Thunder Rose

I read Kang’s website in depth last summer. I am not swayed. Science requires replication and independent verification. Have you taken the time to watch videos of these surgeries? If you have the stomach for it I highly recommend it.

I apologize– I don’t mean to denigrate Kang and I don’t fully understand his method(s). I do find it frustrating that someone would pass up highly skilled surgeons in the US and be so dismissive of their techniques simply because Kang is touting a repair that is supposedly so superior. Comparing the Sue and Peter Jones 2-layer Shouldice on…[Read more]

Also: there’s plenty of research showing that highly experienced hernia surgeons can achieve low recurrence rates with tissue repairs.

Yes he offers two methods: a Marcy repair for indirect and a 2-layer Shouldice for direct. But he calls it a Kang repair and claims it’s different? If you look into what he’s suturing I don’t see any significant difference except for some very cute comic strips.

What is it that makes you think Kang Repair is so worthy of replication? I see him as having hired excellent marketers, but I don’t see that to be correlated with being a great surgeon. There are other surgeons offering a tailored approach (Towfigh, Yunis, Muschaweck, Wiese). I see Kang and Muschaweck both obfuscating the details of their…[Read more]

I don’t think Brown, Yunis, Grischkan, and Kang are the only surgeons offering 2-layer Shouldice. I do think many are calling it Bassini.

I strongly considered Grischkan but ultimately did not feel comfortable with his use of polyester suture material. Similarly Brown uses highly inflammatory silk sutures. I was more concerned about choice of…[Read more]

Hey Dave, my repair is 4 lines of Prolene on the posterior wall (formed by 2 running sutures), what’s commonly referred to as a 4-layer Shouldice. I wanted the 4-layer repair to reduce likelihood of recurrence. The incision length was roughly 6 cm (just under 2.5 inches). I think I was told it would be 3.5 inches so it was shorter than I…[Read more]

Hey AJ9000! I’ve been reflecting that my surgery with Dr. Yunis and recovery were particularly easy because we live at over 7000 ft. in Wyoming, so sea-level in Sarasota was akin to a hyperbaric chamber. It’s good to hear you also had a good experience (most likely without that elevation benefit)!

We flew home on day 6. I kept up with the…[Read more]

I was walking 2-3 miles each day starting the day of surgery. I’ve read reviews of Wiese with folks walking ~5 miles right away. I didn’t start running again until 2.5 weeks after surgery. My memory is that Yunis discouraged biking initially (in contradiction to the practice at Shouldice Hospital) and also discouraged squats or dead lifts. I…[Read more]

I was concerned with minimizing swelling so I wanted papain and bromelain. I ate a lot of papaya and pineapple the week before and week after surgery, but you can also buy these as supplements. I prefer getting them from the whole foods.

Inguinal is a groin hernia. What you describe sounds like an incisional hernia.

I have a friend doing well with DNRS, that could help pre-operatively.

The article you linked to cites 4 recurrences vs. 1 recurrence: that isn’t a lot of data. Have you found any similar studies? I’m swayed by the research showing that the recurrence rates for the Shouldice repair are correlated with a surgeon’s experience with the repair, so I’m inclined to trust Yunis if he says he can do a strong repair without…[Read more]

Regarding exercise: I had a large direct inguinal hernia for more than 5 years of watchful waiting. Most exercise was indeed fine: running, x-country skiing, swimming, downhill skiing, dancing, road biking and stationary biking, figure skating, and hiking.

Mine finally worsened last summer and I do think it was in part due to a change in…[Read more]

I was reading the preview chapters of “The SAGES Manual of Groin Pain” (Towfigh is one of the editors) and I saw “snapping iliopsoas tendon” listed as one of the causes of groin pain in the chapter “Groin Pain: An Overview of the Broad Differential Diagnosis”. Did you end up getting a diagnosis?

Please don’t give up. I think you’ve read about the SH patient — the wife on the runner’s blog — who went to Meyers after Brown and had a lot of improvement. Grischkan does Desarda reversals so that’s another potential option. I went to Yunis and he did amazing work with me — he’s also a vascular surgeon and I believe his work is world class…[Read more]

One caveat is if you think you’re reacting to the suture material on the posterior wall (in this case silk which is much more inflammatory than Prolene). If that’s the case than you probably do want that removed, and most likely they’d need to place a mesh. In your shoes I’d want a Nyhus repair with polypropylene mesh. But given my experience and…[Read more]

Hi Peter,
I hope you’re getting more answers from Drs. Zoland and Meyers.

I think your questions about the closing of the External Oblique Aponeurosis get into complexity of the anatomy of the inguinal canal. My understanding is that the modern Shouldice or Bassini uses the external oblique aponeurosis just anterior to the inguinal ligament,…[Read more]

Dr. Reinhorn is a big fan of the Nyhus repair. Since your mesh is large for an open repair that’s probably what you have. With the Nyhus repair the mesh is in the posterior space normally accessed in a laparoscopic or robotic repair. It seems likely your PCP hasn’t encountered this type of repair before and may be misinterpreting what she felt.

My understanding is none of the nerves were cut and I have no reason to think otherwise.

One surgeon who told me he would transect the genital branch nerve told me it would take 6-24 months to grow back and I would have numbness. I have nothing like this. Another surgeon told me he would transect both the genital branch and the ilioinguinal…[Read more]

Anesthesia: I don’t know the specific meds. At the surgical center I first signed a paper where the two main options were General Anesthesia or Monitored Anesthesia Care (MAC, i.e. IVCS) and I only signed permission for MAC. Then I spoke to the anesthesiologist and finally to the anesthesia nurse. If you want to know the specific meds you could…[Read more]