@good-intentionsActive 24 minutes ago
In 2011 the method was probably very similar to what was done to me in 2014. A single procedure bilateral repair was probably laparoscopic TEP or TAPP. A large cavity is created between the peritoneum and the fascia and two large pieces of mesh are slipped in between. The top of the cavity would be below the navel but pretty close to it. So…[Read more]
Forever seems to be the answer. The research in to the absorbable/resorbable biologic materials is done in the hope that the FBR will destroy/replace the foreign biologic material and replace it with human tissue that is strong enough to function properly.
Good intentions started the topic Shouldice technique shown to be better than mesh – but still not recommended in the forum Hernia Discussion 3 weeks, 2 days ago
I think that I’ve posted this paper before. I just looked through it again and was struck by how the authors seemed afraid to just say directly what their own analysis showed. Instead, they fell back on the old canard that more work needs to be done. I respect the fact they could not twist the data to support the use of mesh but am disappointed…[Read more]
Good intentions replied to the topic best method for curing bilateral hernias and is nausea a hernia symptom? in the forum Hernia Discussion 3 weeks, 4 days ago
I think that mesh is over-used. I think that for the common inguinal hernia a pure tissue repair should be used first. There is no way to undo the results of a mesh implantation, and problems with mesh are not uncommon.
The selling points used today by the surgeons that use mesh are that the results are “about” the same for mesh and pure…[Read more]
That’s a shame Jay. Hope you get through it indecent shape.
Can you share the details of the procedure that was attempted? A surgeon might have some ideas of what to expect.
Good intentions replied to the topic best method for curing bilateral hernias and is nausea a hernia symptom? in the forum Hernia Discussion 3 weeks, 5 days ago
You should just read through the posts on the forum. There is nothing new today that wasn’t the same ten years ago. Your odds of having problems are the same. It will be tempting to think that the stories from many years ago are the past, and that “there’s no way they would not have solved these problems by now”. But that is not the case.…[Read more]
Wow, that is a scary story. What happened? Was it supposed to be a routine hernia repair? Was the orchiectomy part of the plan or the result of an error?
Normally, the function of the penis should not be affected by a hernia repair. The don’t get near any of the critical parts for erection. Your pain medication might be causing problems. If…[Read more]
Good intentions started the topic Of known hernia repair methods, over time – which is best for a typical patient? in the forum Hernia Discussion 1 month ago
I’ve realized that almost every presentation, discussion, or research paper that deals with hernia repair avoids the most fundamental question – what is best for the patient?
They all pick a small sub-topic of the bigger question. Which method gives fewer recurrences? Which method gets the patient back to work soonest? Fixation or no fixation?…[Read more]
Thanks for posting Colin. Parents with children would get great value out of your experience with the Shouldice repair. 20 years, and passage through puberty to adulthood, with no problems is a success. Even many of the mesh proponents in the community of surgeons recommend against mesh for adolescents, but there are probably thousands of kids…[Read more]
Any surgeon who tries to justify the use of mesh based on equivalent chronic pain rates needs to also consider the damage done in relieving the patient of the chronic pain. The damage from mesh removal as compared to whatever methods are used to cure non-mesh repair chronic pain.
Which hernia repair method gives the patient the best odds of a…[Read more]
Here is the abstract of the paper that seems to be the foundation for Dr. Orenstein’s conclusions. Dr. Orenstein is, apparently, a research scientist. This is a very shaky foundation for any conclusions. A single paper put together from databases which do not accurately define or quantify chronic pain.
The work in the paper seems to have…[Read more]
Good intentions started the topic (Law firm presentation) Case Against Prophylactic Mesh – SAGES 2019 in the forum Hernia Discussion 1 month ago
Kudos must be given to the organizers of the 2019 SAGES meeting. Not only did they ask a mesh surgeon to take a look at non-mesh repairs, they allowed a lawyer to present about the flaws in the mesh development process that lead to lawsuits.
For some reason, Dr. Robert Bendavid’s name is on the presentation. Maybe it’s a tribute or maybe…[Read more]
I don’t remember the SAGES youtube page being so well organized and filled with videos. Maybe the pandemic gave them some time to work on it.
Here a link to what seems to be all of the presentations at SAGES 2019. It’s worth browsing through.
Dr. Towfigh has a good one about diagnosing inguinodynia, presentation #102.…[Read more]
Here’s another presentation from the same meeting. Dr. Orenstein is a teacher at OHSU, one of the premier medical universities in the Pacific Northwest. So, the things he is presenting here are probably the things that he is teaching his medical students.
I saw the title and the presenter and was really hoping for more objectivity. But, as you…[Read more]
Good intentions started the topic Current State of Non-Mesh Inguinal Hernia Repairs, SAGES 2019 in the forum Hernia Discussion 1 month ago
I just came across this presentation from the SAGES 2019 meeting, “International Hernia Symposium: Progress Through Collaboration” session.
It is a good review of hernia repair techniques in general, with the goal of comparing mesh repair to non-mesh repair. Watching the video you can feel the pull to supporting mesh repair over non-mesh. He…[Read more]
I was trying to make you aware of the potential problems with any mesh at all. I am saying “avoid mesh if you can”.
If you do choose a mesh repair, make sure that you know the details of the material and the method. It is more complex than just “open” or “robotic”. There is a very wide variety of mesh products that can be implanted, and…[Read more]
The internal conflict, possibly even fear, for Dr. Jacob must be incredible. Here is a video showing a TAPP removal of mesh by Dr. Jacob. The video ends at about 4:30 but the audio continues. There is no follow-up information about how the patient did in the long run. This might partially explain the watchful waiting.
I feel like I am…[Read more]
This would or will be a fascinating story, from a psychological perspective. Dr. Jacob is aware of the damage that mesh can do and the pain that it can cause, as a surgeon who removes mesh. He must also be aware of the general recommendation that watchful waiting is a waste of time, and could be life-threatening due to incarceration. He seems…[Read more]
Take your time and do lots of research. You’re worried about money but if you get a bad result money will be meaningless.
You should just spend time reading the posts on this web forum. Nothing has changed at all over the years since the first post on the site. The materials and methods are the same. There is no special method, or level of skill, that changes the way your body will react to mesh. People that are very physically active seem more susceptible to…[Read more]
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