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[USER=”2758″]Dill[/USER] – I empathize with you 100%. You and I are in very similar situations, just opposite sexes. I can’t answer many of your questions, but will offer what I can. I’m also located in the Midwest, and share your frustration with the apparent lack of no-mesh hernia surgeons in this part of the country. I continue to look but without success thus far. Some of the names you mentioned: Dr. Yunis – agree that making contact with/getting a response from him/his office is difficult if not impossible. Indianapolis Hernia Center offers no-mesh option but seems to prefer lap surgery (and likes OviTex – did my own research and decided against OviTex even before reading Good intentions’ excellent write-up on it). I researched and talked with the Ohio Hernia Center – same concerns as you with follow-up, as well as other concerns. I also considered Shouldice, but not sure the hospital setting, procedural rigidity, and potential follow-up issues are a good fit for me.

If you do ever get to the point of seriously considering the 95% absorbable mesh (you mentioned that in another post) please, if you haven’t already, read Good intentions’ post: https://www.herniatalk.com/10510-new-material-ovitex

FWIW, below are surgeons I’ve considered so far who do no-mesh repairs exclusively, or almost exclusively:

At this point Dr. Brown is a very appealing option – have not contacted him yet but you can learn a lot about him and his hernia repair experience/philosophy from his excellent website. I also understand that Dr. Brown is very responsive to questions via email or phone. Only drawback is that he’s far away, which introduces the complexities and stresses of air travel, hotel, car rental, etc.

If you are considering a Shouldice repair, Dr. Ashwin Maharaj is probably closest to you, but is out of country (Canada) so your insurance may balk. He spent time at Shouldice (~1300 repairs worth) and is now in private practice in Vaughan, Ontario (northern suburb of Toronto) – his stated objective is to bring the Shouldice repair to the outpatient setting. An additional unstated objective appears to be to change things in the traditional Shouldice experience that may be a bit outdated or off-putting. His website is fairly informative. Dr. Maharaj is happy to talk on the phone or via Skype to answer any questions you may have (both he and his office have offered this via email). They are also quite responsive to email. As of a couple of months ago total cost for unilateral no-mesh Shouldice repair was $4250 U.S. – not sure how that may compare to your insurance out of pocket cost (not that that should be the deciding factor but I know it enters one’s mind).

Dr. Zafar Parvez in Artesia, New Mexico is an attractive option if you’re interested in a Desarda repair (does Bassini repair if for some reason you aren’t a good candidate for Desarda). I’ve talked with him on the phone, very helpful, love his approach to performing the surgery, but the hospital he is now working at can be extremely difficult to communicate/work with, especially if he isn’t covered by your insurance. I was never able to finalize costs with them, but not for lack of trying on my end.

Dr. Tomas in Florida is another Desarda option – have also talked with his office. I understand he’s an excellent surgeon and gets good results, but some of the things I was told when talking with his office raised red (or at least yellow) flags so I tempered my enthusiasm a bit and kept looking. But the hand-holding through the process from his office seems first rate.

Dr. Petersen in Las Vegas was mentioned as a possibility, but he uses general anesthesia and takes no insurance – last I heard cost for inguinal hernia repair (unilateral) was about $5000. He has lots of info on his website and the FAQs are very interesting to read through. But I have some reservations so have not pursued talking with him at this point.

Not sure if any of this is useful to you or not – just trying to help out a fellow weary traveler…

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I’m happy to share about friends experiences, at least as much as I know. All had inguinal hernia – don’t know if direct or indirect.

1) Age 45 or so at the time – had non-mesh repair probably at least 10 years ago – hernia incarcerated and was handled on an emergency basis. Spent a week recovering in ICU but has had no problems since.

2) Close relative had a total of 3 inguinal hernias over a period of years, all repaired without mesh (one was a small recurrence of a much larger hernia repaired years earlier). Aside from the small recurrence, he never had any issues or chronic pain with any of the repairs. Repairs were all done before mesh became popular in the hernia world.

Three others I know all had mesh repairs:

1) One had mesh repair at least ten years ago (around age 60?), tries to stay physically active (no sports) but has pain/discomfort at hernia site every day. Has had since it was first repaired – went back to the surgeon more than once, tried other doctors to try to get rid of the pain to no avail, finally resigned himself to living with it the rest of his life.

2) Second had severe pain immediately after mesh repair – lasted several weeks if I remember right. Pain finally subsided, felt pretty “normal” for several years I believe, then pain returned with a vengeance. Doctor said no recurrence at the time – I’ve lost touch with him so don’t know current status.

3) Third has pain that borders on disabling. I don’t know when repair was done, when pain started, or what steps he has taken to try to get relief (not something he likes to talk much about).

4) Also learned, while discussing my hernia with yet another friend, about her brother who had mesh repair and has had two recurrences since initial repair, both repaired again with mesh. Don’t know timeline on those as I don’t know him, but seems like the initial hernia was within the past 8-10 years.

I realize that I may unknowingly be surrounded everyday by people who have had successful, pain-free mesh hernia repairs, but I’m not aware of any in my circle of friends/acquaintances. I also realize that those who’s mesh repair is doing fine wouldn’t necessarily have reason to talk much about it (since everything is going well), so I’m probably not as likely to hear about those. But first-hand experiences like those I described above make me want to seek out a good repair without mesh, wherever I need to go to get that. Close to home would be nice, but it’s becoming apparent that may not be realistic so I’m trying to focus on finding the surgeon that’s the best fit for me and my needs – I’m open to any and all suggestions.

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Thanks [USER=”2029″]Good intentions[/USER] – I’ll try to answer your questions in two posts so it doesn’t get too long.

I can tell you what I know about type of hernia. Surgeon I saw said it was inguinal hernia (not femoral – which I already pretty much knew) – said he couldn’t tell by exam if it was direct or indirect, wouldn’t know until he had me opened up, and that it didn’t matter anyway because he fixed them both the same way – mesh. Is that what you are asking?

So far as activity after repair, I can safely say no high-level sports or heavy weight lifting or workouts. Would like to get back to daily walking (1 hour/day, not a runner), basic exercise, and low-level sports with my kids/grandkids. Most of my work is handyman-type work – you name it, I pretty much do it – so would need to have strength and good flexibility to get on the floor, on roofs, reach on ladders, move and work on large appliances, crawl under cars and in tight places, and be able to do at least moderate lifting and carpentry/mechanical work. If you need more specifics just ask.

Current medical state is probably decent overall – late 50’s, male, some ongoing back and foot issues/pain, year-round allergies (used to be severe, have improved somewhat as I’ve aged), and some others I’d rather not mention here. Nothing cardiac or lung-related, no serious chronic disease at this point. But enough to handle on a daily basis that I don’t want to add the potential problems of a mesh hernia repair.