Hernia Repair
 

There are apparently two different operations.

Any experience in which is better?

There are more than two types of hernias, let alone procedures to repair them

The one that you pay for yourself is the better one.

I have a run of the mill inguinal hernia.

I think you're thinking of open versus laparoscopic. The open technique (there are actually a myriad of variations of open techniques) makes an incision over the inguinal ligament in your groin. It's the tried and true method. Usually a piece of mesh is used to "reinforce" the repair. It leaves you with a bigger scar and some more pain during initial recovery.

Laparoscopic herniorrhaphy uses a camera and special instruments through three or four fingertip-sized holes to perform the surgery. A piece of mesh is placed to cover the hernia defect. Benefits are lack of the open incision and less resultant pain. If you're going to have both sides done, it probably will be less painful to have it done laparoscopically. If you've had previous abdominal surgery, it may not be possible to perform the laparoscopic surgery due to scar tissue.

In the end, both types of repair get good results. Both are acceptable ways to do it. I'd pick the surgeon over the particular technique. I did my residency at St. E's, so if you want a recommendation over there let me know.

Thank you, yes, open vs. lap.

Just saw the surgeon my doctor recommended. He only does open, not a fan of lap. Dr. John Schuler at Mt. Auburn hospital. He did say there's more pain and it's a 1-2 day longer recovery period, but he only does the open.

He seemed like a good guy, older, and to be honest, anyone my regular doctor recommends has to be good.

Thank you for the offer on the rec, much appreciated; anyway to check out Dr. Schuler? I'm hoping to get it done next week, otherwise middle of August.

An experienced, meticulous surgeon will pick the procedure best suited for your particular type and size of hernia.

I never worked within the Mt Auburn system, so I'm not familiar with their docs.

I don't do lap hernia repairs, either. There's some benefit to it, but in the end with this problem I feel you need to be comfortable with your surgeon, as opposed to picking the procedure and then finding a surgeon who does it that way.

Whichever you have, be ready to sleep at least a night or two in a recliner. I have had 2 hernias and sleeping in the recliner plus a little ice and a pillow on your lap and you'll be set.

Thank you Gentlemen, I like this guy, so I'll go with him. Hoping to be down for 2 days max.

I blew a gut over the memorial weekend. I had 3 shows to do in 22 hrs. Holiday weekend, ER my only option and I couldn't bail on any of these shows. One show was at the VA hospital and I wouldn't miss that for anything. Lots of pain but I ice packed the area and when it was good and cold I took a deep breath and pushed that sucker back in. I kept it on ice between shows and by the time I saw my Dr. the following weds. He told me it was back in..but it could pop back out at any time. This is good info for me as well as it will need to be done eventually. Let me know how it turns out Shaun.

hey David! PM sent.

I've had both. And there are a few threads on this here if you want to go back.

My first was done by a surgeon that did open and no mesh, just a good sew up job. No problems in 20 years and I've tested it for sure. The draw back was no way 2-3 day recovery. I couldn't walk well for a week and was on Vicodin for at least that long. I was off hard labor for 6 weeks.

So, 2nd one comes along a few years ago and my urologist says he can do it. Not that well versed in laproscopy (he should be), he says 2 inch incision and mesh deployed and sewn below. I would use a general surgeon now for hernia repair.

I'd go for the both hands in if it ever came to be that I needed another repair. I don't think I'd have any choice. But, the lack of mesh would be my choice because that lump has never been right for me. For a year I had to modify how sex was performed. It just wasn't comfortable if there was a lot of motion on the area. The first side is like it was never done.

One more thing, be prepared for skin numbness around the incision for up to 2 years. Must be a lot of nerves down there.

I don't know if your 2-day downtime expectation is realistic. I'd think you'd be mostly on the couch for about 1-2 weeks. And no significant strenuous activity for about 6 weeks.

During residency I actually got to perform this surgery on a roommate. It just worked out that his surgeon was one of my attendings, and I was on that service at that time. It took about 2-3 months before my roommate was back to playing soccer (Irishman living in Brighton--go figure), and he said about 8 months before he was entirely painfree. Just one anecdote, but I think his experience was fairly typical.

My dad had a hernia and a cyst removed from a testicle and was back in the restaurant in 3 days working.

He was a tough SOB.

I had an inguinal repaired about 3 years ago. The repair was an open surgery with mesh. I went in on Friday, was completely out of commission Saturday, but by Sunday I was walking around. Went back to work on Monday but I was tender down there for a few weeks following.

Good luck with whatever method you choose and I hope you have a speedy recovery!
Michael

have a cough pillow, small pillow you hold against your belly when you cough, ice is your friend, you do not want to be constipated, the dope they give you for pain can make your bowels go all Elvis Aron Presley on you

I assisted on a bunch of them as a resident. It always seemed to me, when you are fixing stuff that is blown out, scar tissue would sort of be your friend, add to the stability. I did a lateral ankle repair that was a total freakin' nightmare from hell. Utterly non-compliant patient, got it wet, got infected, worst looking scar ever, but that ankle was solid, eliminated the instability. I always figured the open procedure would be better for hernias

I'm scheduled for that surgery at Kaiser on July 19th. This is the left side. Had the right side done about 15 yrs. ago. Mine was the open surgery with mesh, and this one will be the same. On the one I had before, the doctor did a local. He had a partner and the three of us conversed & joked the whole time. He told me to take a walk the next day, which I did for 2 miles. When I talked to him next, he said he did't mean something like that. I gave up the pain killers the second day because the pain wasn't that bad & I didn't want to take the chance on getting plugged up. As for sex, my girlfriend (now my wife) made me do it the second day after the surgery. It wasn't wild & sweaty, but it was just fine. I wasn't down much but did't do much either & went back to work in about 4 days. I'm hoping this one will go as easily, but my age now might not be a guarantee for that. Good luck to you.

Dang Shaun that was one hot date ;)

I have had this done three times. One original failed and had both sides done in one go the second time in.
Not to be too negative, but 3 days of downtime isn't realistic. You won't be feeling much like moving around. Forcing yourself to go for a walk is the best you can do.
If you are planning on driving, keep in mind that one panic stop will probably hurt you badly.
Keep some fiber (Metamucil) around and get some over the counter stool softeners for the first few days after.
Mine have never really been the same. Could be scar tissue or maybe it is what I used to do for a living that contributed to the pain I get from mine if I overdue it a little.