• I don’t think a mesh is a good option, but if I had to place one, I’d choose Onstep for sure. There is good experience with this mainly in Portugal and Denmark, even if on a worldwide basis that’s small yet.

  • Tigerpawn and Profile picture of kaspakaspa are now friends 2 days, 16 hours ago

  • Pediatric surgeons are experts in non-mesh indirect hernia surgery. Often, they only ligate hernial sac, but sometimes they do a Marcy repair, if hole is too big. I once thought about hiring a pediatric surgeon. Their patients are mostly babies and children, but they can treat people until they’re 18, and these are physiologically and anatomically…[Read more]

  • @DrBrown can you recommend some expert surgeon in ringplasty in North America and Europe?

  • The problem, Scott, is that then came industry. We have 2 types of inguinal hernias, direct and indirect. It’s my conviction that an indirect hernia could be treated just by sac ligation. You risk missing a direct hernia (10% according to Shouldice statistics) or may have a recurrence that can happen in years or decades, if ever. For direct…[Read more]

  • It’s quite clear that Shouldice is used either for direct or indirect hernia or both.

  • Of course a mesh can be done either way, open included.

  • Problem with BioHernia is that their surgeons do many types of hernia repairs, mesh and non-mesh, laparoscopic and so on, and I’m not sure you can grant you’ll have the repair you want. According to some reports here, sometimes they do a tailored repair, which may mean you’ll come from the operating table with a surprise (see Baris here in forum).…[Read more]

  • @Casimir I understand English is not your native language (neither mine) and it’s hard for me to fully understand what you really mean. I invite you to please write it in your own language and I’ll try to have it translated by Google so that I can help.

  • kaspa replied to the topic muschaweck procedure in the forum Hernia Discussion 1 month ago

    I once considered Muschaweck, but she charges 6,000-7,000€ enough to take the repair anywhere else in the world, and as Dr. Towfigh already said her method isn’t validated outside her clinic.

    Dr. Kang’s (not that expensive) isn’t validated either.

    In a time of “mesh do it better” publishing tissue methods would be of utmost importance for this a…[Read more]

  • kaspa replied to the topic For Direct Treatment Only in the forum Hernia Discussion 1 month ago

    @Casimir If your’ hernia doesn’t bother you too much maybe it’s better to wait and see. I wouldn’t agree though that a non-reducible hernia cannot incarcerate.

    Indirect hernias usually have intestinal contents, not fat…

    About 10% of patients from Shouldice Hospital are doctors. So they take the full repair for direct or indirect hernia.

    If…[Read more]

  • kaspa replied to the topic For Direct Treatment Only in the forum Hernia Discussion 1 month ago

    I said “incarcerated” but should be “strangulated”.

  • kaspa replied to the topic For Direct Treatment Only in the forum Hernia Discussion 1 month ago

    Dr. Kang is perhaps the only doctor doing specific repair for indirect hernia. I don’t think non-reducible hernias aren’t able to be treated by any tissue repair (perhaps you mean incarcerated?).

    Treating your indirect hernia only means you have a small risk, perhaps 10%, you can have a recurrence because of a missing hernia and you’ll need to…[Read more]

  • Chief-surgeon explains that they use mesh to have lower recurrence than “Canadian” operation.

    I don’t understand the interest and wouldn’t recommend that to informed people.

  • According to Shouldice numbers 1991-2001 secondary hernias are not as prevalent as in Obney’s article.

    They repaired 72.228 hernias. Of these 60% were indirect and had 8% occult hernias, 38% were direct and had 25% occult, 1.88% femoral and 70% occult. This makes about 15% on average.

    If you have no complication after hernia repair, I think…[Read more]

  • Shouldice claims that often enough there are occult hernias and these account for a percentage of recurrence. That’s why they explore the whole area, including searching for femoral hernia (here, if present, they apply a mesh almost always). To explore the area completely they must cut a lot of structures and reconstruct them. That’s the…[Read more]

  • To the best of my knowledge Shouldice and Desarda work both for direct or indirect hernias, or both.

    Dr. Kang is an expert in tissue hernia repair and perhaps technically speaking those repairs are more adequate for direct hernias.

    Dr. Kang uses different repairs for each hernia and so he must be aware what’s more perfect for each case.

  • There are very good doctors that can do a tailored approach and you can discuss that in detail beforehand. However, if you’re not lucky a tailored approach may only mean that you leave operating table with a mesh, and that’s all, as I’ve heard in some [dramatic] stories.

  • kaspa replied to the topic No mesh in the forum Hernia Discussion 1 month, 4 weeks ago

    If you want best non-mesh-treatment for your hernia IMHO you should choose Shouldice. Surgeons elsewhere might disagree but a specialized center is always a best option.

    Not that I think it’s funny to spend 4 or 5 days closed there without anything interesting to do. I think smokers can’t even smoke a cigarette. Only some exercising and asking…[Read more]

  • kaspa replied to the topic No mesh in the forum Hernia Discussion 1 month, 4 weeks ago

    It’s not always that easy to distinguish direct from indirect outside operating table, so I’m not too impressed. That’s no big deal and it’s unlikely to make treatment much different.

    I had gastric symptoms long before my hernia appeared and I couldn’t correlate them until I had a hernia and they disappeared when I reduced the hernia. I’m not…[Read more]

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