[pinto]

William, you’re modest for being a main contributor here and importantly helping others out. No-one here can claim posting flawless posts or commentary. We help each other out along the way. We’re all in this together. You’ve been very helpful.

[pinto]

Blast the tech of this website! I just noticed strangely how a laugh mark can unintentionally impart insult. Produced by this website! A post of mine above with a laugh mark is presented in two different forms: 1) in this threat; and 2) in the “activity” list of my posts elsewhere. The same post but found in two different ways. In #2 my post is correctly presented with the laugh attached to a laughable 90% stat. Contrarily, in #1, the present thread, the laugh mark got separated and stuck with mention of William, not how I originally posted it.

• This reply was modified 10 months, 1 week ago by  pinto.

[pinto]

Just in case, my laugh mark above was about the 90% figure but got separated so I hope it didn’t cause offense. William, everywhere I’ve looked over the years I see surgeons speak of weeks/months but never saw one other than the one noted speak of healing in terms of years. Having little experience medically, I have a lot of questions about it.

[pinto]

@ajm222: “most mesh surgeons will say a mesh repair is fine almost immediately after surgery”
Exactly. One I read say when leaving the clinic you’re 90% healed. 😀 Has William heard 2ys. from surgeons? I’ve never have, only that one. But I have seen mesh surgeons say tissue takes longer.

Now ajm you’re well experienced having had a mesh removal and then a tissue repair. It’s not just this question of time but what to expect physically. As I said the operative word is “complete,” for estimates of time given may be in the sense of “practically healed.” When you had mesh, eventually were both sides of your groin completely flat, no elevation on the one side? If you touched the mesh side, it was the same as touching the other side? The mesh doc cited is speaking in terms of completeness though he didn’t describe it in physical terms particularly how close does it come to the prior state of non-disease.

[pinto]

That’s great news Oceanic and handsome scaring. You take care fella.

[pinto]

@Jack2021, again much appreciation for the Kang link. Evidently the link came after my operations. Mention was made to me Stephen was working on a English guide for patients. Let me point out something from the link: “Kang repair for indirect hernia is similar to the one described by Dr. Marcy in the past, but modified to avoid the high recurrences…. That is why this new sort of procedure has not been developed until now.” This statement if valid surely would make KR, Marcy Supercharged, an approach underreported, unappreciated by both Lorenz and Towfigh in their comments made at HT. In their defense, KR is under the radar researchwise, so it would be hard to evaluate it. In short, KR is not Marcy in disguise. Again if the KR as claimed turns valid, then in my humble opinion it would be revolutionary.

[pinto]

@Herniated, I respectively refer you to none other than Doc Brown on Marcy: “in a young athlete with an indirect inguinal hernia, the Marcy hernia repair with ringplasty yields excellent results with minimal dissection and minimal postoperative pain.” https://herniatalk.com/forums/topic/shouldice-vs-desarda/

If true that Brown served pro male athletes in healing their hernias, then it’s quite possible that you have shortchanged Marcy.

• This reply was modified 10 months, 3 weeks ago by  pinto.

Shouldice vs. Desarda

[pinto]

@Jack2021, I stand corrected, thank you also for your considerate post. Let me point out though as I made clear in my own related post: My statement about Kang Repair was solely and entirely based on Dr. Kang’s postings here at HT. He clearly stated that he didn’t agree that KR necessarily is or based on Marcy. Further when we draw analogy to another source as A to B, we must realize that just like a mouse and human sharing 98% similarity of DNA, we still may end up with two very different entities, as your post suggests. Anyway bravo to your post.

[pinto]

@Mike M, I agree. Would you care to share your ideas about that now that you are well out from your recent surgery? How have you progressed. Your outlook. Any tidbits now having experienced it all?

[pinto]

@G, thank you for your post. As far as I know, HT is more an information-exchange rather than a social media per se. To that extent I’m not looking for friends; rather information. Information that will advance my own understanding of things. You claimed—I believed—that Kang’s surgery is basically the same as Brown’s. You said that. Your own words. Well obviously that is quite a claim and I indicated it hoping you could back it up. Well apparently you can’t.

Some people could make unfortunate medical decisions based on your words. The two surgeries could be dramatically different. And by the way you are quite wrong in claiming that I offer “protection and allegiance to Dr. Kang.” Yes I favor him in the same way that others recommend their own surgeons. But it stops there. I am perfectly willing to entertain opposing views. I seek a dialectic so that our conversations can refine my understanding. If it would mean Kang Repair would be less than thought, then so be it. If you just want a koffee klatch then you might be at the wrong website. Lots of people here seek reliable information; less so a friend. Many other social media have that as primary.

[pinto]

@G, congratulations, sounds like you won the lottery. I’m happy for you. I’m unsure we can equate the two surgeries but the outcomes might be quite the same. If you were so technically savvy as to say so definitively the surgeries are the same, then you would be able to write a decent paper outlining how they do indeed dovetail. Many of us surely would be happy to pay the journal fee to read it. 🙂

[pinto]

Correction of my previous post: KM should be KR (Kang Repair).

