[Mike M]

Dr. Kang does femoral hernia repairs. It is also listed on his website if you want to check out more info on it. The pricing structure is the same as an inguinal hernia repair.

My experience I saw both male and female patients in the waiting room at Dr. Kang’s hospital. It is my understanding Dr. Kang has worked on some high profile international cases for well known female clientele too. The hospital nurses and techs there were amazing. I would have no reservations to suggest Dr. Kang to my female family members if the need arose and they were willing to make the trip.

In regards to the method of repair – Dr. Kang has his own procedure which he can elaborate on as it. I understand the repair as it pertained to mine (Inguinal, Direct) but not sure what his exact repair method is for femoral.

[Mike M]

@William Bryant

I had similar concerns prior to my surgery except my symptoms were starting to enter into the moderate range+. The way I was able to resolve it was to lay on my right side all night when I slept. My hernia was left side direct*, large.

After I did that it almost completely resolved all symptoms unless I did something stupid that day.

I also visited two of the best hernia doctors in my area. Both doctors shook their heads and said it is extremely rare to get a strangulated or even incarcerated (non-reducible) hernia from their experience.

I was considering pulling the trigger on imaging if I was going to wait any longer. It does make you paranoid but fortunately (According to doctors) the dangerous situations are not very likely to happen if you are aware and careful.

[Mike M]

Dr. Kang appeared youthful to me when I met him. There was no indication while I was there he was retiring but I did not ask.

He has some examples where he operated on very elderly patients with success since he does not use general (which tends to be one of the biggest obstacle). He will do an EKG prior to surgery for older patients from what I understand.

Hope it works out for you and your dad either way!

[Mike M]

There was no indication to me that Dr. Kang was retiring anytime soon.

It is my understanding that the other doctors (including his son) are very successful in completing Kang repairs as they perform them every single day in mass.

I would assume Dr. Kang’s information regarding recurrence, chronic pain, etc. are for his hospital as a whole and not just for him performing the procedure personally.

His new book clearly shows the other surgeons who perform the repair along side Dr. Kang.

These would be great questions for Dr. Kang or Stephen Kwon.

All Hernia repair surgeries including surgeons that use mesh require extraordinary skills that are uncommon imho. This topic of discussion is one the thing all of the best Hernia surgeons and hospitals seem to agree on regardless of the type of repair.

There was a discussion previously on the Shouldice hospitals in CA negative vs. positive reviews that were channeled towards specific doctors and not the hospital or procedure itself. The biggest issue a lot of potential candidates had with that hospital was the inability to pick the doctor.

[Mike M]

I meant being dead set against being asleep btw. Edit mode disappeared too quickly.

[Mike M]

@WB The OR Table you are strapped down. Sedation can be lights out and/or twilight. I woke up the last 15 mins of the Umbilical repair though and managed to watch part of the repair through the reflection of the OR light which was pretty awesome. I was super chill in twilight mode and gave the doc the thumbs up when he asked me if I was ok.

Initially I was dead set on being asleep at all throughout the entire procedure up until the doc rolled in with his team. I’m glad I took a little nap during the first part / inguinal portion tbh. I was feeling the anxiety at showtime more than I would have anticipated.

@MarkT Did you have your cremaster cut and/or reduced through another repair and had no issues? I just did not want to chance it just in case.

My hernia was not the worst but it was complicated because of the size and depth. A lot more involved than the typical case. Recovery is on track with everything I researched from other similar cases and what multiple doctors (Shouldice and Dr. Kang) have previously told me it would be prior and post surgery. Dr. Grischkan would have used some polybuster on me for his shouldice procedure given the size. I am glad Dr. Kang was able to successfully avoid that tbh but I completely understand why it would be used for Shouldice. Dr. Kang repair is not as tensionless as mesh or Desarda but less than Shouldice from what I understand. At the end of the day you have to take a leap of faith to a degree with any of the possible procedures and doctors. Pinto did a tremendous amount of research on Dr. Kang prior to my surgery. He had a tricky one too and his final outcome was a great experience.

I think once Dr. Kang retires what you suggested might be a real possibility. Stephen Kwon is translating Dr. Kang’s new book to English now which is a start.

There might not be one main Shouldice hospital but Dr. Towfigh, Dr. Yunis, and Dr. Grischkan all do Shouldice procedures which was a serious consideration for sure.

