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No-mesh inguinal hernia repair near Minnesota/Midwest?

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  • No-mesh inguinal hernia repair near Minnesota/Midwest?

    I'm trying to find an experienced no-mesh hernia surgeon to repair my 4-week-old inguinal hernia. Of the 4 people I know who've had similar hernias repaired with mesh, 3 are now living with chronic pain and discomfort - no recurrence of hernia but apparently mesh-related issues. I've tried to read both sides of the mesh issue, and have decided to try to avoid mesh and its potential complications at this point in my life - I have enough issues already and don't care to add that one if it can possibly be avoided.

    I'm located in Minnesota and would obviously love to find a surgeon in-state, but am willing to travel if necessary to see an experienced, talented, and supportive surgeon. I would like to find someone in the Midwest someplace (Minnesota, Wisconsin, North or South Dakota, Iowa, Illinois, Indiana, etc) if possible, but will consider traveling farther if I need to. I'm aware of Dr. Kevin Petersen in Las Vegas and Dr Robert Tomas in Florida, but I'm unable to fly and the long drive with a hernia isn't very appealing if I can find closer options. But I'll do it if I need to!

    I'm scheduled for a consult in a couple of weeks with a "Top Doctor" general surgeon here who does many hernias. I've tried to get information from his nurse and others at the clinic but nobody seems able or willing to tell me much about his experience or areas of expertise. The best I can get is that it's possible he might possibly consider a no-mesh repair if conditions are ideal, but it sounds like he normally uses mesh. I'd like a surgeon who prefers to do tissue-only repairs as a general rule, rather than as a lesser- or rarely-used option. How do I determine if this surgeon would be a good choice?

    Any thoughts or opinions? Recommendations on qualified surgeons I might look into in my area or out? Advice on how to try to find local/regional surgeons experienced with no-mesh repair?

    If there's a better place/forum for me to ask this question please let me know. I'm just trying to do my due diligence, and this kind of info seems very tough to track down online.

    Thanks for any help you can give me - this forum is a wealth of knowledge and information!

  • #2
    The Shouldice hospital is close - https://www.shouldice.com/

    Be careful with a doctor who says that they'll do it if conditions are "ideal". That just leaves the door wide open for waking up with mesh.

    Can you give more detail on your friends who had mesh, then chronic pain? It's going to take numbers and examples to break down the resistance to accepting that any mesh, anywhere, one-size-fits-all, is guaranteed to give good results. And that chronic pain is more than just minor discomfort. The mantra is so strong that many doctors don't even see the original concerns about mesh, tacks. See the other recent thread.

    The widespread rejection of the thought that a mesh implantation can cause problems is pretty incredible. Highly educated people who just refuse to see it. It makes you wonder what they're being taught in medical school and residency. Reject, reject, ignore seems very common.

    No offense to the doctors here who are listening and thinking. It's the others that seem brain-washed. Or, even worse, know, but are accepting the failure rate, for the "greater good". It really impacts a person's faith in the medical system.

    Comment


    • #3
      Good Intentions, I agree with your statement that “the widespread rejection of the thought that a mesh implantation can cause problems is pretty incredible”. I’ve recently wondered that if the doctor admits that mesh is causing problems, is it then harder to justify the continued use of mesh in future patients!! I know everyone reacts differently and there are many factors to be considered in choosing the best hernia repair for each individual, but there certainly are patients who should not have mesh implants. Dr. Towfigh has identified certain subsets of patients (those with autoimmune, allergies to polypropelene, very thin, etc.) who will not do well with the standard mesh repair, if there even is such as thing!! Thank you to the doctors on this forum that are considering individual factors and tailoring their hernia repairs for each patient. I speak from experience because I had an allergic reaction to polypropelene, which had been implanted for hernia repair and, ultimately, Abdominal wall reconstruction, and was removed after causing two years of suffering with pain and systemic reactions. I am not sure that I will ever fully recover from all of the damage caused by the mesh and multiple surgeries, but I am doing everything I can to try and make that happen. So, when a doctor doesn’t acknowledge or believe that mesh causes problems, I feel like that is a slap in the face to those who have suffered so much! Certainly makes one lose faith in the medical system.

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      • #4
        Good intentions - thanks so much for your comments.

        I have indeed considered Shouldice, but they appear to be cost-prohibitive. A bit too pricey for us to handle at this point in time. Still trying to find someone in the Midwest someplace that does quality non-mesh hernia repair. Not looking too promising at this point though, unless someone here has names or ideas where to look.

