Good intentions

Just posting to show the other end of the spectrum from the pain reports from the thousands of Shouldice procedures. Here is a material, described in the paper linked below, with a perfect record. No recurrences and no pain. 31 patients.

It is definitely tough to ignore the concrete, Individual stories of pain. They have impact, for sure.…[Read more]

Funny, I screwed up the title. It’s Abdominal, not American. I missed the tiny editing window.

I found the questionnaires on the ACHQC (formerly AHSQC) web site.

https://achqc.org/resources

Reproduced from the EuraHS form, apparently.

“Used with permission from the European Registry of Abdominal Wall Hernias (EuraHS)”

https://achqc.org/uploads/general_images/ACHQC_COMBINED_POSTOPERATIVE_ASSESSMENT_-_ENGLISH_-_6-22-20.pdf

EuraHS stands for European Hernia Society, apparently. The data is apparently collected and input to a database by individual doctors or their staff, then made available to anyone that wants to use it. A sample of a questionnaire would be interesting. I think that it is similar to efforts by the AHSQC.

This is from 2012 for ventral hernias. I…[Read more]

Actually William, this is another area that you can separate out for your decision-making process. The surgeon’s own decision-making process. Dr. Koch is apparently a very capable surgeon. But, according to Baris’s story, he made poor decisions.

Just another aspect to consider.

I also enjoyed hearing Dr. Muschaweck’s very logical thoughts on placing a stiff inflexible material in an area of the anatomy that has to be flexible to function properly. Why do that?

Most mesh surgeons will acknowledge that the mesh becomes stiff after it becomes “incorporated”. But they don’t seem to make the connection between the loss of…[Read more]

I can’t speak to anyone’s confidence in statistics. That’s a whole separate issue, personal to the person.

The main thing that I enjoyed about listening to Dr. Muschaweck was her very logical and rational decision-making process. There was no hand-waving about recurrences, or “what-aboutisms” about pure tissue repair pain occurring also. Just…[Read more]

Thanks William. I wonder how Baris is doing? That Topic is four years old. @baris

The whole story looks bad for Dr. Koch.

Here is an old Topic about Biohernia. I think that you had pulled a quote from it recently.

Biohernia – Hernia surgery without mesh

“Don’t let perfect be the enemy of good” is a quote that I hear often.

When looking at any of these techniques or repair options or surgeons I think that the best that you can do is to try to assess the odds, the probability of a desired outcome, and the weight of solving any problems that might happen. For example, Dr. Muschaweck has, if I…[Read more]

Thanks William, I do remember reading that post in the past now that you’ve recalled it.

Could you possibly post the actual link that you copied the post from? It will have the date of the post and the context around it. If you’re on a phone, typically you can choose an option to copy the link then paste it in to a post.

Besides the date and…[Read more]

That was a great interview. Thank you.

p.s. Real Madrid is one of the top teams in European soccer. 6:00 minutes, the comment about the 100 year anniversary of Real Madrid.

Thank you for that interview Dr. Towfigh.

She does not like the Desarda technique. She gives reasons.

@drkang might be interested in Dr. Muschaweck’s views.

She said that she does not remove laparoscopically-placed mesh. Too difficult. So glad I found Dr. Billing.

39 minutes and on gets interesting, re mesh. It starts with “sports hernias” but ends up talking about all hernias. Dr. Towfigh put up written questions about “sports hernias” but was talking about all hernias. Good to see that normal hernias got some discussion.

We need more Dr. Muschaweck’s. She covered just about all of the issues. She…[Read more]

Dr. Towfigh posted the Youtube link already, at the top of the page. I have not watched the whole thing. Over an hour.

Here’s the link since sometimes the “pinned” stuff at the top is not obvious when it changes.

It would be interesting to compare your surgeon’s notes with the Consensus Method. There might be a clue there. At the least it might offer a distraction from the pain.

Here is your other Topic where you originally discussed the problem. It looks like you had what is known as a “pantaloon”…[Read more]