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  • My Hernia Repair Surgery

    This thread, which is still extant on Tally's board, was lost in the crash of Ron's old board. I am resurrecting it here, because it is relevant with other FRs posting about their own concerns about inguinal hernia and inguinal hernia repair surgery in relation to their FR efforts.

    I noted that the first post on this board, was about injuries.
    #1 Old
    July 21st, 2014
    TheRifleman [IMG]file:///media/lrmain05/9405-893C/Ron-Hernia%20Repair%2001_files/user_offline.gif[/IMG]
    Senior Member
    Join Date: Oct 2011
    Posts: 344
    [IMG]file:///media/lrmain05/9405-893C/Ron-Hernia%20Repair%2001_files/icon1.gif[/IMG]My Hernia Repair Surgery
    I am posting this surgeon's report on my hernia repair surgery, because I have, in quite a few posts here, noted that some of the tugging I have done has caused pain with the hernia repair, which I have been avoided by adjusting how I do my tugging.

    While some of the men with hernia repairs claim no problems with their tugging, others say that, like myself, they have had problems.

    Since I don't know exactly why it is that some men do and some men do not have problems with their hernia repairs from their tugging, I'm hoping that those who know more about hernia, and hernia repair, might be able to provide some answers.

    Some of the factors I wonder about are whether the hernia is direct, or inderect, a sliding hernia, or a non sliding? hernia, and what kind of repair was done.


    PT: Mccain, Lucas
    DICT PHY: James Ryan, MD
    DOP: 12/07/98

    SURG: Dr. James Ryan,

    PRE-OP DX:

    1. Bilateral inguinal hernias wiwth recurrent left inguinal hernia.

    ANES: Spinal.

    PROC PERF: Laproscopic bilateral inguinal hernia repair using Prolene mesh.

    ASSIST: Raquel Cherry, RN.

    IND: The patient is a 47-year-old gentleman with a previous left inguinal hernia repair who presents with a recurrent left inguinal hernia and a new right inguinal hernia. He understands
    the risks and benefits of the procedure due to bilaterality and the recurrence on the left side. We plan on a laproscopic hernia repair. He understands the risks and benefits and agrees to proceed.

    FIND: Patient had a direct left inguiinal hernia with an indirect right inguinal hernia. Mesh was used. Good repair was obatained. No complications. EBL minimal.

    PROCEDURE: Patient was taken to the operating room, laced on the table in supine position. General endotracheal anesthesia was induced. His abdomen and perineum were shaved, prepped and draped in a sterile fashion. A Foley catheter was placed.

    Using curvilinear infraumbilical incision with an 11 blade knife, the anterior fascia was identified and a nick was made in this, carried down to the posterior sheath. The GSI baloon 1500 cc capacity was placed and insufflated in the standard fashion. The baloon was removed and insufflation with C02 was obtained. ----- was performed.

    The 30-degree scope was placed. The patient was placed in Trendelenburg, and the area was visualized. Small nicks were made in the midline in the suprapubic region, and 5 mm trocars were placed there.

    Beginning on the left side, dissection was carried down. A small nick was made in the peritoneum and this was unable to be stapled. Therefore a 14-gauge Jelco was placed into the upper abdomen to remove pneumoperitoneum. The pneumopreperitoneum was in good working order, and there was no obscuring of this with the bowel.

    Dissection was initiated, and the spermatic cord was identified. External iliac artery and vein were identified and preserved. The superficial epigastric vessels were identified and
    the hernia was medial to this. It was a direct inguinal hernia. Cooper's ligament and the pubic tubercle were identified as well. The mesh was marked, trimmed to the appropriate
    length, and a keyhole cut laterally, and this was placed into the pneumopreperitoneum and placed around the spermatic cord in a standard fashion, stapled with the tacker. The mesh
    was stapled medially more superior to the hernia defect, thereby obliteratinig this. The mesh was stapled with the pubic tubercle as well as the Cooper's ligament and then laterally along the musculature taking care not to injure the external iliac artery or vein. The
    lateral portion of the mesh was then placed more medially over the spermatic cord to close
    the window created there. There was a good result with minimal bleeding.

