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Medical Forum / General / General / March 2007

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Hernia Recurrence?

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Dave - 02 Mar 2007 22:05 GMT
I'm glad I found this board because I'm totally freaking out right
now.  I had a ventral hernia repaired in August and now it's come
back.  No mesh was used.  I just saw the original surgeon today.  He
says it's twice as big now and started to give me all sorts of scare
stories like now it's a re-do and the risks of recurrence are twice as
big and the tear is twice as big (13x14") and I have a 5% chance of
having a heart attack in the OR.  I'm only 32 but I am overweight.
Obviously that's a concern for me for more than just the hernia but
he's making it sound like having this redone is DANGEROUS and that
even if he uses a mesh the chances of success are small and doesn't
want to do this until I lose 50 pounds (ok maybe that's
exaggerating).  It sounds like I'm screwed no matter what I do.  I'd
like to know if the size of the new hernia is inherently dangerous in
and of itself (i.e. risk of strangulation aside).  He also said that a
mesh doesn't really help because if the sutures didn't hold around the
repair they won't hold around the mesh either and the mesh could make
things worse!  Is this true???  If I do it without the mesh it won't
hold either and he makes surgery sound like it's dangerous.  It sounds
like I don't have any good options.  We discussed the idea of
laproscopy but he said he doesn't do that anyway.  Does laproscopy
help anything?

Fortunately I'm not in great pain right now and the hernia seems to be
"behaving" itself.  There's no nausea or vomiting, just an occasional
cramping.  But I'm kind of freaked out now because he made it sound
like I'm screwed if I don't do it soon and that I'll die if I do it
soon.
Howard McCollister - 02 Mar 2007 22:18 GMT
> I'm glad I found this board because I'm totally freaking out right
> now.  I had a ventral hernia repaired in August and now it's come
[quoted text clipped - 23 lines]
> like I'm screwed if I don't do it soon and that I'll die if I do it
> soon.

I assume by "ventral hernia" you're  referring to an incisional hernia.

It's hard to envision any competent surgeon repairing an incisional hernia
without using mesh primarily, especially in someone who's obese. If your
recounting of what your surgeon told you is accurate, then you need to find
a surgeon who knows what he's doing. This one doesn't.

Your re-repair needs to be done laparoscopically, so you need to find a
competent minimally invasive surgeon.

Yes, your obesity puts you at risk for recurrence.

HMc
Jeff - 03 Mar 2007 02:47 GMT
Related question: My father had a prostectomy a few years ago. The following
year, he had a ventral hernia that was repaired with a mesh. through an open
incision. All is fine. The mesh is just nifty.

Should it have been repaired laproscopically?

How do you tell when it should be repair laproscopically vs. an open
incision.

I am kits curious.

Merci.

Jeff
Howard McCollister - 03 Mar 2007 13:43 GMT
> Related question: My father had a prostectomy a few years ago. The
> following year, he had a ventral hernia that was repaired with a mesh.
[quoted text clipped - 6 lines]
>
> I am kits curious.

There are virtually no incisional hernias where an open repair is superior
to a laparoscopic repair - in fact quite the opposite. However, laparoscopic
repairs require more experience and skill on the part of the surgeon.

HMc
Jeff - 03 Mar 2007 14:06 GMT
>> Related question: My father had a prostectomy a few years ago. The
>> following year, he had a ventral hernia that was repaired with a mesh.
[quoted text clipped - 13 lines]
>
> HMc

Thanks.
 
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