[pinto]

For thoughtful conversation: Chuck reports, “Dr Towfigh calls his [Kang] repair a marcy like repair…which she only uses on petite women and children…”

Consider what Doc Brown says about Marcy: “in a young athlete with an indirect inguinal hernia, the Marcy hernia repair with ringplasty yields excellent results with minimal dissection and minimal postoperative pain.” https://herniatalk.com/forums/topic/shouldice-vs-desarda/

A reasonable presumption is that by “young athlete” Brown has in mind male adults. OK, so we have a Towfigh vs. Brown runoff. 🙂
If true that Brown has serviced many pro athletes successfully we must give the nod to Brown. And if agreeable—then Kang Repair ain’t too shabby (though he doesn’t agree with the Macy characterization).

Granting my naivete but how can you so easily categorize KM as a Marcy when Kang might have the smallest IH incision size in the world? Who knows what will happen to me but I have to sing KM praises because my post-op has been so painless (besides other reasons). I think it is quite possible that the Marcy labeling is too premature by other surgeons not fully understanding the KM. (BTW, incision size here has no concern about cosmetics but rather pain. My understanding is the larger the incision, the more pain. I presume also to produce it must entail other surgical techniques rather advanced!)

Shouldice vs. Desarda

[pinto]

“Could Dr. Lorenz mean as far as he knows the suturing is the only difference between a Kang repair and conventional Marcy.”
I don’t think so. If he meant to be so tentative, then he would have said so. He is well experienced about such matters and knows quite well the difference even if speaking in a language not his own. He didn’t do anything wrong; it’s just simply how he views methodological differences.

“Agree with Jack that it’s a shame Dr.Lorenz didn’t reveal who his surgeon was. Mind you I suppose it’s giving publicity to a rival and presumably one in Germany.”
It was interesting how Dr T asked him and left it at that—shifting between professional and personal levels. She let him have his space; besides the matter of “shifting,” his cultural background might have figured into it also. If he were American and possibly more familiar, the outcome might have been different. She handled it very well.

[pinto]

Please understand my posting intends for me to learn by our discussions. My posts often try to be food for thought. Shouldice obviously is a great approach but we also can wonder about things, can’t we. Unfortunately there is risk in almost any decision we make. As I indicated in my earlier postings, I was so shocked by the growth of my IH that I flew into action without checking off all the boxes. So accident insurance or other to cover such things, I didn’t inquire about. I did have at the time a nifty credit card that automatically covered me for travel insurance. So I was covered somewhat but not to the extent you are wondering about. If you happen to look into it and find insurance that covers the contingencies you are thinking about, please share.

[pinto]

ajm222, you’re knowledgable, I know, someone we all appreciate, but it seems to me imaging operators differ in ability, some better than others, which can make a big difference. I wonder if it applies to the imaging you received.

[pinto]

Mention of Kang Repair (KR) by Lorenz: I got a mixed impression. On the one hand Lorenz is enthusiastic and apparently open to various approaches and excited that the field is growing, precisely the reason he mentioned Kang Repair, but I thought also he was a bit dismissive of it. He stated, “it’s a modified Marcy and of course the difference is only that you” suture horizontally not vertically [emphasis, mine]. He says that so authoritatively. Perhaps he truly knows but Kang himself might disagree. Kang might be able to identify other substantial departures from Marcy. I say so only based on how he described KR here at HT.

• This reply was modified 10 months, 3 weeks ago by  pinto.

[pinto]

MarkT, I apologize for overlooking your point that Shouldice has unlikely changed its method over the intervening years. Some of us here discussed a rather biased (negatively) Canadian surgeon’s view of the Shouldice Hospital. I relooked at the commentary at her blog by some Shouldice patients and I was so shocked about some of the hospital polices (e.g., mandatory wakeup call for all patients at 5:30am). Someone described the polices or venue as like being in the military. Assuming that’s all true, I have to bow to you that the methodology likely has not wavered ever a bit over the past decades. 😀
https://canadianfemalesurgeon.wordpress.com/2015/05/19/the-problem-with-shouldice-or-the-most-dangerous-phrase-in-the-english-language-weve-always-done-it-this-way/

[pinto]

William, this is a bit unrelated about Shouldice but you might be interested nonetheless. Sometime ago I might have been part of a discussion about a rather biased (negatively) surgeon against Shouldice Hospital (maybe you too). Because of her bias, I took her article with a grain of salt:
https://canadianfemalesurgeon.wordpress.com/2015/05/19/the-problem-with-shouldice-or-the-most-dangerous-phrase-in-the-english-language-weve-always-done-it-this-way/

However more notable are the comments by patients, which give an inside look at the hospital. I am surprised to read some of the criticisms. Please note this only pertains to the hospital not the surgical method. If I were to choose the same method, it would not be at the “head” hospital for sure. I suppose elsewhere hospital policies are quite different for patients. (However implications arise for the claimed success of Shouldice based on such hospital policies! Success rates might only be achievable there, a concerning point.)

[pinto]

Some takeaways:

— Both tissue repair and mesh repair important methods of surgery
— Unrealistic to think mesh can be done away with
— Imaging is vital prior to any surgery as it can plot out the situation for the surgeon
— Hernia size/type and age of patient dictate surgical method
— Suturing, if absorbable, better to use one not with half-year life but much longer
— Stainless steel sutures out of favor in favor of prolene

Dr. Lorenz appears to be eclectic in approach but apparently favors Shouldice by the fact that he and his surgeon friend repaired each other’s own personal hernia by that method to both their full satisfaction. (Or did their respective bio-data dictate only Shouldice repair? 😀 )

We thank Dr. Lorenz for kindly sharing his expertise!