I appreciate all the support from everyone and I am doing fantastic now.

[Mike M]

Also just want to add you want to be very careful and check with your doctor before doing any type of exercise that could potentially put additional pressure on your abdomen making it worse.

If you have inguinal hernias too you might not be able to perform some of the exercises that could reduce the symptoms of your hiatal hernia as stated in the linked research example.

Here is some good information regarding Yoga and Hiatal Hernia once you get your inguinal hernias resolved.

https://www.livestrong.com/article/375233-stretches-for-hiatal-hernia/

[Mike M]

@linz

It is estimated up to 60% of adults 60 and over will develop some form of Hiatal Hernia. Larger hernias may require surgery, but typical hiatal hernias can heal with exercises and stretches that can strengthen the diaphragm. These exercises can reduce the risk and may even relieve some symptoms.

Yoga is a big one I found through research that can help. Just be careful as some poses are not productive and can possibly increase symptoms.

Also exercise and losing weight can help a lot if you are outside of your normal BMI.

Here is positive research regarding all of the above –

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734640/

[Mike M]

@Monika. It is local with sedation and not General. I would never do general for this type of operation except for an emergency.

I am writing up a little bit about my experience with that during surgery.

It was a good no issues at all.

[Mike M]

Thank you Doctor. I relayed similar information to some of the members overseas regarding my assumption of a potential hack last week.

A few of them assumed they were personally “banned” and I assured them that was not the case after seeing what error messages they were receiving.

[Mike M]

@william bryant

You can do it for a lot less than I paid.

#1. I paid for two people (myself and a friend) to fly out first class with only 1 stop (there was no non-stop from my location). While you might not need first class I highly recommend against economy class. Do the next one up for it for minimal increase but a lot more comfort on a long flight. Economy is not ideal for only a week stay with this type of surgery even with a small hernia repair imho. Ideally you can fly out American Airlines upgraded economy for around $2k. Business class and first class are sort of the same now with the new flagship American airlines class. You get your own private cubical with lay flat seats. These are around $6k each depending on the dates.

#2. Hotels vary widely and depend on market condition deals. I was able to book an amazing 5 star hotel through Priceline for only $130 per night. The same room is normally $250 and up. There are some cheaper 4 star hotel options that are really nice too. intercontinental was a great location and the staff spoke great English. Service was exceptional, mall was located below the hotel, everything within walking distance except the hospital which was an easy 20min taxi ride away with good traffic. Breakfast was included at the Intercontinental.

#3. Prices on food, merch, clothes, etc are most expensive near the hotel but get extremely reasonable as you go further away the tourist areas. There was a fantastic Korean BBQ place near the hotel that was extremely well priced too. About a 5min walk. Shuttle app is your best friend if you want to order food in and is very reasonable too. Shuttle app is designed for foreigners in Korea and I had zero issues with it my entire stay. I used it a lot at night.

#4. Procedure itself with a private room was around $4k total because I had two hernias. This is less than most people’s deductible nowadays since the quality of health care in the US has plummeted while the costs have skyrocketed. Single hernia with private room would be close to $2700 US dollars with a private room.

$1000 per week hotel on the high end places with a good deal. $2750 for procedure with private room and single hernia. $2000 for upgraded economy ticket. $500 for food per week is overkill if you eat at normal places. Add another $1000 for good measure you are probably at $7250. If you have a long flight and can squeeze it get the flagship class seat and you will have a perfect flight.

Pain relief – The medicine the hospital gave me was good. I did need an extra shot the day after surgery to get home but after the first day or two it wasn’t too bad. Manageable by careful movement and the pain medicine they gave me. You can take two of their pills every 4 hours as needed preferably with a meal.

I used the stool softener 3 times a day and 30 minutes after each meal. I had no issues and never had to “pushed” once. No diarrhea or anything crazy either. I was extremely careful and took it slow. I ate beef and rice mostly and drank bottled water provided by the hospital and hotel. It was delicious.

I absolutely knew going into it there was going to be some pain but it was a small price to pay for the pain now rather than later with the mesh. Just know it DOES improve and will go away including the tension.

Sonogram and everything else is included in the hospital price. No hidden fees or extra charges for medicine or anything like that at all.

