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Inguinal hernia repair with absorbable stitches


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  • Inguinal hernia repair with absorbable stitches

    Hi, everyone!

    I'm supposed to have an inguinal hernia repaired in August or September, and my doctor wants to use a mesh, but I won't allow it. I'm here because I want it to be repaired with absorbable stitches, so I'd like to hear opinions on the (original) Bassini vs Desarda techniques. Also, out of curiosity, does anyone know if it's possible to do Shouldice with absorbable stitches?
    I know some people ask, so I'm a female, 23, slightly underweight and my hernia measures 4mm.

    Thank you in advance.
    Last edited by AGF; 07-07-2018, 02:41 PM.

  • #2
    Hey AGF, yea you definitely don't need mesh but you will likely have to travel to get Non-mesh repair with a competent surgeon. To answer your question there is a guy in Cleavland, OH, Dr. David Grischkan who will perform a partial 2 layer sholdice with absorbable if you request, I will go to him if mine is a direct hernia, I've spoke with him on the phone personally, but am now thinking of going with Dr. Brown since most likely my hernia is an Indirect type and he can perform a more specific technique for that type (marcy repair). I get an Ultrasound tomorrow and hope that I can get an answer.


    • #3
      Look up William Brown in California, his website has great info on the different kinds of suture repairs and he does not use mesh.


      • #4
        Just out of curiosity, does your hernia hurt? How were you diagnosed? Do you have a bulge or just physical symptons?

        Where are you located? Perhaps someone can recommend some regional options near you for a non-mesh repair.

        As for absorbable sutures, that is much more rare as far as I know, but I think Desarda repairs in Florida by Dr Robert Tomas are done with absorbable stitches. Other surgeons may use them as well, maybe by request, you'd probably need to inquire directly and ask.

        A partial list of surgeons in the USA who are able/willing to perform a no-mesh hernia repair using a traditional suture technique (various types of repairs, ask for clarification) include the following doctors:

        - Dr Shirin Towfigh in Los Angeles, California

        - Dr David Chen in Los Angeles, California

        - Dr Edward Phillips in Los Angeles, California

        - Dr Robert Burns in Newport Beach, California

        - Dr William Brown in Fremont, California

        - Dr Paul Dally in Vancouver, Washington

        - Dr Robert Martindale in Portland, Oregon

        - Dr Michael Mastrangelo in Bend, Oregon

        - Dr Kevin Petersen in Las Vegas, Nevada

        - Dr John Etlinger in San Antonio, Texas

        - Dr Zafar Parvez in Gallup, New Mexico

        - Dr Samer Sbayi in Long Island, New York

        - Dr Michael Reinhorn in Newton Massachussets

        - Dr Igor Belyansky in Annapolis Maryland

        - Dr William Meyers in Philadelphia, Pennsylvania

        - Dr David Grischkan in Cleveland, Ohio

        - Dr Paul Szotek in Indianapolis, Indiana

        - Dr Bruce Ramshaw in Knoxville, Tennessee

        - Dr Jonathan Yunis in Sarasota, Florida

        - Dr Robert Tomas in Fort Meyers, Florida

        - Shouldice Hospital in Toronto Canada (just in case you're near the border)

        There are quite likely to be other surgeons with significant no-mesh hernia repair experience. If anyone happens to know of any other surgeons then feel free to add them to the list, or offer any input.

        Good luck and keep us updated on your case, progress, and decision making.


        • #5
          You probably mean 4cm, not 4mm?

          Dr Brown is not a fan of meshes. He's very responsive and will answer your questions personally.


          • #6
            I believe the Desarda repair by Dr Robert Tomas is done with absorbable stitches, I am not sure if other doctors go that route. You'd have to ask directly

            Where are you located? Perhaps a no-mesh hernia surgeon is located near you that you could consult with.


            • #7
              ive had a shouldice technique operation with absorbable sutures and it only lasted a couple months. When i called the actual shouldice clinic to explain to them the issue and schedule surgery there they told me that a shouldice technique should never be peformed with sutures that are absorbed as this is highly likely to fail and were quite shocked this orocedure was actually performed..


              • #8
                Originally posted by idoncov View Post
                You probably mean 4cm, not 4mm?

                Dr Brown is not a fan of meshes. He's very responsive and will answer your questions personally.
                Dr Brown is Amazing Person !


