How to deal with a hernia?

Dear friends and allies, 

Several months ago I developed an indirect, inguinal hernia. Perhaps it was hauling heavy, burlap bags of roots down mountain slopes at age 73.  At any rate, it is a major inconvenience since I still plan on carrying a lot more loads of roots down mountainsides.  I have been doing some research to decide how to deal with my hernia.  It is a bit embarrassing to talk about this publicly but perhaps the conversation will prove not only useful to me but to others who will get hernias in years to come.  About 80 percent of hernias are inguinal, and mostly experienced by men over 50. About one in four men will experience a hernia in their lifetime.

I am trying to decide which route to go.  Undoubtedly some of the people who read this have also had hernias and their experiences might be helpful to my understanding.  So do please send in comments here or to me directly in emails. [email protected]  Once the dust has settled, I can report what I’ve found out about the range of options, experiences and outcomes.

* Laparoscopy operation with inserted mesh.  This looks like the most common operation these days.  It has a high success rate, but there is a percentage of people who have ongoing pain, complications or recurrences. 

Tepp, minimal-invasive extra-peritoneal access

Tapp, minimal-invasive intraabdominal access

Albin method. See book The Hernia Solution by David Albin.

* Robotic surgery with inserted mesh.  This is the most modern method and perhaps the most expensive since the machines don’t come cheap.  The operation takes a bit longer.  Supposedly safer.

* Open surgery with inserted mesh. Mesh has been around since the 1980s.

Lichtenstein.

Stoppa repair

Wantz repair

* Tissue Repair. Open surgery without using mesh.  This was the old method.  It isn’t practiced or taught much anymore.  Neighboring muscles are drawn over the hole and sutured together. The advantage is that the body doesn’t have to deal with the foreign mesh and the body’s tendency to reject it.  Tissue repair costs less. There are a number of specific types including:

Shouldice, Developed by Dr. Shouldice and performed at his hospital in Toronto, Canada.  They have a great record of success.  The posterior wall is repaired with 4 layers of muscle overlapped.

Bassini. Includes reinforcement of posterior wall.

Desarda. Started in 2000.

Guarnieri

McVay/Cooper’s Ligament

* Healing without surgery option. I have found one book where the person claims to have cured their hernia without surgery.  Basically he went on a raw food diet to clean up his digestive system and reduce internal pressure and wore a special truss long enough for the hole to heal itself over.  He details this in his book

How Will I Get Rid Of My Hernia? Without Surgery! By Carsten Bachmeyer, 2012.

* Wait and watch method.  No surgery.  Wear a truss and hope for the best.  Live with the hernia.

* Other considerations:

Tacks, vs glue vs suture.

Absorbable vs. non-absorbable mesh.

Absorbable sutures vs. non-absorbable sutures.

Light-weight mesh vs. heavy-weight mesh.

* Youtube Videos

For anyone interested I can send a list of some Youtubes I found helpful.

Please send me your comments. Post here or email me directly. [email protected]  Once the dust has settled, I can report what I’ve found out about the range of options, experiences and outcomes.

       ~Michael Pilarski

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