[Mike M]

Also yes I know I spelled Desarda wrong. LOL

I edited in a few things quickly after I posted and didn’t have a chance to correct typo before it locked me out.

Hopefully a moderator here can edit that and delete this. lol

[Mike M]

There are just under 60k active mesh related lawsuits per year and growing in the United States alone with 800k new mesh repairs per year that comes out to 7.5% of all new mesh cases per year.

Obviously some of those cases are multi-year litigation but even so that is still something to ponder.

Additionally many countries overseas like Australia and Scotland have moved the mesh repair into the HIGH risk category.

I think certain meshes have their place but it just shouldn’t always be the go to “gold standard”, especially for younger active patients. imho.

I think there are some incredibly skilled surgeons that can install it correctly and have lifetime success like Dr. Towfigh, Dr. Yunis, Cleveland Clinic but the same can be said about open tissue repair and you aren’t dealing with the possibility of a mesh mishap.

Best way to find an Attorney for anything is to do your research. Find an experienced *trial* attorney that the insurance do not want to fight in court. You might want to talk to Dr. Grischkan in Cleveland, OH as he has extensive experience in winning mesh cases as an expert witness against mesh.

[Mike M]

Thanks Dan. I will have a write up next week as soon as my recovery is completed!

[Mike M]

@Jack

Thanks Jack! Shouldice Hospital (from what I read with reviews, other patients) is a very good option if you get one of the premier doctors at that location. It is my understanding you cannot choose. You might want to consider Dr. Yunis in Sarasota, FL or Dr. Grischkan in Cleveland, OH if you are still considering Shouldice.

I am sure you already know but there are other risks not associated with Shouldice, Dr. Kang, open tissue no mesh procedure, etc. that are present with laparoscopically performed procedures too. There is some valid debate that the chronic pain results are similar as well as reoccurrences.

Biggest thing imho with any procedure is choosing the best doctor you and your insurance can afford. As you have probably already read from the forum feedback that makes the biggest difference over anything else. If I was doing lapa I would consider Drtowfigh or someone at the Cleveland Clinic. You will be able to find a lot of good options if you go that route too.

[Mike M]

@Jack

I am traveling in the next few days to have surgery with Dr. Kang in South Korea. http://gibbeum.com/main/main.php . He explains his procedure in the other threads but essentially it is similar to Bassini / Shouldice for direct hernias with smaller incision and a less “traumatic” procedure than Shouldice with equal or better results reported. Less tension too. Indirect Hernia the closest type of procedure would be the Marcy but it is not really a Marcy repair. All his procedures are known as his own Dr. Kang procedure.

If I did not discover Dr. Kang I would have reluctantly still been in the phase of “watchful waiting” with the Shouldice procedure and Dr. Grischkan being my #2. choice. I felt 100% comfortable with Dr. Grischkan but the Shouldice procedure is more involved but still with really good results.

I would never consider any other type of repair at my age other than an open tissue repair without mesh. I would only consider mesh as an option if I was 65+ or a couch potato. That isn’t to say mesh repairs are bad just not my preference. It is strictly a personal opinion based on what I have researched that it would not be in my best interest at my age. I am not a doctor so get a few opinions from actual doctors and testimonials from patients before you make up your mind imho.

If it means anything though – I never travel for anything other than traveling to another state for family vacation, occasional work obligations (I own a few companies and have to unfortunately), and recently this year for the Superbowl. I am not a travel person at all. Whatever is the opposite of travel person is me. Also having worked with medical professionals in my career (as a non-medical professional) at the highest level I am one of the most cynical people on the planet as it pertains to doctors.

tldr; Dr. Kang is the man.

[Mike M]

So here is my thought process coupled with my experiences.

– Watchful waiting is probably bad imho. –

#1. It almost certainly will progress unless you limit your lifestyle. In my particular case it went from undetectable to hmmmm something is moving there slightly to pop oh I now have “moderate symptoms” all because of coughing from a minor cold. Obviously every case is different but recognize that it is a possibility it could progress quicker than you expect.

#2. Fixing it sooner usually results in a better outcome with less aggressive surgery being needed.

#3. There are MANY other serious symptoms that can occur and even potential damage other than just the “strangulation scenario” if it progresses. Nerve damage, cut off circulation to other “sensitive” areas vessels down there, tension, etc.

#4. It can progress to a serious point (even without strangulation) where other options you had for repair are no longer an option.

