drtowfigh
Forum Replies Created
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The type of repair is best chosen based on the size and location of the hernia, your own risk factors, and the skills of the surgeon.
There is no one best repair.
Pick a surgeon who can do all options and go through pros and cons of each.
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Done thanks
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[USER=”2029″]Good intentions[/USER] thanks for all the informative posts. Very nicely done. You make this a better forum because of your participation.
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A little tugging at the repair, especially within the first year, may be normal. If it’s not affecting your ability to perform normal daily activities, then usually not necessary to worry. If any more concerns. I would seek an examination by your surgeon.
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Allow me to provide some background and context to this.
The surgeon being interviewed is well known and respected for her hernia research, which is mostly based on population databases. She is a resident in training. She’s reporting on what data was presented based on her population based research. As you know, the Danish and Swedish hernia databases provide us with robust and longterm patient data that we really don’t have anywhere else.
Note that these databases are government based and objective. They are not influenced by industry or company sponsors.
Most data show superiority in outcome for umbilical hernias when mesh is used, no matter the size of the umbilical hernia. It also shows laparoscopic to provide better outcomes than open, again regardless of the size of the hernia. Outcomes are mostly based on her i recurrence, but also include pain and infection risks , etc.
But that’s not the full story. My belief and that of some others is that we are overusing mesh. That is, the benefit of mesh placement is not as high for smaller umbilical hernias. It is more beneficial for larger hernias.
My analogy to this is driving a car (aka using mesh) Vs walking (aka nonmesh repair). Driving somewhere will always be faster than walking there. But there are risks with Driving (Ie, mesh), such as pollution, car accident, cost of gas. And when needing to visit a neighbor a few houses away (Ie, small umbilical hernia), the Lee really is no need to drive there. Walking (Ie, non mesh repair) is just as good and without the risks of driving, though driving will still be faster to get to your destination.
[USER=”2580″]DrBrown[/USER] I agree with him because we need to add some logic in interpreting the data. This is one of the problems of database research. It doesn’t account for tailoring to the needs of the individual patient.
Again with the driving analogy: for some people (eg, broken leg, wheelchair-bound) (Ie, patient with high risk factors for recurrence, such as smoker, obese, chronic cough), perhaps the drive for 1 block away (ie, small umbilical hernia) is still better than walking (ie suture only repair).
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– the lymph nodes are normal and not part of the problem. No need to operate on those
– MRIs are often misreported for hernias so I read my own in addition to the radiologic report. Ie, just because the report said you don’t have a hernia doesn’t necessarily mean you don’t.
-Any core exercise is perfectly safe. -
Dr Koch is an excellent surgeon.
you can search this site for posts about him. -
So did you have hernia repairs already and they recurred?
in my patients with mast cell activation, i offer tissue repair or use of hybrid mesh by TelaBio.
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Agree with Dr Brown.
no need to wait to get the nerve blocks.
do not contemplate any surgical intervention for at least 3 months -
[USER=”2817″]columb.if[/USER] not sure i would repair both if wish a non-mesh repair. Determine which is the cause of pain and focus on that.
foe example: Any tissue hernia repair will add tension to external oblique tear repair and make that fail.
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I suspect that the open approach to the laparoscopic mesh repair may have disrupted the mesh repair.
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Not possible.
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Scar tissue from the hernia repair can cause a rise in the level of the testicle. Mesh removal is not necessary not recommended. In extreme situations (yours does not sound like one), release of the scar tissue can help lower the testicle to a more normal position.
Penile positioning should not be related to any hernia repair.
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[USER=”2804″]pinto[/USER] I can see your incision attachment.
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1.5 T is fine for most people.
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[USER=”2804″]pinto[/USER] message me regarding any issues re posts and posting pic. I will try to repair.
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As far as I know, Beverly Tower Wilshire does not have our protocol. You can share it with them. Beverly Hills Imaging does have our protocol, just a few streets away. As does Mink and Cedars-Sinai.
See our protocol, attached, and you can show it to them to see if they will follow it.
#MRI #MRIProtocol
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A small incisional hernia should not be giving you any nausea or distressing urinary symptoms. Hard to know your specific situation.
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Few hernia specialists in Texas, if you can believe it!
Try Dr Kent Van Sickle in Houston
also, other great surgeons: Daniel Scott, Michael J Lee, Nicole Basa
also look up surgeons locally in Americanherniasociety.org -
We don’t repair 12-year old hernias with mesh. Their biology of hernia development is different than in adults. Your pediatric surgeon will be the right one to follow.
