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Jack thanks for providing more light and less smoke to this forum. I agree with you that keeping it simple is often the optimal way. Occam’s razor. The medical device industry is strong and well established. When you go to a doctor it is routine to have mesh prescribed as the cure for your hernia. The honorable Dr. Kang is one of the few pure tissue surgeons left. I also hope the honorable Dr. Kang or some other master of the pure tissue technique make their services available in the future. There is significant push back against pure tissue repairs ranging from folks akin to internet shills on down to the more common useful idiot. People get what they tolerate. With all the pain, repeat surgeries, chronic pain management, etc. maybe people will opt for the less invasive option. Money talks.

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Pinto, I think sensei is right about your unique personality characteristic. I do understand your protection and allegiance to Dr. Kang however. I think that is a productive and positive response especially when so many things can go wrong with hernia surgery. Like you I got a good outcome from Dr. Brown (although I didn’t have a recurrence like you did and everything held up from day one). Having experienced bad healthcare results from other procedures in my life and then the exemplary success I experienced with Dr. Brown I understand your emotionality. Your protective nature towards Dr. Kang is very well warranted and a break from all the gloom and doom rhetoric. Unlike you I don’t like to engage in walls of text with random forum members. I’m less into the minutia and more big picture orientated. Less into the “white papers” and more into positive personal results. So here I must step off the Karpman Drama Triangle with you and bid you farewell. Find another source of positive or negative attention. Just cast another lure and I’m sure you’ll get another bite in no time. Good luck.

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I had a successful hernia repair by Dr. William Brown (now retired). It is basically what Dr. Kang is still doing now (until he eventually retires). In the interest of brevity and because I don’t like repeating myself I’ll cut and paste my comment from a previous post:

For what it’s worth I had a no mesh, nor a Shouldice (described by some as a “sushi roll wrapped up with a guitar string”) repair done by Dr. Brown (basically what Dr. Kang does) several years ago. Pure tissue (no mesh) repairs can differ greatly. I’ve had no pain to speak of and didn’t need to take any pain medication. I’ve had no problems and work out (extensively) six days a week while working over 40 hours a week at a traditional job. I’ll be 70 years old in the not to distant future. Like I’ve said before, there are solutions to problems. Everything isn’t all gloom and doom. That is not to discount or negate that there is a lot of self serving and potentially questionable products and services marketed to the consumer however. “It’s nothing personal, it’s only business”. Cress selling, upselling, all kinds of marketing. Caveat emptor.

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Hi Anonymous. I had a pure tissue (no mesh) hernia repair by the esteemed and talented Dr. William Brown (now retired) about three years ago. He commented directly after surgery that everything went well and that I had excellent tissue quality. I’ve had no problems with the repair and function very well once again thanks to the good doctor. I’m nearly 70 years old now and I’ve been an exercise and nutrition adherent for years. I ate right, supplemented with bone broth and occasionally gelatin for the supposed collagen benefits. I also went from a high of 233 lbs. to 136 lbs. on the day of surgery so Dr. Brown would be able to work on a “low body fat” patient to see the nerves better, etc. I don’t know if collagen supplementation is a panacea or not but I do believe the patient is as responsible as the doctor in the outcome when it comes to giving the doctor something to work with. Too many people (myself included in the past) plop themselves down in front of a healthcare professional and say “fix me”. In my experience that isn’t the optimal approach.

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It appears as if all the hernia surgeons, that do no mesh hernia repair, thus far listed do not take insurance. I’ve noticed this business model appearing to be much more prevalent, particularity after the pandemic. Dog I believe you would have significantly more options and better access to a no mesh repair if you would reconsider “paying out of pocket”. It seems to be part of the new normal nowadays. All the best to you and good luck.

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Hi dog. First off I want to thank you for recommending Dr. Brown after your hernia repair. I followed your lead and had my hernia repaired by him shortly before he retired. It was the best medical experience I ever had and everything went well. Like you my repair has held up very well and I workout with weights and run like I did previously. Dr. Brown and his wonderful staff gave me back my life. There aren’t many non mesh repair surgeons left. If I ever had another hernia I would check out Dr. Peterson in Las Vegas NV. He’s been doing no mesh pure tissue repairs for a longtime. All the best to you dog. Keep us posted.

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What I find fascinating isn’t whether mesh or non mesh pays more, rather instead why there is a commonality among many pure tissue only surgeons to opt out of the insurance realm altogether. In the case of pure tissue surgeon Dr. Petersen his business is actually named “No Insurance Inc”. In the case of Dr. Kang many posters on this site have mentioned paying “cash” (not using insurance) when being treated by D. Kang. What is the benefit for pure tissue no mesh surgeons like Kang and Petersen to opt out of the managed healthcare insurance system? Does a more managed healthcare system, aka insurance limit ones choices?

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cpk303 Thanks for you excellent explanation of why pure tissue no mesh repairs are so difficult to find in the USA. It would seem that “no insurance” surgeons like Dr. Petersen who does no mesh pure tissue repairs and removes mesh is doing well in Nevada. The two options I gleaned from your excellent post are in order to make a living as a no mesh surgeon you must be high volume like Dr. Kang or no insurance like Dr. Petersen. Maybe more creative and/or altruistic surgeons who want to practice the “ancient art” of no mesh pure tissue repair can get some inspiration from your post. I would miss having the ability to choose in my healthcare decisions, although those caught up in the managed healthcare system already have to some extent.

