[Jeremy B]

Thank you DrEarle, I was told that having the absorbable suture might add a 1-2% as far as recurrence rate.
Do you have experience with using absorbable sutures in a hernia repair?

Regards,
Jeremy

[Jeremy B]

Dog, I just added to my post after Shouldice. Im doing alot better.

[Jeremy B]

A ~2 month update on my progress after Shouldice (w/absorbable suture) with Dr. Grischkan in Ohio…

Swelling has reduced to a very minimally raised Inguinal ligament with what feels a pencil girth of scar tissue around the incision site. (The swelling started out nearly hamster size)
Pain is now almost non-existent with intercorse having a slight odd pulling feeling but nothing major at all.
Flexibility is fine; However I have not attempted any yoga or any major stretches yet.
I walk completely normal now and climb stairs with authority. I have snowboarded and x-country skied a few times successfully with only a few moments of very minimal discomfort.
Overall it is a huge relief from what I experienced post-op, and It is definitely better than having to manage a hernia with a truss and walking on eggshells.
I hope my journey can bring some clarity on what one might expect from a primary open shouldice procedure performed by an expert.

Regards,
Jeremy

[Jeremy B]

Thank you for sharing paco. Who performed your surgery? And have they used absorbable before during shouldice?
I’m a little worried If my repair will hold once the sutures are absorbed.

[Jeremy B]

Thanks for sharing paco. Who performed your surgery? Have they done Shouldice before with Absorbable?
I’m a little worried now about recurrence once the sutures are absorbed.

Regards,
Jeremy

[Jeremy B]

Hello all, below is my progress ~1 month post-surgery:
The swelling has decreased to about half.
There is still a very hard lump around the incision site, deeper than skin level.
Numbness still remains from the Incision to the base of my package.
Walking and general movement has become less painful, I even went snowboarding with no issues.
I hope the healing continues and can get to a point where I’m glad to have had it done.

Dog, in response to your message; Dr. Grischkan only performs Shouldice.
I researched all methods and watched loads of surgeries to come to my conclusion on choosing this method and surgeon. Was It a good choice? Time will tell; I’m about a month in and the negative issues vs positive is about the same as If I still had the hernia, just different. The major positive thing is not having to worry if my hernia is out or not and constantly checking myself down there (what a nightmare for years). The negative issues are a hard lump, numbness, minor pain which will all hopefully diminish with time.

Why I chose Shouldice and not Desarda.
Desarda method seems to alter the anatomy more than Shouldice; It incorporates a strip of external oblique and moves it down to the deepest fascia layer. Shouldice seems to repair the issue directly by suturing the facia back together. My thinking is that your anatomy is closer to how it was before the hernia existed once tissues have remodeled. With Desarda you’re always going to have a piece of external oblique sewn down into a deeper layer rendering your anatomy vastly different from original. Shouldice also has an extensive track record regarding recurrence and chronic pain. I couldn’t find enough information on Desarda other than Dr. Desarda himself promoting this method. I guess what is important is that the repair will hold and not feel strange or painful long term.

Regards,
Jeremy

[Jeremy B]

GI, I did get the Operative Report; I made Dr. Grischkan very aware I would not accept any mesh and reminded him the day of surgery.
One thing that was odd about the report is that it states that:
“Shouldice repair was fashioned with 2-0 PDS in the usual manner with four runs.”
Maybe I got the standard sholdice?, I guess it doesn’t really matter at this point.

another thing that concerns me from the report is a statement: “There was excessive inflammation and friability of the tissues.”
Does this indicate an underlying Issue?
Is Friability secondary to Inflammation?

Regards,
Jeremy

[Jeremy B]

Hello all, It has been three weeks since I had a Shouldice operation with absorbable sutures performed by Dr. Grischkan.

Recap: 37yo 170lb 6′ 2″ athletic male; barely noticeable hernia for a couple of years that was painless.
During the last year I managed it with a truss.

Update:
The area is still very swollen, Id say unchanged;
Pain is slightly more tolerable and comes and goes in waves.
I am a bit more mobile and am forcing myself to walk at a normal pace.
The incision has wept a little bit the last two mornings after showering.

This is very frustrating, however; I am getting slightly used to the suck of it all.
I hope you all have a good holiday, I’ll post more in the coming days.

