drtowfigh
Forum Replies Created
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Small Umbilical Hernia Repair Advice
It’s hard to recur from these repairs but it does happen. Sometimes the pain is from a partial tear not a full recurrence. And it will heal and scar in.
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Pain after inguinal hernia repair using PHS.
No. Hernia pain is never below the knee.
No. Sciatic nerve cannot be injured by any groin surgery. Femoral nerve may be, but that would be very rare. -
Diagnostic laparoscopy as the definitive means of hernia detection?
Dr Garth Jacobsen in San Diego
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4 years of hip/groin pain. Help!
Try Dr Garth Jacobsen in San Diego. If he sees a hernia on laparoscopy, he will repair it.
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Recovery from second surgery
Not too early to get imaging and be re evaluated.
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Looking for a Hernia Specialist near North Alabama
Please update us after your consult
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Years of inconclusive groin pain on right side. Maybe swelling? Maybe Hernia?
Yes to all your questions, except:
No, nerve injection is not diagnostic for hernia.
Start with an ultrasound.
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Diagnostic laparoscopy as the definitive means of hernia detection?
If a hernia is not noted laparoscopically, it is okay and I would say it is preferred, that mesh is not placed.
Laparoscopic Dissection of the hernia area alone does not predispose it to hernia formation. It’s one of the perks of laparoscopy.
I offer robotic-assisted Inguinal hernia repair without mesh. I do it under a research protocol so that I can follow my outcomes prospectively. I am hopeful that it may be a valid non-mesh option that is also minimally invasive.
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Mesh After Removal
It’s either thrown away or it is sent to pathology for identification. Then it is thrown away at some point.
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Desarda
I’ve had the luxury of reviewing the Desarda technique with colleagues and mentors of mine that trained or taught in the 1950s and 1960s. They mentions to me that this technique fell out of favor then due to high recurrence rates.
It is not the Halsted technique. That uses the external oblique aponeurosis as a strength layer to the pelvic Floor closure, exteriorizing the spermstic cord.
I think we can learn a lot from history.
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Femoral Hernia?
Hernias typically present with intermittent painn
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Learning about various techniques: Dasarda Technique versus Mesh surgery?
I’ve had the luxury of reviewing the Desarda technique with colleagues and mentors of mine that trained or taught in the 1950s and 1960s. They mentions to me that this technique fell out of favor then due to high recurrence rates.
It is not the Halsted technique. That uses the external oblique aponeurosis as a strength layer to the pelvic Floor closure, exteriorizing the spermstic cord.
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Perineal hernia
So sorry to hear. You do have a very difficult problem. Sounds like your surgeons re doing their best. Make sure you also reduce any risk factors you may have to recur from these perineal hernia repairs:
– maintain excellent nutrition
– be as close to normal weight as possible
– prevent all constipation
– prevent coughing
– prevent lifting
– no prolonged standing
– exercise -
Femoral Hernia?
CT should show a hernia that is so symptomatic. Dynamic hernia ultrasound and MRI pelvis are better and more likely to show the hernia.
Remember that all images are interpreted by a radiologist. Just because the image is normal does not mean you don’t have a hernia. It just means that radiologist interpreted it that way. Hernias are notoriously missed or undervalued on imaging.
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Finding no-mesh inguinal hernia surgeons on west coast?
There is no study that shows polypropylene or other mesh can cause autoimmune disorder. There is also no study to confirm that those with autoimmune disorders do worse with mesh.
Anecdotally, I have treated patients whose autoimmune disorder flared up or presented with an autoimmune disorder soon after mesh implantation. In some, removal of mesh reduced their symptoms. In others, there was no change.
In short, we don’t know enough to answer this question. In my practice, I tend not to place mesh in patients with lupus, rheumatoid arthritis, fibromyalgia.
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Continued proliferation of Millikan tension-free plug and patch repair?
Depends on the surgeon. The reason why we on this forum urge that you seek consultation from true hernia specialists is because we know that these surgeons are constantly learning and thereby changing what they are doing to improve outcomes among their patients. For example, almost everything I do now for hernia repair I learned after residency training. And I trained at one of the top universities for surgery. It’s just following the science and the times.
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Something weird after workout: bulge seemed to recess
Pressure… Squats have been shown to increase abdominal pressure. Most believe that increased pressure leads to larger and possibly more symptomatic hernias.
Take the squats out of your regimen.
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Umbilical hernia question
In the groin. No problem. But with the umbilicus, there were reports of chronic pain as the abdomen expands, as the area of mesh repair cannot expand. And then this is the source of the pain. I don’t put mesh if I can help it until the women are done with their pregnancy. That said, your experience is helpful to know. I’ve never done it myself. Just gone on others’ experience.
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Pain Diary
The number I was told by one of our pain docs is 9months. That is, if pain is left untreated for 9months, that increases your chances at centralization and reduces your risk of cure.
That said, these are all risks. They are not 100%. For sure I have patients with much longer chronic pain without centralization of pain and who have been cured.
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parietex progrip removal, an exercise in futility?
Hi there
Any update as to how you’re doing?
Did you seek consultation with any of the surgeons?