                • #9
                  Baris, who performed your shouldice repair?
                  Apparently if PDS slow absorbing sutures are used it will hold and give your body enough time to heal.
                  Dr. Grishkan will do a two layer shouldice with absorbable upon request.
                  What type of repair did you end up going with?

                  Thanks in advance!


                  • #10
                    Hi jeremy,
                    i had my surgery done in cottbus germany by Dr Koch. It was arranged through bio hernia and he is a specialist in removing hernia mesh. I had my first in august 2017 didnt hold with absorbable sutures. I went back with complaints and he said no hernia. I insisted that i did and once he opened me i up at the start of december 2017 i had hernias again. he said he went over one side with a short permamanent suture and the other side he put a mesh over although i had enough muscle and it was indirect hernias. The side with the stitch reoccured straight away. The mesh side repccured after 3 months. I conctacted the shouldice clinic and they were very dissapointed why a surgeon will use the technique with absorbable sutures and without the cremester muscle being cut as this does not reflect back on the success of the technique. Cutting the cremester mucle makes a big difference with reoccurence rates with this technique as the founders have stated. They were more shocked the fact that although i had hernia why the doctor reoperated on me after just 3 months as they state that it takes 1 year for the muscle tissue to heal properly. So now i am scheduled to have surgery again at the end of the year this time at the shouldice clinic with the chief surgeon. I was asked to lose 35 pounds and was told that if that certain weight wasnt reached they wouldnt operate as again it made the surgery more risky. Its been a tough time but hopefully ill get there. But the hardest and most frustrating for me was the fact that i believed that i had done enough research and believed in ideas that sounded way too good. If your opting for a shouldice id certainly say contact the clinic in toronto. Doctors will say they have learnt there and so on. However speaking to the chief surgeons assistant they can only come and watch for a couple days and training is not provided. If shouldice id say contact the clinic.


                    • #11
                      Baris, did Dr Kock just go ahead and use absorbable during the Shouldice or did you request it?
                      Did he say he had good luck historically with absorbable?

                      Thanks in advance


                      • #12
                        Hi jeremy.
                        He told me the day before surgery exactly what he will do. I actually went to him for a desarda repair thinking that would be nore ideal and better and found him through moham desarda website. However he said once he will open me up he will decide which technique is suitable. After surgery was completed and inwas out of recovery i was told that a shouldice technique was peformed with absobable sutures. So no i didnt specifically request it. I believe its something he does quite common as he knew i was involved in high level sports at the time and still used absorbable.


                        • #13
                          Originally posted by Baris View Post
                          I believe its something he does quite common as he knew i was involved in high level sports at the time and still used absorbable.
                          Hi Baris. Could you give more detail on your situation? Your story sounds very interesting, in many ways. I think that the "holy grail" of hernia repair is one method that works for everyone. What type of sport, and did you gain the 35 lbs afterward, or does Shouldice just like very skinny people? Was your sport a high frequency sports like running, or a high intensity sport like weight-lifting? Or a combination of both like soccer (football)?

                          I was very athletic, mainly soccer, before my hernia repair with mesh and I found out why very few, if any, professional athletes get repairs with mesh. The mesh is a constant irritant to the surrounding tissue, which cannot handle the stresses and strains of continuous high level activity, with mesh. Since the mesh is gone I am slowly working my back to a higher level. All of my personal data, three and a half year's worth, points to the mesh as the main cause, with the extensive unnecessary dissection as a secondary cause. It's incredible how much healthy tissue was damaged to insert mesh in to areas that had no problem.

                          It would be great if you could tell more. Dr. Mucschaweck is known for working on athletes and her association with Biohernia is important.


                          • #14
                            Hey good intentions. Did you happen to do any type of body work that helped you post mesh removal-like myofascial release or ART etc?


                            • #15
                              Hi good intentions,
                              i was the same weight before the surgery however i have also realised that with the mesh wateva instant move i do or strain slightly it is a very uncomfortable situation. I kicked a ball once after 6 months and couldnt get out of bed for a week. I was told after that it was scar tissue re adjusting. I did a lot of heavy lifting combined with football. Although the surgeon states that he dsnt like to use mesh in athletes involved in intense sports i still believe in my situation permanent sutures from the first surgery would of been more ideal rather than ones that are absorbed.


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