drtowfigh
Forum Replies Created
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I hope to share my results. Please share the survey with your friends who may have had adverse reaction to meshes.
This can happen to any implant, including absorbable ones.
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Thanks so much.
For all the participants, you may be asked to log in again, for security purposes as we clean up the old site.
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It is incorrect to feel that incisional hernias never open. The overall risk of incisional hernia is 11% and that number can vary based on the specifics of the operation and the patient.
The inguinal area is more prone to herniation because of the collagen in the area being abnormal. Also, we are upright beings, so there is more pressure in the pelvis. Lastly, male pelvis is narrow, so from a physics standpoint there are more forces into the inguinal canal than in females.
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Contact my office directly and speak with Sheila. My office has experience with VA care and perhaps we can help.
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Just use the Search function for Miami or Florida.
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Dr Grishkan sometimes does a combination Shouldice + Lichtenstein repair.
The picture is inaccurate in that the transversalis fascia should not be open at the stage of mesh onlay placement.
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Yes. All professional athletes I’ve operated on so far have had laparoscopic inguinal hernia repairs with mesh.
For their umbilical hernias, all but one was non-mesh. These were all small hernias.
Biologic or absorbable meshes are improving. Almost all of the newer ones have clinical trials showing okay results.
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Discussed this week!
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We looked at why we remove mesh over a span of about 5 yrs. The majority of mesh removal was after prior open operations (83% total). However, over time, we noted that the need to remove mesh after prior laparoscopic/robotic surgery significantly increased in a stepwise fashion. So, your observations are valid: we are seeing more complications after lap/robotic surgery than we were seeing before.
The full article can be found here: https://pubmed.ncbi.nlm.nih.gov/30382481/
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We discussed this on the last 2 HerniaTalk LIVE sessions, if you’re interested to watch/listen.
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Congratulations.
And yes, that is typical pathology for any foreign body removed for any reason.
We published on this here: https://pubmed.ncbi.nlm.nih.gov/30772445/
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Usually not. Larger hydroceles classically are checked with a small flashlight against the scrotum. It will show a water sac.
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I’m unclear as to why hydrocele is considered. But the work up involves figuring out the story first (what symptoms, when did they start), and then a good physical examination. From there, the surgeon should be able to determine if this is a hernia related issue (MRI pelvis) or a urologic problem (scrotal ultrasound).
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@wirsz Sounds like you simply have a small recurrence after an otherwise successful Shouldice repair from 5 yrs ago.
Go back to the surgeon who recommended laparoscopic repair. Make sure they’ve done at least 250.
Best of luck.
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She uses the terms fascia and connective tissue. That is not anatomically correct. The webs she shows are connective tissue but not fascia.
From a hernia standpoint, we rely a lot on one’s fascia. It so often the strength layer of the muscle repair. Also, you can have fascia tears distinct from hernias. These are most commonly sports related.
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Fortunately we will be upgrading the Forum to a more modern format soon. Hopefully the next gen will be easier to navigate. It will be more like a Facebook forum.
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These misleading and reactive titles are not helpful.
Searching via Google will not find every HerniaTalk post. can’t control what Google serves as results.
In the meantime, we are looking to make sure the Search function on this website is accurate
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This reply was modified 1 year, 5 months ago by drtowfigh.
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This reply was modified 1 year, 5 months ago by
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Details from the first surgery and how it was performed is key. Eg, was it a keyhole technique?
Mesh allergies/reactions don’t present with local pain.
I’m concerned you’ve had so many back to back operations. I’m curious what the thought process was behind each one. And what was the technique. Each operation has its own risks and thus may be causing you to be further injured if not performed by a specialist.
Post your first operative report here if you’d like. Alternatively, I offer Online Consultations to help figure these puzzles out and provide advice on next steps. You can contact my office directly.
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Unfortunately this paper is an open access article in a non surgical journal.
I’m not saying absorbable suture fails in everyone. It’s just common knowledge that the results are inferior to those with non-absorbable sutures. And scar tissue alone is inadequate to prevent hernia recurrence.
As long as you and your surgeon have an understanding of what risks and benefits you are choosing, and are informed, that’s what matters.
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Recurrences are higher with absorbable sutures. It is not how they were originally described. You cannot expect the same outcome by changing the sutures.