British Hernia Centre anyone had any experience of them

Hi,

Thanks for that.

I guess we'll just have to wait and see what happens.

Good luck with your "large repair".

Phil.

Hi, I know it has been a while and your hernia repair was several years ago. I hope you don't mind sharing you experience with me your experiences with the large and open surgery on incisional hernia.

I had a Whirlpool surgery, too, in Oct. 2019. Now, I'm having a hernia the size of a fist through a 3X5cm hole on the abdominal wall. The original surgery team has offered a larger op that will cut on the scar of the Whirlpool op, remove the tissue, put mesh on the hole and other potential holes and, then, stitch me up.

Was your op similar? Was it successful? Has there been any more hernia?

I hope it has worked and you are doing well.

Lucy

Dear Phil:

Thank you so so much for the posts. They help me a lot to understand what I need to do. I'm trying to make a decision and feel that Mr Borley in Nuffield may be my best choice.

What do you think? You can know my situation from the reply I sent to Dramatist.

Things are much worse for me now and NHS neglected me for ten months and have just put me on a waiting list.

Thanks

Lucy

Hi KR,

Thanks for your comment, I'll take that into consideration after I have had my consultation.

Of course it's very difficult to compare like-for-like in this situation. Had you had your operation on the NHS and your sister had her's privately, say, then that might lend weight to your argument.

From my perspective I have had extremely good experiences with the NHS and have nothing but praise for them, especially when it's a serious situation. Over the last 26 years I have had life threatening cancer that ended in an extremely serious 5 hour operation, I have had a heart valve replaced and I recently had emergency surgery to save my life from a twisted gut - the hernias that I now have are as a consequence of that life saving operation by the way which is not uncommon. I also had two inguinal hernias repaired more years ago than I can remember, one on the NHS and the other privately, from both of which I have had no problems.

My comments above are the result of some small amount of research and merely reflect what my GP has said to me and what seems to be the general opinion. From what I have read, the NHS don't have units that specialise in hernia repair but this task falls to a general surgical team some of whom are very experienced and have repaired numerous hernias and some not so experienced.

So I think you will agree that I am not making some random comment or criticism of the NHS but I am speaking from a considered point of view.

I have concluded that I would rather use a surgeon who specialises in hernia repair than a general surgeon.

Phil.

Hi Lee,

Since I last posted on this thread things have moved on a tad. I went for a consultation with the British Hernia Centre (BHC) and met with a consultant, Mr. Hakky, who confirmed the diagnosis and recommended repair as soon as practical using what he called a hybrid technique. This seems to be a combination of a mesh placed over the weakened area behind the abdominal wall (posterior hernia repair, sublay, preperitoneal) done laparoscopically and suturing of the muscle wall done open.

Mr. Hakky sounded very knowledgeable and at that time, September 2016, had done over 100 incisional hernia repairs since January. I was very impressed by him and happy to have him do the repair. The BHC subsequently quoted me £12K for the operation; this was more expensive than I was expecting.

I have to say that although Mr. Hakky was very professional the admin staff at the BHC left a lot to be desired. When I received Mr. Hakky’s report there were a number of inaccuracies and mistakes that I had to get them to correct.

Mr. Hakky had mentioned that if I had come up on his NHS list he would not hesitate to operate. Thus I started to investigate being referred to him under the NHS. My GP was not happy to do that saying that the Gloucestershire Clinical Commissioning Group only supported referrals outside the area if that expertise was not available within the area. He referred me to the colorectal consultant in Cheltenham responsible for the group that did the operation to resolve the twisted gut (volvulus) which subsequently resulted in the hernia.

Meanwhile I had done a lot of research on incisional hernia repairs and was extremely concerned about the use of a mesh. I suggest that you search on this forum for comments by Shirley123 and have a look at the Dutch TV programme that she talks about (Radar) in thread “Laparoscopic incisional hernia repair” started by Selphie85. It's very worrying.

Eventually I got to see the colorectal consultant, Mr. Borley, and he impressed me mightily (but then I was impressed by what Mr. Hakky had to say … I dunno, maybe I’m just easily impressed … but in my defence I have learnt a lot more since I saw Mr. Hakky). He recommended a different approach not using mesh at all. To be fair he did say it might be that he would have to use mesh but he was not expecting to do that.

Mr, Borley said he would recommend using a Component Release technique (referred to as CST in the states) which involves freeing one of the abdominal muscle layers from it’s anchor point in the flank to form a patch over the hernia thus forming a tensionless repair. No mesh would be used. I was mightily relieved. This is a much more complex procedure and requires experienced surgeons. I realised afterwards that Mr. Borley was approaching this as abdominal reconstruction rather than merely a hernia repair, this is just my take on what he said and so I may be misrepresenting him.

Anyway, I’m now on his waiting list but he warned me that his list was very long and that I might wait a long time. At this time I have passed the 18 week RTT threshold and no sign yet of a date for my procedure. Mr. Borley did say I could transfer to another consultant’s waiting list but frankly I would rather have him do the procedure. I am now investigating what it would cost to have Mr. Borley do the procedure privately but I suspect it will be prohibitively expensive!