Cheers,
Jeremy

[Jeremy B]

The swelling remains unchanged unfortunately.
I requested the operative Report from Dr. Grischkan that states: There was extensive inflammation and friability of the tissues.
Friability? Does this mean my titues were weak and crumbling in his hands?
Also the Report states that this was an Indirect hernia; I had an ultrasound performed in my home state of Minnesota and I was diagnosed with a Direct hernia.
The reason I went to Dr Grischkan was that I concluded that a Shouldice repair would work well for a direct hernia.
Had I been properly diagnosed initially with an Indirect hernia, I would have gone to Dr. Brown to have a simple Marcy repair performed with less trauma and reconstruction.

[Jeremy B]

I just had Surgery with Dr. Grischkan, in Ohio. He will perform the first two layers of shouldice, and PDS absorbable suture upon request.
I am exactly two weeks post op and still have considerable swelling/pain that has not relented. It’s too early for me to tell If the procedure was successful since the swelling is very large.

Regards,
Jeremy

[Jeremy B]

Thanks for the encouraging words Baris; I think you’re right and I need to give it time.
Did the letter from shouldice state that it is a Seroma formation? I just want to know what I’m dealing with here.
I snowboard at an elite level and just want to get this thing reduced so I can start training this year.

Thank you all for supporting.
This forum is a huge help to many.

Regards,
Jeremy

[Jeremy B]

Chaunce1234, It does seem like it could be a Seroma, It looks like warm packs might help.
I wonder if there is a chance something was left behind in there.
Thanks for the suggestion on cold laser dog; I’ll look into it.
I did have to travel; Drove from Minneapolis to Beachwood, Ohio (~12hrs).
Very frustrated to say the least.
regards,
Jeremy

[Jeremy B]

dog, drtowfigh; I sent the photo to my surgeon, Dr. Grischkan of ohio and his response was: “Looks fine from this view. Just give more time-keep active”
So I guess I’ll just ride it out for now since there does not seem to be an infection. I have started taking advice from Dr. Towfigh and starting to massage the swollen area. Its just so damn uncomfortable and painful; Muscles/skin seem tightly wrapped over this hump making walking difficult. I wonder what it could be, blood hardening up in there? It couldn’t be scar tissue could it? It would be great to see even a slight improvement.

Regards,
Jeremy

[Jeremy B]

Thanks for the input Baris, it’s not hot or red in the area from what I see. I still have the tape on the incision. I’ll send this photo off to Dr. Grischkan to see if it’s concerning.

Regards,
Jeremy

[Jeremy B]

Drtowfigh, Is this the “Healing Ridge” ??
I took this picture today (10 Days post op)

[Jeremy B]

Thank you Drtowfigh, Is there anything else I can do to reduce the swelling? It’s literaly looks like a hamster has been sewen onto the inguinal ligament. Ibuprofen is not touching it.
Baris, to your reply; I had Dr. Grischkan make the repair.

Regards,
Jeremy

[Jeremy B]

Paco, thank you for sharing, looks like its healing well. I still have the surgical tape on mine, It’ll be interesting to see how it looks.
I’m with you on the muscular pain, I have it along most of my front side up to my lower ribs with bruising. I think all the muscles are upset that they were cut through. that’s a relief to me that you also received absorbable sutures, I almost felt like I was an experiment receiving absorbable and maybe we are; were all of your sutures absorbable?

Regards,
Jeremy

[Jeremy B]

Thank you for the response Good intentions. It certainly is in its infancy, in which the most of the changes are occurring.
I guess one of my main concerns is losing blood supply to my right testicle as It is somewhat painful and surrounded by what I suspect is hardening fluid.
I was also expecting to see some improvement in the swelling along the inguinal ligament by now. It’s seriously swollen to the size of a rodent in there.
This anxiety is heightened by the fact that the surgeon told me the pain would sharply decrease in 3 days along with the swelling.
I guess I have to ride it out and deal with the pain and swelling until it fades. I’ll definitely keep you all posted on any changes.

[Jeremy B]

Thanks Chaunce, Yea; If the numbers are correct that is a huge volume of repairs. he normally uses a polybutester suture but will do PDS upon patient request.
I personally don’t want any remaining foreign body if I can avoid it, he also said that he almost always uses PDS in female patients.
I wish there was a Surgeon or Patient on here that has had some experience with him. Most of the reviews I have found are glowing.

[Jeremy B]

I am in the same boat; live in Minnesota, even checked with Mayo clinic, all mesh. I think Grischkan in OH is probably the closest non mesh hernia specialist. I wish someone here could speak to Grischkans results.