Good intentions

@good-intentions thanks for your replay and thoughts.

I know tho in open mesh removal nerves have to be cut as well to eliminate the risk of chronic pain.

There isn’t a lot of information about open mesh removal on the web and seems to be true for this forum as well.

Any other information about open mesh removal would be greatly apriciated!

@good-intentions yes, I had Lichtenstein repair with the progrip mesh, no plug and patch was used.

Maybe I didn’t ask my question clear enough.

I wonder if it’s easier/safer to remove mesh that is in the inguinal ligament(Lichtenstein) than if the mesh is in the extra-peritoneal(TEP) or peritoneal cavity(TAPP) since well-known Drs. remove mesh…[Read more]

@good-intentions

I read the full paper. I think the most controversial aspect of the procedure as they do there is completely cutting the cremaster and the genital nerve branch. Most surgeons outside the Shouldice Hospital don’t do this.

It’s interesting that there’s some disagreement on this within the Shouldice Hospital as well. The paper…[Read more]

@good-intentions

This confusion of cause and effect (as well as correlation and causation) is really disturbing to see. How can it be one thing in the abstract, and then the opposite in the conclusion? Some sort of circular logic?

This kind of vague ammunition for dismissing patients with chronic pain after groin surgery is likely to be abused.…[Read more]

@good-intentions

Yes, that’s an interesting approach for indirect hernias. Much less problematic than mesh or tissue repair when it works. However, I think I passed the age where it would apply.

It’s laparoscopic high ligation of the hernia sac which should work fine if the internal ring tightens by itself after the hernia sac is removed. That…[Read more]

@good-intentions

The only other muscle there is the dartos muscle, and it is innervated by the same nerve that’s cut (the genital branch).

Maybe the muscles on the intact side have some residual effect on the operated side.

@good-intentions good point. Scholar.Google.com is an excellent resource of peer reviewed articles.

Best advice by @good-intentions.

@good-intentions thanks for the link…if I understood correctly there is an ongoing effort to reduce the risk of infection, both for absorbable as well as non absorbable meshes, which is a good thing.

I had the impression though that the main criticism against absorbable meshes was that the recurrence rate was too high, and/or it caused too…[Read more]

I agree with @good-intentions, set the limit (minimum that is) of what you want to be able to do in life: if you cannot achieve it, then surgery may be warranted…(this is what will push me to get surgery actually)

I would also consider exercising as an option first, this may not fix your problems but might improve your body and mind, which is…[Read more]

@good-intentions

Yes, with Dr. Heniford.

Here is the link to the video

and the relevant bit is after 43:30 more or less….it seems as though Dr. Heniford is in favour of absorbable meshes, whereas Dr. Towfigh has reservations…

It is mentioned in the video above that synthetic absorbable meshes…[Read more]

Yes, hello, @good-intentions. Good to see you active, for we can all benefit. Speaking of conflating something, please re-read your posts for an example. 🙂 As to the matter directly, you misspeak when you make these two false claims:
“Dr. Ramshaw is just an example of how a person seeking [1] a simple hernia repair can end up with [2] a doctor…[Read more]

@good-intentions I agree 100% with your post!

I wonder whether in the future genetic engineering of the problematic tissue might provide the ultimate cure to the problem…whether this will happen or not, the PT component will never go away i.e. one should always exercise the body, whether with or without an hernia, or after an hernia fix…
and…[Read more]

@spinotza Just so I understand, do you have any pain because of your hernia? Is running the one thing in life that makes a difference for you? If the answer to both questions is no, then I would totally agree with @good-intentions ….

What a great post! Thanks for this @good-intentions

@pinto @good-intentions

Thank you both for your kind responses and follow up. I’m sorry I didn’t respond to either of you sooner. I’d just like to summarise what you’ve said, based on your replies:

1. While (possibly) an extreme measure, going to a surgeon who does pure tissue repairs (such as Dr. Kang/Brown/colleagues) is a good step to…[Read more]

@good-intentions – just sent you a PM regarding your healing trajectory

@good-intentions
Dear Good Intentions.
I agree. If you review the papers from the shouldice clinic, they do not report any chronic pain after hernia repair. In my experience, if the patient does not have chronic pain before surgery, then there is no chronic pain after a pure tissue repair. There are no articles in the literature that report…[Read more]

@good-intentions

I agree with James.
I have not used mesh to repair an inguinal hernia in 20 years and I have been very happy with the results.
Regards.
Bill Brown MD

Brilliant example. It’s like the fox speaking for the hens. 😀 😀 From the start he clearly puts himself in the ring of mesh proponents, which makes me wonder why in the world does this conference choose a mesh provider to give us the state of the art for tissue repair??? (He stated he was invited to speak on the topic.) Oh but he states he does t…[Read more]