanation for mesh problems (from a product standpoint)– absorbable Mesh (aka biologic mesh or synthetic absorbables) don’t work. That’s been tried. And they are very very expensive—they cost more than the
Insurance reimbursement for the operation.
– I think the hybrid mesh has been the best option so far. I use Ovitex by Tela Bio. It has just enough synthetic to prevent a recurrence but not enough to have the inflammatory reaction that can cause chronic pain.If hernias would have higher reimbursements from insurers, then that would allow technology to strive for better options.
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– I don’t recommend mixing a chronic pain procedure with a new elective operation, in most cases.
– just sewing shut with absorbable sutures doesn’t work. -
Just because there is no bulge doesn’t mean there is no hernia.
But we go by clinical symptoms.
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Direct and indirect are different animals. Indirect is a hole. Direct is a laxity.
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drtowfigh
ModeratorFebruary 3, 2020 at 5:46 am in reply to: Non mesh laparoscopic indirect hernia repairNo
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You should be fine. It’s normal to have intermittent twinges or pangs that don’t disrupt your day.
That is a really small sliver of mesh, though.
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drtowfigh
ModeratorFebruary 3, 2020 at 5:44 am in reply to: 90% recovery after mesh hernia repair in 1 weekThe risk of watchful waiting is grossly overestimated.
And no one uses the darn technique anymore. It was abandoned in the Western world at the turn of the prior century. It may still be used in very very poor countries.
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drtowfigh
ModeratorFebruary 3, 2020 at 5:37 am in reply to: no mesh surgery with continuous absorbable suturesThe cremaster is cut during a classic Shouldice repair as they feel it improves hernia recurrence outcome. It is unrelated to the pelvic floor.
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It’s all unreliable.
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drtowfigh
ModeratorFebruary 3, 2020 at 5:31 am in reply to: Some random comments re: mesh removal + forum critiqueThanks everyone for the input on the site. I encourage you to give me all the feedback that you have so that we can make this a better site.
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drtowfigh
ModeratorFebruary 3, 2020 at 5:23 am in reply to: any consensus on “best” nonmesh repair?Tailored approach. No best repair.
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Usually by imaging.
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We’ve published on this multiple times and it’s also searchable on this forum.
And, no, imaging does not affect the mesh.
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drtowfigh
ModeratorFebruary 3, 2020 at 5:06 am in reply to: SHOULDICE Hospital experience by membersLots of experience here with Shouldice. Use the Search function on the home page (bottom) to help.
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PRP is super expensive and not covered by insurance. The cost would be more than most pay in network for their hernia repair.
Also, there have been no studies that validate use of PRP on a regular basis for most procedures.