    Dissection was initiated on the right side and this was an indirect hernia. The spermatic cord was identified, the peritoneum was taken down, and the spermatic cord was visualized, and lipoma of the cord was reduced. There was no direct component. The Cooper's ligament and Poupart's ligament were cleard off using using the blunt dissection.
    Hemostasis was meticulous. Another piece of mesh was brought into the field, trimmed the appropriate length, and the keyhole cut laterally. This was then placed in the proper
    position around the spermatic cord and stapled. obliterating the window. This was stapled laterally taking care not to injure the external iliac artery and vein, and likewise stapled to the pubic tubercle and Cooper's ligament and the musculature anteriorly.

    Irrigation was placed and removed. Ther was no bleeding noted. The pneumopreperitoneum was removed. The scrotum was evacuated of air using direct
    pressure and the trocars and insufflation were removed. The wounds were copiously
    irrigated.

    The fascia was closed with interrupted 0 Ethibond suture, subcutaneous tissue was closed
    with running 3-0 Vicryl suture, and the skin was closed with interrupted 4-0 Monocryl and
    running 4-0 Monocryl. Steri-Strips and Band-Aids were placed, and the patient was taken
    extubated to the recovery room in stable condition for discharge later. The Foley catheter was removed.

    D 12/07/98 10:22
    T 12/09/98 07:54/090

    James Ryan, MD
    __________________
    You're giving me the shoulder / Still I want to hold you/ Something's really wrong / We better talk it over / come a little closer / standing on the border / between loving you tonight / and loosing you forever / now tell me, how can I love you when you don't even truy / how can I hold you, you're not mine / standing in the wings, by and by . . .

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  • #2
    Post No. 2, reply by Distalero. Distalero, are you here on the new board, under a different name?

    Old July 21st, 2014
    Distalero [IMG]file:///media/lrmain05/9405-893C/Ron%20Hernia%20Repair%2002_files/user_offline.gif[/IMG]
    Senor Miembre de la Luz(ers)
    Join Date: Jun 2007
    Posts: 1,030

    [IMG]file:///media/lrmain05/9405-893C/Ron%20Hernia%20Repair%2002_files/icon1.gif[/IMG]Re: My Hernia Repair Surgery

    I understand your concern, but if you re read your questions then you'll see that you seem to be trying to draw a direct relationship between this procedure, ie surgical repair of both areas, with "problems" tugging, referring to pain. There may not be a direct relationship. In other words, the repair, the types of inguinal hernias you ask about (vs what is described in the report), the methods used in repair of your case, can be completely separate from having intermittent pain in the area, at least directly.

    Your surgeon presumably has the patient history you two discussed, so he is the best resource to answer your questions. He can explain what "recurrent" means in relation to your questions. I would hope you discussed tugging with him. If not, then he is still the best (really, only) resource of information that will answer your concerns; he was the guy that opened you up and observed your particular case. I realize that some time has gone by since this procedure was performed. He will have perspective on that fact as well.

    Otherwise, you can just google for general definitions of the terms you ask about, but obviously, good communication between provider and patient is the only way to go, and the safest way to go, rather than guessing. You won't find anyone here who has your history, or his training, and another member who's had a similar procedure trying to answer the questions behind your questions won't be satisfactory.
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    • #3
      Post # 3 my reply to Distalero
      Old July 22nd, 2014
      TheRifleman [IMG]file:///media/lrmain04/9405-893C/Ron%20Hernia%20Repair%2003_files/user_offline.gif[/IMG]

      Senior Member
      Join Date: Oct 2011
      Posts: 344
      [IMG]file:///media/lrmain04/9405-893C/Ron%20Hernia%20Repair%2003_files/icon1.gif[/IMG]Re: My Hernia Repair Surgery

      Thanks for the post, Distalero. You make many good points.

      Since, with my present tugging techniques I am not having any pain, I don't see any need to see the surgeon, although if I did start to have pain I would see him again.

      At the time I had the surgery, I was not using any "set and forget" type of tension, and it's only been relatively recently that I have had the pain, wich stopped when I changed my tugging techniques.

      I did ask the surgeon on my follow up visit if there was an problem with my doing certain Yoga poses, showing him photos of the poses in a paperback book which I took with me, and he said the poses were OK for me to do.

      __________________
      You're giving me the shoulder / Still I want to hold you/ Something's really wrong / We better talk it over / come a little closer / standing on the border / between loving you tonight / and loosing you forever / now tell me, how can I love you when you don't even truy / how can I hold you, you're not mine / standing in the wings, by and by . . .

      Name That Tune!

      Reply With Quote

      Comment


      • #4
        I had a double hernia surgery a few years ago and (as far as I can/could discern) it did not have any effect on my FR or vice versa.

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