MarkT

I will reiterate my advice, which mirrors what Dr. Towfigh has also suggested: get imaging done (and you absolutely do not need to fly to Korea for that).

No one thinks you are nuts for choosing Dr. Kang…he seems like a solid choice…what may be a bit nuts is going there without a diagnosis. Imagine how you will feel if you book surgery with…[Read more]

Chuck, I agree 100% with Watchful…don’t put the cart before the horse…diagnosis is the priority.

A hernia can still be palpable if there is no visible bulge…so a physical exam is the first step. If you already had a physical exam that did not find anything, then imaging is the way to go.

Get a dynamic MRI done. It is likely your best…[Read more]

@cdnguy – there might be a thread on here with more detailed info, but if you tag stephen or drkang (just put the ‘@’ in front of those usernames), you will probably get a response from Stephen.

Stephen works with Dr. Kang and helps with non-Korean patients…I think he is translating Dr. Kang’s work into English too.

@cdnguy – there is some info on the hospital’s site:

http://gibbeum.com/whykr/Why-and-What-Kang-Repair.php

I think the same holds true for MRI…if you can get dynamic done, that is the way to go. Unfortunately, as GI mentioned for US not everywhere will offer dynamic with MRI either.

I copied this from an old post by Dr. Towfigh:

MRI Protocol for Hernia for non-contrast dynamic MRI pelvis for imaging of occult inguinal hernias:

1. For all of our…[Read more]

Thanks for the detailed posting of your experience, Watchful.

I’ve posted mine many times, but of course they are going back many years and we have wondered what has and has not changed. My main contribution at this point is anecdotal in confirming that both of my repairs were flawless with zero post-op complications or restrictions on activity…[Read more]

What you need is a proper diagnosis and MRI is likely the best tool for that.

With the caveat that your case may be different because you have had mesh removal, MRI is the more reliable imaging method for detecting non-palpable ‘hidden’ hernias:

https://jamanetwork.com/journals/jamasurgery/fullarticle/1893806

“Magnetic resonance imaging is by…[Read more]

I really hate this site sometimes…type up a detailed reply, but it times out and requires login again, with the entire post gone.

I give up…the short of my reply, from memory:

The follow-up time convention seems confusing…what does “36-6 months” mean…36 hours to 6 months or counting backwards from 36 months to 6 months? In one spot they…[Read more]

Watchful, I agree that is it something worth wondering about.

On the one hand, a hallmark of Shouldice has been the regimented nature of its operation…all of their protocols seemed very standardized…consultation, admission, surgical training, repair, recovery, etc.

On the other hand, things tend not to ‘stay the same’ forever (at least not…[Read more]

@saro

I did not have bilateral hernias…my hernias occurred many years apart (one side was repaired just over 30yrs ago, the other side almost 20yrs ago).

For bilateral hernias, my understanding is that Shouldice prefers to space the repairs apart by two days and simply extend the patient’s stay accordingly, but I can’t recall where I read…[Read more]

Hydrolyzed collagen is typically the form you get in all the health/supplement stores, though there are different types and sources.

There is a summary of some research below from someone whose work I enjoy that suggest some potential benefits. The wilder claims out there typically have very little (if any) good research to back them up…lots…[Read more]

That is quite the false equivalency to respond with “none of us know the real statistics”.

I know that you are smarter than that.

So I’m an outlier, a rare problem-free, back-to-normal case after two separate surgeries, and the ‘at least minor issues’ rate is hovering somewhere close to 100%?

I think perceptions of reality are being badly skewed by non-representational sources like this forum, doctor review sites, anecdote, etc.

I would suggest that the reason you haven’t…[Read more]

“…have yet to find anyone with a tissue repair who is back 100 to normal”

Really?

There are good solutions to a hernia…our definition of ‘good’ simply can’t be ‘perfect’.

‘Perfect’ is an ideal to strive for, but in practise it is not achievable.

Shouldice Hospital uses stainless steel, not Prolene. Some people don’t like the idea of stainless steel for whatever reason, so they elect to get a Shouldice repair done elsewhere.

AFAIK, Shouldice has sourced their stainless steel from the same supplier for a very long time. When Dr. Sbayi left Shoudlice after about a year and a half and setup…[Read more]

I think there needs to be some clarity.

Virtually no one should/will make a blanket statement of ‘watchful waiting is a good idea’.

What most people will grant is that watchful waiting is acceptable or appropriate for non-symptomatic inguinal hernias. The logic being that it may never progress to the point of becoming symptomatic enough to…[Read more]

GI, maybe you have come across this somewhere…

There was some mention recently of an institution considering amendments to its surgical training program, including more attention to tissue repairs ‘in part due to the desires of its young surgical students’ or something to that effect. I’m almost positive this was somewhere in Europe, but for…[Read more]

I strongly disagree.

Things like communication and payment schedule are indeed relevant from a ‘patient satisfaction’ perspective, but they have virtually nothing to do with the quality of repair you can expect.

What is most important to you, getting the best surgeon and best repair possible or…other things?

Unless you have good evidence to…[Read more]

To be clear, I don’t see either the repair or the hospital as ‘flawless’ and above criticism. Nothing is certain or perfect.

I’m a fan of Shouldice because the repair has a long history of success, it avoids the use of mesh unless warranted, the training is specific and intensive, and the frequency/volume of repairs performed means that the…[Read more]