[T. Hayano]

Thank you for your replies. I thought the mesh is strong enough to last for rest of my life, but it seems that the standard polypropylene mesh last only for 10 years and after that it probably erode and become weak.

According to my doctor, my abdominal wall has large enough gap, so that the risk of strangulation is little. In this case, what will you recommend?
1. How about Shouldice method? (I don’t know where I can find a doctor who can perform it in Japan, and I think the gap on the abdominal wall is big, so I might have issue of tighter abdominal wall after surgery.)
2. There is a risk but should I have surgery to implant the mesh in my body? (I’m 49 years old, so I might have complication when I am around 60 years old.)
3. Leave it untreated. (My hernia might get bigger and I may have difficulties in future. Or leave it untreated until a better kind of mesh will be invented.)

[T. Hayano]

Thank you for the information. I think the surgeon just watched the operation performed by Shouldice surgeons. Below is excerpt from the hospital’s website.

— Translated by ChatGPT —
…The Shouldice method is a complex and difficult surgery with limited reproducibility, and there are no facilities in Japan that have adopted it. Our surgeon, Dr. XXX, visited Shouldice Hospital in Ontario, Canada, where the Shouldice method originated, to observe surgeries. Over the course of three days, he participated in 15 surgeries and received detailed guidance on surgical techniques directly from the staff surgeon. Since then, we have been carefully performing tissue repair using the Shouldice method after discussing it with the patients themselves…

—Original Japanese texts —
…Shouldice?????????????????????????????????????????
???????XXX??Shouldice?????????????????????Shouldice Hospital?????????3???????15?????????Staff surgeon???????????????????????????Shouldice????????????????????????????????…

Maybe he is not a real Shouldice surgeon but I guess he is one of the leading specialists of the field in Japan. Because he has published many theses about it.

[T. Hayano]

Thank you very much for the information. It seems that there is no statistically different in complications occurrence rate between non-mesh and mesh treatment.

I found a surgeon in Kyoto, who claims was trained in Shouldice Hospital, Toronto. I’m thinking to contact him for consultation…

[T. Hayano]

Yes, you are right. I have not found any negative information about the mesh in Japanese media. But I found it on BBC documentary posted on YouTube. I don’t know why these issues are not well known in Japan. As you said, the mesh is common method to fix the hernia here. I found two people, who had the mesh hernia repair, among my approximately 50 colleagues. They told me that they are happy for their treatment. (Though, one of them also told me that it is not serious but he feel something in his groin) We have culture like “Don’t make a fuss”, so I’m not sure if the problems really does not exist or just have been hidden.