Good intentions
@good-intentions
Active 1 day, 15 hours ago-
Good intentions started the topic Patient-reported rates of chronic pain and recurrence after groin hernia repair in the forum Hernia Discussion 1 week, 5 days ago
With the recent discussion about pain rates and the findings of the very small 280 patient study I took a look around and came across an interesting paper from 2017 about a very large study using data from a very large database. The introduction is flawed in that it uses a flawed document, the International “Guidelines”, to state that mesh is a…[Read more]
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Good intentions replied to the topic High rates of pain with pure tissue repair? in the forum Hernia Discussion 1 week, 6 days ago
Without reading the full paper and seeing how they performed the surgeries, and defined pain, and queried the patients, there’s not much value in the summary. The summary is not clear, and for some odd reason, a different primary author led the effort to rewrite and republish the study results. The link to the 2007 paper contains the full…[Read more]
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Good intentions replied to the topic High rates of pain with pure tissue repair? in the forum Hernia Discussion 1 week, 6 days ago
For what it’s worth, Dr. Billing uses the TAPP mesh implantation procedure for his hernia repairs. At least he did when I talked to him. I can’t remember the type of mesh but I think he used the procedure taught at the Mayo Clinic when he was there as a resident. Smaller well-placed pieces of mesh, only covering the defect. Not the large…[Read more]
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Good intentions replied to the topic High rates of pain with pure tissue repair? in the forum Hernia Discussion 1 week, 6 days ago
Here is the 2007 paper again. It has more detail, and a different author line-up.
https://academic.oup.com/bjs/article/94/5/562/6142702
Long-term results of a randomized clinical trial of Shouldice, Lichtenstein and transabdominal preperitoneal hernia repairs
M Butters, J Redecke, J Köninger
British Journal of Surgery, Volume 94, Issue 5, May…[Read more] -
Good intentions replied to the topic High rates of pain with pure tissue repair? in the forum Hernia Discussion 1 week, 6 days ago
Was it modified Shouldice or the Shouldice Hospital method of Shouldice? Polypropylene or SS or absorbable sutures? What type of hernias were repaired? How many recurrences were there?
The 2nd to last statement in the summary is odd. Lichtenstein is a mesh procedure. They changed the verbiage to postoperative complaints. Not clear why.
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Good intentions replied to the topic High rates of pain with pure tissue repair? in the forum Hernia Discussion 1 week, 6 days ago
When you guys are researching pain and chronic pain and discomfort you should try to differentiate static pain from dynamic pain. My discomfort from mesh was mostly static. Sitting in a chair, like a person would do to work on a computer, was not tolerable. I actually progressed from an office chair, to a straight-backed dining table chair, to…[Read more]
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Good intentions replied to the topic Big picture – Litigation – Perfix plug in the forum Hernia Discussion 1 week, 6 days ago
Delay, delay, delay seems to be the current state of the Bard litigation. New motions made by lawyers who know that they will be rejected. Expectations of a settlement were proposed as the reason for the delay to May, now the trial has been delayed to October of 2023. This major healthcare problem has become a purely financial and legal…[Read more]
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Good intentions replied to the topic Best surgeon to fix recurring hernia after mesh removal? in the forum Hernia Discussion 2 weeks, 5 days ago
My first inclination to go with Dr. Kang is based on the interactions over the years on this forum. You really should just search his name and go back to the early posts on the forum and follow them up to today. He started his career in hernia repair as a patch and plug mesh practitioner. He saw the damage that the plug caused as patients…[Read more]
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Good intentions replied to the topic Dr. Kang – 1 Year update – Direct Hernia repair in the forum Hernia Discussion 2 weeks, 6 days ago
It would be very interesting to know what she considers “trouble”, and how she could differentiate your hernia from others. Does she have a belief that she can predict “trouble” with a patient based on the type of hernia repair performed?
I doubt that the trouble she referred to was chronic pain. The vast majority of attempts to define an…[Read more]
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Good intentions replied to the topic Dr. Kang – 1 Year update – Direct Hernia repair in the forum Hernia Discussion 2 weeks, 6 days ago
One often cited factor to consider when choosing a surgeon is experience. I am certain that Dr. Kang has much more experience in pure tissue repairs than Dr. Towfigh does.
