Good intentions
Forum Replies Created
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“inguinal hernia repair” is a very broad and undefined term. Many surgeons, apparently, according to various descriptions of technique, routinely perform neurectomies, of varying degree, during hernia repair. This would probably cause numbness in certain areas.
There is so much variation in the field of hernia repair that without asking specific questions of each surgeon you just don’t know what you will be getting.
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Was the mesh implanted laparoscopically? Consider Dr. Peter Billing or Dr. Shirin Towfigh. Both are experts in laparoscopy and will remove mesh, and that’s how it should be removed if ti was placed that way.
Mesh removal recovery is generally a long drawn out process. Much tissue damage is done during implantation and while the mesh is in there, and removing it does more. But, the positive is that after removal the path is constantly upward, although slow and bumpy.
Good luck.
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quote mattl:I was told that its not possible prior to surgery… I assume this is not true?
My hernia was obviously a direct hernia. There is a bump in a certain spot and the sensations are specific to a direct hernia.
I think that what your doctor might have really meant, and what kaspa was implying, was that “it doesn’t matter” for mesh implantation. The mesh implantation is the same for many different types of hernia. That is why it is popular, it’s a “one method fits all” procedure, a lowest common denominator type of procedure, which can be learned and applied in an assembly-line type of fashion.
That is if he is talking about laparoscopic mesh implantation. You need to get more details about what is planned. I assume that your next step is referral to a “specialist”? The specialist should be able to tell you what type of hernia you have, and describe in detail his/her surgical method and materials.
Just be aware that today’s “standard of care” is to go directly to laparoscopc mesh implantation, for a wide range of hernia types. Odds are that that is what will be recommended for you, and that there will be pressure to schedule surgery as soon as possible. Wait and learn if you can.
Good luck.
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[USER=”2804″]pinto[/USER] I misunderstood the point of your first post. I apologize.
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The acronyms can be undefined. Most of them refer to placement of the mesh. IPOM is, apparently, still an “intra-abdominal” laparoscopy method, as opposed to TEP which stays between the peritoneum and fascia, never entering the abdominal cavity. The work is done inside the abdomen.
So, adhesions are one possibility for pain. That’s the main reason for the coating on the mesh. Also see where the sutures are placed. We just had a short discussion about tension in another topic. If he mesh shrinks the sutures on the corners get pulled, along with the tacks. That seems like potential for discomfort.
This video seems informative. I assume that there are variations, of course.
https://www.youtube.com/watch?v=I_kSyqdpROE
[USER=”2871″]Runner123[/USER]
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Actually, without the report you don’t know how big the piece of mesh was.or where exactly it was placed.
The entry point does not determine placement with TAPP or TEP. And the initial reason for the surgery does not determine the final result. If your surgeon saw an inguinal hernia he/she might have “fixed” it without your knowledge. He/she might have dissected the peritoneum back the point where you’re feeling pain to make room for the umbilical mesh.
I would not assume anything. Get as much information as you can and let the facts determine what’s happening.
Good luck.
[USER=”2871″]Runner123[/USER]
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[USER=”2871″]Runner123[/USER] notifying, forgot.
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quote Runner123:[USER=”2029″] I just had an umbilical repaired a couple of months back that I’m having minor problems with.
That is an important disclosure. Do you know how the umbilical hernia was repaired? It is often repaired with mesh. Mesh is rapidly becoming the “do-all” repair method for all sorts of abdominal problems. Since the mesh and tissue contacting it contract, a mesh repair can often cause new problems.
Get the details of your first repair to see what was done. It will also play a part in the repair of your new hernia if you have one. It will affect the types of repair that are possible.
I’m sorry that you are in this situation. You’ll want to become very educated in what was done to you and what might be happening.
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[USER=”2871″]Runner123[/USER] notifying
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Hello Runner. Have you had a physical examination by a doctor? I can almost guarantee that that will be suggested. It could be the start of a “normal” hernia, impacting a nerve. If you have insurance and/or can afford it you should start with your doctor, or maybe go directly to a hernia specialist.
Your screen name choice implies that you might be athletic. Does the pain get better or worse with physical activity? If it gets worse that’s a sign of athletic pubalgia, AKA sports hernia. If it gets better but hurts the next day, that might be a normal hernia starting.
