drtowfigh
Forum Replies Created
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– no. All tissue repairs have tension.
– it’s possible to do. It adds a lot to the cost—-more than the reimbursement provided by the insurer. And patients do not want to pay out of pocket for this.
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– to be fair to Dr Felix: he was assigned to debate one side of an issue.
– the AHSQC is the US database that is formed to do exactly as you suggest. We need more surgeons to participate (I do). We also need the patients to respond for their longterm outcomes. -
Most pain management specialists should be able to offer that
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Yup. Unrelated.
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– 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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– 10x15cm for lap, 4×6 inches for open
– smaller is not better. It will just tear or give way.
– synthetic mesh is not inert. -
Direct and indirect are different animals. Indirect is a hole. Direct is a laxity.
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No
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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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The 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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Agree with @momof4
We’ve discussed this in past threads. Perhaps can search.
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The 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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Thanks 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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Yes. Contact my office to initiate an Online Consultation. Info@beverlyhillsherniacenter.com
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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.