The text on the web page does not describe what a patient who is a good candidate for pure tissue repair would look like. I think that if a person went to Dr. Towfigh with a…[Read more]
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Good intentions replied to the topic Dr. Kang – 1 Year update – Direct Hernia repair in the forum Hernia Discussion 2 weeks, 6 days ago
@drkang might work. Or you can go directly to the Gibbeum hospital web site.
Stephen Kwon is the contact person for travelers. His email address is at the bottom of the web page. I copied it from there.
http://gibbeum.com/abroad/From-abroad.php
Dr. Towfigh is a proponent of lap TEP mesh implantation. And, I believe,…[Read more]
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Good intentions started the topic American Hernia Society Mesh Advisory Statement in the forum Hernia Discussion 3 weeks ago
I just came across the AHS Mesh Advisory Statement. Pretty fascinating that they felt the need to create a statement, and also fascinating how worthless it is in providing any useful information to the patient. A carefully crafted statement with no value except to show that the AHS is aware that there are problems.
Odd that I haven’t seen it…[Read more]
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Good intentions replied to the topic The European Hernia Society's relationship with major medical device makers in the forum Hernia Discussion 3 weeks ago
Why would everything in the Library of the EHS be for members only?
https://europeanherniasociety.eu/category/video/
Here is what they provide for patients that happen to find the site. Embarrassing to watch. (Beside the word patient being…[Read more]
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Good intentions replied to the topic Can we mention the Germans? in the forum Hernia Discussion 3 weeks ago
If you scroll down to the German Hernia society on the EHS chapters page and open the + button you’ll see some familiar names. Kockerling, Conze, Lorenz. I think that William might be right to focus on what’s happening in Germany. They don’t seem as tied to mesh as the EHS is. The EHS started the push to mesh and is fully invested in promoting…[Read more]
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Good intentions replied to the topic Can we mention the Germans? in the forum Hernia Discussion 3 weeks ago
Here is more from Dr. Wiese’s bio.
https://www.chirurgie-hessen.de/Martin+G.+Wiese
“Since my training in the clinics of the Main-Taunus-Kreis Bad Soden under Professor Peter Wendling, I have increasingly dealt with the topic of hernias, i.e. soft tissue fractures, in addition to general surgery. Since then I have helped to develop new procedures…[Read more]
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Good intentions replied to the topic Can we mention the Germans? in the forum Hernia Discussion 3 weeks ago
I got back on to Dr. Wiese’s practice web page to see what types of procedures he performs. It looks like he has the ability to do several and chooses the one that he feels will give the best results. In another current thread there is much discussion about how surgeons tend to be “one-trick ponies”, only performing a single type of hernia…[Read more]
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Good intentions replied to the topic Can we mention the Germans? in the forum Hernia Discussion 3 weeks, 1 day ago
Thanks for posting your story Freeman. It is great that you had a good result and know some of the details of the method.
I found a link to Dr. Wiese’s profile on the internet. It is in German but anybody can use Google to translate it.
https://www.chirurgie-hessen.de/
Also, the jameda link…[Read more]
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Good intentions started the topic Mesh-based inguinal hernia repairs…a cohort study of 110,808 patients in the forum Hernia Discussion 3 weeks, 1 day ago
Here is a new paper with an interesting new angle to it. It originates from a huge healthcare corporation, Kaiser Permanente. Apparently they have a “Medical Device Surveillance & Assessment” department. You can see the very narrow focus on reoperation, with no mention, at least in the short summary, of quality of life.
Three of the five…[Read more]
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Good intentions replied to the topic Patterns of recurrence associated with specific types of inguinal hernia repair in the forum Hernia Discussion 3 weeks, 1 day ago
How do you know that guy knew what he was talking about?” He’s just one guy. There was probably another guy right down the hallway that would have a completely different opinion.
The guy said that they were “seeing new chronic pain cases on a weekly basis”? What does that mean? How new, like one week old, or one year since surgery? How does…[Read more]
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Good intentions replied to the topic Herniasurge – what happened to it? No updates, no contact points in the forum Hernia Discussion 3 weeks, 1 day ago
Four months in to 2023 and still no sign of updated Guidelines. And the link to the newsletter does not work anymore.
EHS seems to have revised their web site. Some material that you’d think would be free is members only.
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