The details will help but you might have to get imaging to be sure.
Post your general location and people might have a recommendation for a doctor close to you. Choosing the right doctor is important.
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Certain words and/or terms seem to trigger the filter. If you think it might trigger it’s best to copy it and change some words if ti does get triggered. Or write your comments in Word or Wordpad and copy them over.
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quote pinto:Seems you both are barking up the wrong tree. ‘Tension‘ here is neither shrinkage nor tissue rejection. By definition suture repair involves tension because it stretches the IH membrane together to patch the IH gap or hole. Because mesh repair instead ‘covers‘ not stretches the membrane, mesh repair is hailed as tension-free. If suture repair also can do that then its the biggest story ever–and begs to be told.quote Good intentions:“Tension-free” is meant to refer to sutures not pulling through tissue, I believe. So, a surgeon that takes care to evenly distribute the sutures and layers the tissue so that it attaches to itself, could end up “tension-free” after healing occurs, I’d guess.
I think that my words said just that, if you look a little deeper. You can’t pull through the tissue without tension. Pulling is tension.
If you want to criticize Dr. Kang’s claims you should just do so directly. Not really clear what you’re trying to accomplish. We made some good comments about what “tension ” is, or means, by definition of the word tension. Neither of us is barking up a tree, just responding to your remarks.
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Another article about lack of oversight from trusted governmental agencies. It’s just the state of government in the USA today. All under the same umbrella. Not just the current administration either, a slow degradation over many years.
https://www.nytimes.com/2019/07/27/business/boeing-737-max-faa.html
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quote Ben999:I’m surprised Dr. Conze hasn’t been mentioned yet. He’s absolutetly amazing, removed my bilayer mesh and did a Shouldice repair. He does use mesh in some cases, but only if it’s called for.
https://www.hernia-centre.com/How are you doing now? Is there a link to your story. I can’t keep up with everyone.
Forest is on the path to mesh. Can’t see the forest for the trees seems to apply, he has a surgeon who plans to use one of the uncommon meshes, apparently, “hybrid mesh–disappearing, with some small kevlar weaved into it”, so no verifiable data just the surgeon’s confidence to depend on. He’s also using the latest tools, “robotic, laporascopic surgery”, which means large pieces of mesh implanted.
So, on the one hand we have the “Guidelines” which imply a verifiable proven method and materials, and on the other hand we have an unproven material and new tools to get the mesh in. Regardless, all of these things are used to justify the use of mesh, when the most important thing, chronic pain, is ignored. Sales and marketing are winning.
https://www.herniatalk.com/12329-patulous-bilateral-inguinal-canals-containing-fat
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The more broad-based discussions are where you can find the truth about the situation. The surgeons just “don’t know” the levels of chronic pain that they are creating. They are becoming more like mechanics or automatons, just following the installation instructions and moving the patient along. It really is a travesty and part of a bigger problem with medical care, worldwide.
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quote kaspa:When will my post flagged as spam be revised and published?
It might not. Dr. Towfigh has to have the time to look at it and release it if she decides to.
[USER=”935″]drtowfigh[/USER]
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quote Forest:The surgeon is planning to use a hybrid mesh–disappearing, with some small kevlar weaved into it. I cannot find anything more online about this type of mesh.
All my research indicates that the surgeon’s skill is the most important part of the hernia surgery, and there is no way to truly find out how good the surgeon is…only indicators by # of surgeries performed and other doctors recommendations. My umbilical is small and will be sutured.
I just don’t see how suturing the inguinals would be better. Sutures tend to fail more than mesh.
Why would he need an experimental mesh if today’s products are perfected and your problem is simple?
The issue is chronic pain, not recurrence. Your research has misled you, it is biased. Chronic pain is the main problem with mesh repairs.
Good luck. Please stay in touch over the coming years.
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“Marketing” is interwoven through everything we do these days. Selling.
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[USER=”2931″]Kablooey[/USER]
[USER=”2941″]texan[/USER] -
Kablooey, could you describe your experience at Gibbeum Hospital, from start to finish? Traveling overseas is very daunting for most people. How you chose air travel, getting through customs, the need for a passport, etc. Many people in the States don’t have passports and only get them when they need to go out of country.
Texan. your story will help also. Real world details of the experience help people plan their own travels.
Thanks for sharing.