It would be great to hear if anyone, patient or surgeon, had such a case operated on and what the result was?
Question for the surgeons:
When a patient complains of symptoms such as new onset pain with lifting, but has no exam/ imaging findings to suggest reoccurance, how often is an occult reoccurance found intraoperatively?
Herniahelper replied to the topic Dr. Bruce Ramshaw acknowledges that "mesh" is not perfect. in the forum Hernia Discussion 1 week, 3 days ago
Dr. Ramshaw does not seem to be alone here. Many of the most common names in complex hernia revision/ mesh explantation seem to be moving on to other things.
I imagine its exceeding challenging. The surgeries are tedious, patients already injured/ upset and have unrealistic expectations. Volumes are low along with reimbursement.
Many doctors…[Read more]
[You speak specifically in the case of mesh? Such a “weak spot” is a precursor to hernia or is already formed one?]
Speaking of previously poorly placed mesh. If things get pulled on or torn, there’s still a foreign body reaction and perhaps if babied And I’ve scar tissue may form to stabilize things. It’s just a thought as a mechanism for why…[Read more]
I mean you will need to see somebody in order to get a plan together but in general overall you can probably give it a year and see if it works itself out. Sometimes if you have a weak spot it will scar down. Or if it doesn’t get better or you can’t live with it you’re probably going to be faced with having someone go in again.
If you are able…[Read more]
If you were pain free and now have pain similar to your prior hernia… Illicited by lifting and better when laying flat…
That’s a great story for occult reoccurance. Sometimes I feel there’s enough coverage to prevent clinical reoccurance, but things are weak. Maybe there isn’t enough strength and when strained tissue tears or is pulled on.…[Read more]
Herniahelper replied to the topic Shouldice technique shown to be better than mesh – but still not recommended in the forum Hernia Discussion 3 weeks, 1 day ago
I think the real question is whether many of the next generation of general surgeons should (or even could) be trained how to do a good primary tissue repair as part of their armamentarium?
Even if someone is an excellent candidate for it, it’s just not an option right now it seems.
So many generations have been brought up on mesh based repairs…[Read more]
“The Millikan modified mesh-plug hernioplasty.”
He published a case series in 2003 and again in 2008. Instead of deploying the plug in the traditional manner, the outer leaflets of the plug are deployed through the hernia defect and pulled back like a pre peritoneal patch in the pre peritoneal space. The idea being you get the benefits of a…[Read more]