Lee, my advice is, if you can, stay away from the use of mesh, it’s too risky.

Hope that helps.

Regards,

Phil

Hi Phil

Thanks for taking the time to respond, you've raised some interesting points that I'll certainly look in to. My operation 3 years ago was for a large abdominal incisional hernia, and an open surgery mesh repair was performed. Unfortunately it failed in the first 6 months! I'm now in a lot of discomfort, (the mesh is pulling badly) so will need to do something about it soon. I'm in my 40's so not prepared to just live with it yet. I think I'll approach the BHC and see what they can offer, the procedures you mention (particularly abdominal reconstruction) sound promising and I'm hoping a hernia specialist may offer the answer.

Good luck with your situation I hope it gets sorted soon.

Regards

Lee

Hi British Hernia,

Thanks for the clarification.

As it turns out I didn't fall down that particular crack and did in fact see Mr Hakky at the BHC in The Lindo Wing, St Marys Hospital Paddington in Central London. Still hopefully your comment will be of value to other hernia sufferes.

In the event I didn't go with the BHC mainly because of the vast difference in cost, £12k with the BHC Vs £3,7k'ish wth the Nuffield and confidence in the Cheltenham based consultant who has now done the repair using component release with no mesh involved.

Regards,

Phil.

Hi Dawn,

At the time of writing the above posts the hernia was about size of a beer mat, perhaps slightly larger than that. I had that repaired using a component release technique which does not use mesh.

Unfortunately that was only partially successful as the top part of the repair failed. I am putting that down to a sneezing fit that I had soon after the operation. Saying that sounds a bit lame now but I really did try not to lift anything too heavy, although my partner might say otherwise! The resultant hernia was about two inches in diameter when I first noticed it and this ultimately enlarged to about the same size as the first hernia. This was then repaired using mesh since to do more component release would have meant quite a complex operation. I was trying to avoid mesh but , hey, ho, what choice did I have?

The last repair was done on the 7th of December 2017 and having taken it very easy I am now carefully starting to resume a more normal life. It seems to be OK so far except that my abdomen is not quite as flat as it might otherwise be. Maybe that will improve with exercise.

Your husband’s hernia is now very large. [rant start] What do they (NHS?) expect if they tell you to wait and watch ... it's going to get bigger .... a child of 5 could tell you that ... unless you sit down and do nothing for the rest of your life. So if by negligence you are referring to yourselves then I think you are being unfairly hard on your selves. [rant end]

In my own opinion and please note that I am not medically trained, it will be a more complex operation now than when it was golf ball sized but repairable none the less. However like any operation there is the chance that it won’t be completely successful and depending on technique failure rates can be quite significant.

You need to do your own research and gather the, what might loosely be called, “facts”. Then discuss your findings with your surgeon. If he/she is saying unequivocally that she/he can guarantee 100% that the operation will be successful then personally I’d look for another surgeon. You need someone who is going to be straight with you even if the facts are not what you would like to hear. It's your husband's body, honesty is paramount.

Hope that helps, let us know how you get on and good luck.

Regards,

Phil.

Hi Phil he had his first meeting with the plastic surgeon and all seems doable so pleased with that. He has to lose some weight and the hernia surgeon will also do his work. Seeing top guy in Newcastle NHS. Might still be a few months yet though to wait for op typical. The recovery I hear from different people is quite a long time after such a big operation. But hey fingers crossed now 🤞

After having the consultation with the British Hernia Centre (BHC) I discussed things further with my GP and used what I’d learned at the BHC  to apply a bit of pressure on him to get him to “review” his “wait and see” attitude. I asked if I could be referred to Mr Hakky on the NHS, the GP said that in the first instance we should try to find a consultant within the local Clinical Commissioning Group area (Gloucestershire et al). If we failed to find someone acceptable then we could look elsewhere at that time.

Since I had an Incisional Abdominal Hernia, i.e. a hernia as a consequence of an abdominal operation, I should be referred back to the NHS consultant who did the original operation. My GP went on to say that I was quite within my rights to ask for the “boss” (the senior consultant for that group) to look at my case. This I did and his name is Mr Borley;  Mr Borley did not do the original operation but one of his crew did.

I was put on Mr Borley’s long list of patients for an initial consultation (NHS). Eventually I got to see Mr Borley and he agreed the hernia should be repaired and I opted to be placed on to his operating list. However Mr Borley is really a colorectal expert (and I imagine much in demand for more serious operations) so he warned me that his was a long list and we might exceed the Referral To Treatment (RTT) time limit set for the NHS. I can’t remember off hand but I think that was 16 weeks. He was quite happy for me to transfer to another of his consultants if I wanted to if that meant being seen more promptly but I wanted “the boss” as he has a very solid reputation in this area, so I stayed on Mr Borley’s list.

Obviously we exceeded the RTT and after a few more weeks, months with no treatment date in sight I decided to look at the alternatives. I researched the possibility of going privately with Mr Borley and it turned out that most of his private work is done with the Nuffield. So, Melody, that’s how I ended up at the Nuffield as a private patient.

I hope that helps.

Regards,

Phil.