        This comment you made:

        "Be careful with a doctor who says that they'll do it if conditions are "ideal". That just leaves the door wide open for waking up with mesh."

        is exactly what I'm concerned about. The most well-intentioned promises up front aren't likely to prevent a mesh-leaning surgeon from resorting to a mesh repair if he/she sees something at all suggestive of possible recurrence once they get me opened up. Makes me very skeptical about seeing any surgeon other than one that is quite open and up-front about avoiding mesh repairs, understands the reasons to avoid them, and can demonstrate consistently positive outcomes.

        The problem becomes finding such surgeons. To this point I've had zero success calling surgeons' offices and asking questions about preferred repair types, if they offer non-mesh repair, how many hernia repairs they do/have done, outcomes, complications, etc. Staff (including nurses) either truly don't know what the surgeon does (seems strange not to be able to give prospective patients information that would help "sell their product"), or they don't want to/are not allowed to give that information out. It makes it very frustrating and very difficult to find surgeons that are experienced and comfortable with non-mesh hernia repair.

        So, we're left posting on forums like this, desperately hoping to get recommendations of non-mesh surgeons others have identified or stumbled onto. Something is wrong with the system - sad.

        My appointment with a local hernia surgeon is coming up in a couple of days. I don't have high expectations but am trying to assemble enough good questions to help me find a good fit. It's hard to know how much to believe even when asking questions directly to the surgeon. Not that they're intentionally trying to mislead or deceive, but rather that they likely often have non-existent or incomplete follow-up information on patient satisfaction, complications, or repairs gone bad, and/or they repeat the "mesh as the gold standard" mantra they've heard from every direction since med school. In the end hernia repair is really about choice and quality of life for the patient, not about theoretically shaving a percentage point or two off the recurrence rate.

        I don't mean to sound harsh - that's not my intention. But this issue just shouldn't be that difficult. Hernia patients need and deserve treatment choices, and realistically speaking we don't have them in this country anymore. I feel for you surgeons out there who are trying to walk this tightrope and provide what is best for your patients, and I certainly wish more of you would take up the challenge of becoming proficient in and offering your patients non-mesh hernia repair as a viable and readily available option to mesh repair.

        Comment


        • #5
          I've read of a few places that use the Shouldice method in the United States so I searched "shouldice hernia repair united states" on Google. Here's one interesting place in Ohio. No idea about them other than they're on the internet.

          https://herniasurgeries.com/modified.htm


          Have you tried sending a message to Dr. Towfigh? She is active in the area of no-mesh hernia repair, as you probably know, and probably knows of others. Click on her screen name and you should see how to send a message.

          http://www.beverlyhillsherniacenter....-ed4d539b-3184

          Comment


          • #6
            Originally posted by Ddot14 View Post
            I'm located in Minnesota and would obviously love to find a surgeon in-state, but am willing to travel if necessary to see an experienced, talented, and supportive surgeon. I would like to find someone in the Midwest someplace (Minnesota, Wisconsin, North or South Dakota, Iowa, Illinois, Indiana, etc) if possible, but will consider traveling farther if I need to. I'm aware of Dr. Kevin Petersen in Las Vegas and Dr Robert Tomas in Florida, but I'm unable to fly and the long drive with a hernia isn't very appealing if I can find closer options. But I'll do it if I need to!
            Just had another thought also. Don't be too economical or "practical" when making your decision. The effects of a poor decision will last for the rest of your life.

            I think that one of the problems with today's hernia repair with mesh method is that it is so easy to do the repair quickly, with no short-term complications. It's a battle of short-term results versus long term results. We all tend to think in the short-term, and even long-term to most of us is months or a year or two. Both patients and doctors tend to lean toward the mesh repair, I think, because it gives immediate relief and seems so simple. Just get that mesh to cover the defect with a lot of extra just-in-case material, then get out. The patient only has to plan for a few hours away from home. It all seems so simple. The protruding abdominal contents are placed back where they should be, the mesh covers the hole, and the access holes are sewn up. One to two weeks later the patient is functional. But the relief is not full or complete. The patient ends up at some lower level of the person they expected to be, with no apparent solutions.

            So, even though you're avoiding mesh, to avoid long-term problems, you're still planning in a short-term, convenient, way. I did the same thing when I had mesh implantation. I was close to traveling to the Shouldice Hospital but then a different easier path appeared, with confident people telling me it was safe and effective.

            Just an observation and maybe a push for you to go a little farther to get what you want.

            Don't overlook also though, that there are many stories of successful open repairs with mesh. But open repair has more short-term risks, like bleeding and infection. It leaves a bigger scar and there might be a bump. Healing is slower. But the long-term results might be better.

            If somebody on the inside collected information they might find that there are specific bad materials and/or bad methods. Everybody would benefit if the bad actors could be rooted out. It might be though that the biggest device makers are the bad ones, and they control the field. Until somebody identifies who the bad ones are though many people will assume that all mesh is very risky and avoid it like you are.

            Good luck.

            Comment

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