#5. Do you really want to be beholden to your hernia, walking on eggs shells, and ultimately on pins and needles trying to “manage” your hernia for an indeterminate amount of time? You have zero symptoms *now*. Understand that this can change unexpectedly and in a flash.

I took the “watchful waiting” stance at the beginning of Feb thinking it was no big deal. Hernia went from zero symptoms to moderate in a flash then back down to near zero symptoms. I wasn’t even doing anything out of the ordinary either and not even lifting weights.

You know what “watchful waiting” means to me?

The time it takes for me to do the necessary due diligence to find a doctor, procedure, staff, and hospital that best fits my needs.

[Mike M]

@William Bryant

My wife and I could not notice a bulge no matter how close or faraway we looked. However both Dr. Kang and Dr. Grischkan could tell right away without me saying anything to them. So although it must have been extremely subtle to the average eye it wasn’t to an experienced doctor.

Symptoms were the reason that I wanted to get it done. I choose Dr. Kang because I wanted to be back to normal without any complications or restrictions long term. Also there were bonuses with Dr. Kang’s method like lower tension than Shouldice and the fact it only repaired what was actually damaged. Finally Dr. Kang is the best open pure tissue repair surgeon in the world imho.

In terms of pain as per my review in the previous post my case was not the most extreme but was not minor either. I had a pretty nasty hernia I created in a short amount of time. It was the size of an egg and the surgical field was deep. I saw most people walk out of Dr. Kang’s office like it was nothing but I opted to get an extra pain shot for of the all the reasons stated. The first three days were painful but after the 4th day or so it wasn’t so bad and then once a week went by it was just a matter of me taking it easy. Overall the pain was pretty much what I imagined it would be with that type of surgical procedure.

They have you on the basics for the first few days (lax + minor pain killers) but I didn’t have any issues at all regarding any of that and I had two hernias fixed at the same time. Umbilical and the inguinal left side. The umbilical hernia was a joke compared to the inguinal. No pain whatsoever really from it. Umbilical just complicated things in the sense I was trying to be extra careful when using my core.

Extra measures were mostly self imposed in the form of being super careful even after two weeks. The first few days I still got up and moved as much as I could via walking even if it was just in the hotel and the room. I swear I walked about 5 miles in my room one day pacing back and forth.

I plan on stepping up my workout routine (specifically my core) at the 6th month mark but gradually.

[Mike M]

@William Bryant

Pressure and dull pain in the groin region was the primary issue I had off and on for the brief period I knew about or created the hernia in via coughing.

I went through with it because it was affecting my quality of life and ability to lift weights / workout was a major concern.

Recovery is going great. Dr. Kang is top notch. I am about 5 weeks from surgery and every week that goes by I am a little closer to “normal”. I plan on working out at the 6 month mark which is usually when the tissue has healed completely.

There are no restrictions after 2 weeks with Dr. Kang’s method but I am just taking it easy out of an abundance of caution and unjustified paranoia. LOL

[Mike M]

I had zero issues with any of the roads there. The roads were exceptional throughout the city compared to a major US city.

The bumpy taxi ride did not cause the issue with Pinto. The hernia he had was called a “sliding” hernia that is rare and was not detected with the initial sonogram. A sliding inguinal hernia is defined as a hernia where part of the hernial sac wall is formed by an organ, e.g., the colon or bladder. Thus, repair of a sliding inguinal hernia may have higher risk of complications and recurrence compared with non-sliding inguinal hernia.

Sliding hiatal hernia is more common 10% to as high as 60%. Sliding inguinal hernia is not common 3%-8%.

Once the sliding hernia was identified Dr. Kang was able to repair it successfully on the second time around. Obviously the assumption is if was detected on the first time around it would not have an been an issue.

Movement in the car caused zero issues even on day 1 for me. The day 1 issue with me was just standing and walking LOL. Sitting and laying around was pure joy. But understand the hernia repair is EXTERMELY strong. It is very typical for patients to be ultra paranoid about it breaking the first few weeks but it is solid. I heard a lot of stories including one with a patient tripping at the airport, feeling movement, but it was 100% fine. I was equally paranoid rehabbing the first week but you have to trust in Dr. Kang. It’s incredibly strong as long as you don’t do anything ridiculous and take it easy for the first few weeks.