drtowfigh
Forum Replies Created
-
4 Days Post-Op (Laparoscopic Hernia Repair)
Awesome! Love to read these types of posts.
-
Post op ilionguinal neurectomy
hope the doctor was able to shed some insight into his postoperative symptoms.
-
Nerve Entrapment?
This pain and your symptoms do not sound to be related to groin/hernia-related nerve entrapment or neurectomy. In general, anything below the knee is not hernia/hernia nerve-related.
Once mesh is over a nerve, removal of the mesh may damage the underlying nerve. Even with a microscope, it is difficult to judge whether there has been permanent damage (and therefore pain) or recoverable injury to the nerve (in which case neurolysis can help.). Thus, most of us perform neurectomy and do not take the chance at the former.
-
Shouldice repair in Washington state
I don’t know of any in Washington State.
You can call up some of the doctors based on their participation in the American Hernia Society: https://americanherniasociety.org/find-a-surgeon/In Oregon, can try Dr. Robert Martindale.
-
Ok soooo Biofeedback???
Biofeedback can be used as a form of pain control. It works in some patients and some situations. I don’t understand it fully, but it has to do with resetting your brain and how it perceives pain.
-
Recurrent pain?
Excellent discussion…
– Imaging is the best way to know if the mesh is flat, especially for laparoscopic mesh. Feeling alone may not be enough.
– Most of the time, we patch the hernia hole in the groin, and we do not close it. The reason is exactly as was described by MikeL. Eventually, the mesh is the cover for the hole, as well as some surrounding tissues. You will not make new muscles to fill in the hole, though that would be a great option in the future of hernia surgery.
– MRI and Ultrasound are good ways to know if there is a unique bowel adhesion to mesh. This may mimic GI symptoms, but is not a common occurrence.
-
Having a Difficult Time Deciding
I brought your post back up, WasInTN… you’re right. it’s too good not to be left up top.
-
‘The Dissolvables’
If mesh is removed lap/robotically and as a result there is no peritoneum to cover the new mesh repair, then yes, the mesh they place will have to have an adhesion barrier.
-
Recurrent pain?
This is a complex situation.
IBS is a diagnosis of last resort. If your pain is activity-related, your hernia/hernia repair may be the culprit. If it’s only GI symptoms, then the hernia is less likely a problem. That said, is the mesh confirmed to be flat? Is there any suggestion that the mesh is exposed and causing adhesions to bowel?,
-
6th Right Inguinal Hernia
That discussion should be with your surgeon. The choice to remove hernia mesh is very much tailored to each patient’s specific needs. I typically remove mesh for pain or infection reasons. Recurrent hernias may need mesh removal only if it’s a redo redo. Otherwise if it’s a failure of a laparoscopic hernia, then an open repair is indicated the second time usually. If there is yet another recurrence and lap/robotic is chosen, then sometimes that mesh may need to be removed.
-
Post-Surgery Pain Management Questions
best of luck to you!!
hope your surgery went well/is going well.i am a big fan of anti-inflammatories for hernia repair pain. ice, arnica, aleve/naproxen. can add tylenol.
I have a lot of information for you on my site: http://www.beverlyhillsherniacenter.com/for-patients/postop-instructions/ -
Hernia surgeons in London,Ont, Canada area?
Norton,
For sure these are not easy questions to answer.
Chronic pain after hernia repair can occur with and without mesh implantation. We don’t have any hard evidence to say that one is necessarily better or worse than the other as chronic pain after hernia repair didn’t really get the attention until the mesh era, but those who were doing non-mesh repairs regularly, before the mesh era, are very clear to say that it was definitely a known problem and also hard to deal with.
I would rely on your surgeon, who you should trust to provide you with the right evidence and the beret repair as tailored for your needs. Feel free to see more than one if you are not getting your questions answered.
As for the nerve: yes, it is sometimes necessary to cut a nerve that may be at risk for damage after hernia repair.
-
Surgeon challenging Radiologist’s CT scan
Hard to determine if there is a hernia based on these new images. The entire set of images needs to be seen.
-
Mesh Removal/Neurectomy
Thanks for your post, Steelersfan85,
Hernia repairs, as with any operation, have their own cadre of potential complications. Sounds like you had a redo hernia repair with mesh and triple neurectomy.
Though dysuria, insomnia, and headaches may rarely be associated with hernia-related complications, such as mesh infection or even just secondary to chronic pain, I would make sure you are first evaluated for more obvious (non-hernia-related) causes of your symptoms.
The stabbing pain may be related to your hernia repair or the revisional surgery. More details are necessary to help figure this out for you. Removal of the mesh can be done at any time, if it is necessary. It is not related to whether you had neurectomy.
-
How can I find out if I have a hidden hernia?
We have tons of posts here on hidden or occult hernias, including references and articles that you can read.
Also, we have had many in Oregon that we have been able to help. Their names can also be searched on this site by looking for Oregon as your keyword.
I recommend Dr. Sean Orenstein at OHSU.
-
‘The Dissolvables’
Marcello71,
Adhesion barriers are great, if you ask me. There is some evidence that they work in reducing adhesions. However, they are not perfect and they are expensive so many surgeons do not use them. Yes, they all absorb in a short span of time in all patients. We have no evidence to suggest otherwise. We have had plenty of experience reoperating on patients and regularly see that there is no residual anti-adhesive.
Industry reps tend not to post on these patient-focused forums, as it would be considered inappropriately promoting their brand without full disclosure. But I encourage them to chime in on this topic as objectively as possible.
Sounds like you had a great repair. Good luck.
-
parietex progrip removal, an exercise in futility?
Phyrun,
You are correct. 20% is very high. In the studies that show such high percentage, “chronic pain” is defined as “any” pain or symptom 3 or more months after surgery. That includes not only debilitating pain but also a twinge here or there. Debilitating pain is 3%. Most of these also have been shown to diminish by 6 months and 1 year.
Good points you made.
-
parietex progrip removal, an exercise in futility?
Intuitive Surgical, the robotics makers, are just now entering the European market. It is way too expensive for most European centers right now.
-
6th Right Inguinal Hernia
Agreed! Dr. Belyansky is super talented for robotic surgery and nerve-related hernia complications. In Anapolis, MD.
-
Hernia mesh pain.
Good luck to you.
Mesh removal is serious and has its complications. I recommend that patients seek more than one specialist’s recommendations before committing to it.
Best of luck to you.
Mesh reactions are rare, but they do occur.