Inguinal hernia: open or keyhole surgery?

I have two comments 

1) please do your research and also look into having your hernia repaired the old fashion way no mesh.  For about 20-30% of patients mesh cuases major problems, infection, entrapping nerves, migrating chronic pain and once this plastic is implanted is there are issues it is meant to be permanent like a scaffold. No one will help you including your impmatkng surgeon should something go wrong. Ask your surgeon if you should experience pain from the mesh can he remove it and see what he says-you won’t line his answer.

I had hernia mesh implanted and it folded up into a ball and I never felt pain like it in my life. It can attach to your bladder, spermatic cord nerves and other structures 

It took me over 5 years to get to the bottom of this as every surgeon and test said all was fine

Finally after song my wine research and finding one of maybe 4 surgeons who specialize in mesh removal one surgeon found that on a cat scan the mesh was folded. 31/2 hour surgery to remove the mesh. Mesh is plastic and meant to be permanent some do fine with it but believe me there are a little people suffering from it in many different ways.

And there is no research what this stuff does in the body over a 10,20,30 or 40 year period.

That being said if you decide to go with mesh consider open implantation.

When they do laparoscopic they place the mesh and a big piece- ask your surgeon to show you what he uses-it’s the size of a small dinner plate and this method placed the mesh very close to your intestines and other structures.

When they do lapro they also have to carve out space in your abdomen to place the mesh.

Just please do your research-ask your surgeon to tell you what type of mesh he uses and research it. Do not goto a general surgeon search out a hernia specialist no matter what approach you decide on.

The next big thing will be lawsuits against mesh manufatures. They will tell you that mesh will have Lower recurrence rated then the old fashion way-this is a lie-google the shouldice hospital in Canada which only doesn’t non mesh repairs they have a less than 1% recurrence rate and less than 1% chronic pain.   Mesh has a 3% recurrence rate and a chronic pain as high as 20-30%. Not with it in my opinion.

Sonehich is better open or lapro with mesh in my opinion neither big if you had to choose I’d go with open but I’d strongly rx getting the hernia repaired without mesh and even if it means traveling to do so to do it

Go with the keyhole. Your recovery will be much quicker. I had keyhole for bilateral inguinal hernias and was back on the golf course in 2 weeks. It would have been 3-4 weeks with open.

Goid luck

Clive,

I assume key hole is laparoscopic.  I was not a candidate for that due to previous prostate surgery so I had the open.  It has been three weeks and I am just starting to be fully mobile.  I have 3 more weeks until I can play golf.  I am 73 and it has not been a pleasant experience.  Go key hole as long as you are able.

Thanks, Doug. Apparently the recovery period is MUCH quicker for bilateral hernias, but less significant for unilateral ones. I'll see if anyone has experience of this: there is also a slightly higher risk of damage to the gut with keyhole vs open surgery.

My reading of the literature is that keyhole is a much trickier operation hence higher risk of complications unless you get a surgeon who specialises in the technique and has long experience of using it. NICE recommend open surgery for straightforward cases. But you're right that recovery time is said to be shorter for keyhole if all goes well. I haven't had either yet so can't comment from own experience.

On mesh vs no mesh: some people do have very bad experience with mesh (and of course those people are more likely to contribute to these forums than people who are fine). Unfortunately some people also have very bad experience without mesh: also high (10-20%) rates of post op pain. It does seem generally agreed though that mesh reduces recurrence rate. No easy answers I'm afraid. Good luck, whatever you decide, and let us know how you get on.

Thanks, Ulfgar. I really appreciate your input. That's exactly where I'm coming down on this. I'll let you know how I get on. The wait is 2-4 months, so it will be a while before I know. Meanwhile, pain management is the key...

I would look into Dr. Robert Tomas, he is a surgeon who specializes in no mesh hernia repairs. He has repaired well over 2k procedures and maintains a less than 1% recurrence rate. His staff is amazing and they make recovery very easy. Dr. Tomas offers free consults so there's nothing to lose by getting information. Call there and see what they say 239.243.8222 or Google his name. Best of luck!

Unfortunately, I'm in the UK! But then again, fortunately I have the NHS, and I'm deeply grateful for that. They really are a terrific service. Anyone who says "socialized medicine" is bad has never lived in a country that has it! I'm going for a pre-assessment next week. Just met a neighbour who has had 2 hernias repaired, one open, one laparoscopic. He's convinced laparoscopic is the way to go. So that's probably where I'll put my (don't need any) money.

I think open surgery is more reliable from what I've been told. Mine was open with mesh.