drtowfigh
Forum Replies Created
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Not related.
Many have redundant colon because of chronic constipation. If you have constipation, treat it. It’s a major reason for hernia exacerbations.
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Ken,
This horse has been beaten to its death. Go back to prior posts with the same exact discussion at least 20 times over. The purpose of this forum is not to keep repeating the same question hoping for a different answer.
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Depends on the situation, original repair method, original hernia size, patient factors, etc.
He needs full evaluation to see if he even needs mesh removal.
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I don’t talk in absolutes. Each patient’s situation is different.
If you compare mesh vs non mesh repairs for direct hernias, mesh is superior—even more so than for indirect hernias. Doesn’t mean all direct hernias must be repaired with mesh.
Also, Lichtenstein repairs direct and indirect hernias. It should be protective against future direct hernias, but that is also not absolute. Most recurrences from Lichtenstein are medial, I.e., direct.
Lichtenstein does not treat or protect from a femoral hernia.
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Fixation can be associated with chronic pain. Sometimes it’s necessary but if it’s not necessary, then most of us prefer not to use it.
The mesh itself causes an inflammatory reaction that makes it “stick” in place. Also, in many situations where fixation is not necessary, the space is made perfectly to allow for the mesh to stay as it is placed.
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One of the unique features of the ACHQC project is that surgeons log in their results and include exact brand names of meshes when used.
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SILS is single incision surgery. The thought is that with one (larger) incision you can do a similar operation as you would with 3 (smaller) incisions.
It’s an interesting technique. It has been used for gallbladder surgery, kidney surgery, prostate surgery. All of these have a specimens to be removed which benefit from the larger incision.
Some are using the SILS for hernia surgery. It is not yet FDA approved for the Intuitive robotic platform, but that’s ok. Doesn’t mean it can’t be done.
With hernia surgery, there is no specimen to be removed, so there is no advantage to the larger incision. The main advantage of SILS in these situations is it may allow for less visible scarring in some situations.
As with any incision, the larger the incision the higher the risk of incisional hernia. Whether you actually get a hernia is related to your risk factors and the technique of the surgeon. Exercise does not increase that risk; it may even be protective.
(And thanks for wondering about me… I’ve been sick and no voice since before Thanksgiving. Finally starting to feel normal-ish).
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Sam’s answer is very accurate.
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Thanks. We are continuing to make improvements. The site has certain options that can be turned on and off. Plus our team is meeting regularly to make sure we catch glitches, etc of this new forum.
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The Shouldice clinic does not offer hernia repairs if there is no visible bulge. However, the Shouldice repair technique can be applied to occult inguinal hernias.
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The majority of the 7 million hwrnia repaired worldwide per year.
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Spammers gonna spam. We take care of them.
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Speak to your surgeon to find out what are your options for findings of inguinal hernia.
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Mesh repair was introduced in late 1970s and became popular in 1980s and 1990s.
So, yes.
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Testicle loss from first hernia repair is rare, unless the hernia is ginormous.
Repeat hernia surgery, especially from the front/open/anterior approach may disrupt blood flow to the testicle, resulting in poor blood flow or no blood flow. This means the testicle can shrink. In even more rare situates, the testicle may need to be removed.
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Risk of testicle loss goes up the more the blood flow to the testicle is affected. This is more likely if multiple anterior (open) approaches are made in the same groin area.
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Thank you for your contribution.
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The lighter the mesh weight, for inguinals, the more important is the fixation.
Heniford has paper publishing showing chronic pain rate is directly associated with amount of mechanical fixation (tacks). There are also many population based papers which show use of fixation increases risk of chronic pain. That doesn’t mean not using fixation prevents all chronic pain.
Let’s not confound surgeon and surgical technique with fixation vs not fixation. No amount of fixation will counteract a poorly placed mesh or a bad decision making by the surgeon.
Which is why I press that you should find a surgeon who you can trust and allow them to do their job.
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How did the SAGES Shark Tank become something nefarious?
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Thanks for the feedbacks. Please keep them coming. I’m optimistic we can improve this site to optimize the discussions.