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cpk303 Congratulations! I’m glad you went with a pure tissue no mesh repair. I had a pure tissue no mesh repair done by Dr. Brown shortly before he retired. I’m completely satisfied with it and haven’t had any problems. It was good that you got the surgery done before Dr. Kang retired as so few (if any) pure tissue specialists are left. It was refreshing to hear about your pure tissue surgery rather than the latest and greatest new and improved mesh product coming soon to a surgery center near you. All the best and have a speedy recovery.

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Good Intentions, business models are an interesting topic for me. So far the mesh, tobacco and breakfast cereal industries have been touched upon. I’d like to add another one that I find fascinating. The light bulb industry, notably the Phoebus Cartel. Apparently in the early 1900s a world wide group of light bulb manufacturers got together to limit the amount of time light bulbs would last. Interestingly there is still a light bulb that is in operation at a bay area fire department that was made before the light bulb cartel was established. It was produced about one hundred years ago. Planned obsolescence. the next “new” and “improved” thing, etc. seems to have been useful in increasing profits for a very long time. It’s just a part of doing business. I’ll try to add a link.
https://en.wikipedia.org/wiki/Phoebus_cartel

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Watchful it’s interesting that you point out Dr. Kang is the last one doing Marcy like pure tissue repairs. He will retire as all doctors do. When? Who knows. Then according to your observation no one will be doing them. It seems the unwitting consumer has brought this unfortunate demise upon themselves. This lack of choice. It reminds me of a Native American proverb. When asked which wolf would overcome the other wolf, the elder responded the one you feed will prevail. It will get stronger and win. By choosing, or letting our doctors choose mesh for us we have in essence “fed” one wolf while “starving” the pure tissue no mesh wolf. One is big and string and the other is withering away. It’s interesting how that works.

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Watchful my hernia was rather large and getting larger every day. I would attribute that from continuing to workout and run along with waiting. I needed to wait years to get on Medicare and off my employer provided healthcare. With Medicare I could pick my own doctor, a no mesh doctor like Dr. Brown.

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ajm222 I remember Dr. Brown saying the sutures would dissolve. That was about three years ago. I’m almost seventy years old now. People at the gym think I’m in my fifties. I lift weights and exercise six days a week while working a full time job. On Sunday I walk for about an hour. It’s good to take it easy one day a week. Dr. Brown gave me my life back. I wasn’t going to get a mesh repair and Dr. Brown was strictly a no mesh surgeon. If I could give any advice I would say what worked for me was to ask a power greater than myself for what I wanted. Then I just did the footwork. Over thinking it (“paralysis by analysis”) has turned into trouble for me in the past. As you hear many posters here lament about how they had figured this mesh, or that surgeon, or this or that was the answer only to end up in regret attests to that. All the best to you ajm222

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Watchful I had a Marcy or Marcy type repair, no Desarda. Since I had an indirect inguinal hernia a Marcy repair made the most sense. If I had a direct inguinal hernia a Desarda would be more appropriate. All the best with your recovery Watchful.

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I had pure tissue repair with Dr. Brown before he retired. Part of the protocol with Dr. Brown was taking a recommendation of vitamins and herbs before and after the surgery. If memory serves me right Dr. Brown credited Dr. Towfigh with her expertise and knowledge regarding including these herbs and vitamins. Dr. Brown did an excellent job of repairing my inguinal hernia and I never once had to take any pain medication. I was almost completely pain free from the beginning and released to drive my car back home shortly after. I can’t see why, with limited exceptions, anyone would opt for anything other than a pure tissue repair. And on a side note I personally do not consider Shouldice a “pure tissue” repair, a no mesh repair yes. Since Shouldice uses permanent stainless steel sutures I don’t consider it pure tissue. Dr. Brown used dissolvable sutures. Since I don’t come on here very often I wanted to take this opportunity to thank Good Intentions for his positive work of researching and support for this forum. His efforts and dedication to enlightening others is truly a shining light in the darkness.

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Hi Chuck. I have a few minutes before work so I will try to answer your questions. I went with Dr. Brown as he was well recommended by past patients and a consistent quest speaker and contributor to this forum. He was anti-mesh and did pure tissue repair only. He also was sought after as a mesh removal surgeon. I never had mesh implanted so my chances were significantly better that those who are damaged by implantation/removal then re-repaired. That seems true for any surgeon’s success rate for patients who go through multiple surgeries for the same thing. They eventually seem to run out of healthy tissue. A hernia talk Forum member that went by the name of Dog convinced me by his story to go to Dr. Brown. Dog is long gone now living a good life thanks to Dr. Brown and his wonderful staff. I’m just returning the favor Dog did for me by sharing my story. I have a full and busy life once again so I probably won’t be on here very much. Who knows maybe never. I wish everyone the best in their search for the key that unlocks their hernia prison. Believe me I’ve been there and it wasn’t fun. I’m just here to say there are answers and solutions to every problem. I think Dr. Kang would be a good choice Chuck. The no mesh surgeons are disappearing faster than the rain forests. As the old ones retire few if any apprentices are being trained in the “ancient art” of no mesh repair. Good luck Chuck.

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Hi Watchful. Actually by the size of the hernia and the location of the bulge I thought I had a direct hernia not an indirect. When Dr. Brown diagnosed it as an indirect hernia not a direct I was pleasantly relieved. An indirect is usually easier to fix than a direct. I happily blurted out “a Marcy repair?” and he answered in the affirmative. That is as far as I inquired or got involved in the surgery part of his work. I don’t know if it was a pure, hybrid or last minute change up. All I know is that he and the team did a great job. I’d never experienced a more positive healthcare experience before or since.