https://www.ncbi.nlm.nih.gov/pubmed/10452261. Also, I find there is a lack of information on hernias in fertile women and how to treat. The literature on incisional hernias is where the use of mesh was first tested. Fill in your details below or click an icon to log in: You are commenting using your WordPress.com account. 2) No tacks or staples inside the abdomen to further the chance of nerve damage. He said these were all old issues and not an issue wirh the new good mesh. I came up to Shouldice from the States not because of concern over use of mesh but because of concern over general anesthesia which I was told I would have in the States. In fact, after asking permission and explaining the purpose, they live-streamed my operation to a Surgeons conference in Victoria, BC. Yes, but it will fade with time and is overly visible except when naked. The vast majority of procedures are day surgery, or what we call same day admits, where they are admitted (usually after a lot more major surgery than hernia repair) after their operation. Shouldice Hospital (formerly Shouldice Hernia Centre) is a private hospital at 7750 Bayview Avenue in Thornhill, Ontario, Canada. The rate of this risk varies, you say it is low, but the risk exists. I since switched meds and lost a bit of weight but Its so difficult to even move with a cantaloupe sized abdominal hernia. J. Surg. Shouldice also claims that its model allows it to perform at a lower cost per case than public hospitals, and that wait times are a fraction of those in the public system. I am of normal weight, but the physician who examined me advise me to loose weight, just because thats what he probably says automatically to all the patients. Staff was decent, Now the Cons I just had my inguinal hernia repaired at Shouldice. Migration can happen . There are many reasons why mesh is used and many people do fine with it. I have heard of one fellow returning to the gym and heavy squats within 2 months of his op which DOES seem to be tempting fate, so some patients may not be helping themselves. At Tar, I am now currently here in August 2016. I may get the same answers but at least Ive tried. I think is a matter of profit from this industry. The "first" reduction in Tq is much greater!) So Im now working with a new surgeon in hopes that they maybe able to help. Shouldice Hospital is returning to Vancouver to conduct examinations in March 2023! Well, I had my right side hernia done 4.5 weeks ago at the local hospital, mesh method. Your comment/reply from January 25, 2016 AT 11:14 PM says: for the vast majority of patients they will be aware if their repair, or have to take medications for it., I am guessing that you probably meant:they will NOT be aware OF their repair, or have to take medications for it.. In order to lose the proper amount hed need to eat saw dust and exercise. Shouldice consult was Feb 8/2022 and I was booked in for June 2022 surgery that same day. When you say walnut size that may mean the size of the sac which can and often is larger than the actual hernia itself. Chronic disabling pain which needs ongoing pain medication and/or other management (including mesh removal in the most severe cases) is thankfully extremely rare after groin hernia repair, be it with or without mesh. Sonesta Suites355 South Park Road, Thornhill, ON L3T 7W21-800-SONESTA1-800-766-3782. When you come to Shouldice, you can expect to have a positive and pleasant experience. Please call 905-695-4911 to book a time. Mesh does reduce the risk of recurrence but does not make it zero. If that is the case, I would rather stay in NYC but I guess I will have to make the trip to find out. The whole experience was quite pleasant, and Sarasota, Florida is a beautiful, wonderful place to visit. I find it hard to get solid information of one method vs the other, maybe because there really isnt any. Thanks for your comments. The problem is that the mesh industry is so powerful it is impossible to get anything published that doesnt involve a mesh. From what I understand well above 90% of Inguinal Hernia operations are successful, and that this is considered to be a routine operation by the medical profession. Pain clinics are full of patients who have had open mesh repairs. Most of the arguments against Shouldice here seem to have very little to do with the actual technique, pain afterwards or recurrence (irritation, I thought, at the Southfork-like set-up and possibly also at their very existence fuelling endless questions like mine: is mesh a problem or isnt it? Sheraton Parkway600 Highway 7Richmond Hill, Ontario905-881-21211-800-668-0101Call hotel for special Shouldice rate.2.5 miles from the hospital. Ive had other friends have a nerve block and it helped them for months so it is hard to know the amount of help it may give you. I still feel very comfortable with my decision to use the Shouldice clinic. This is so helpful! During the first week if I was too active Id feel soreness but with a few hrs rest it went away. However there is more to it. You dont find Drs in NY doing hernia repairs without the mesh. . Your post here changed my life, my plans, in a good very good way. The day after and two days after the operation I walked around the Shouldice property which helped with circulation and recovery. She suggested that the nerve fibre regrowth in the skin layers around the surgical site may be causing the sensitivity. 65 Minthorn BoulevardThornhill, Ontario905-707-65332 miles from the hospital. Last year, it had a record year and performed nearly 7,500 operations. I believe every patient has to make their own decision. Shouldice Hospital in Canada is widely known for one thing-hernia repair! Hilton Garden Inn300 Commerce Valley DriveThornhill, ON L3T 7X3905-709-60083 miles from the hospitalTo receive a 10% discounted Shouldice rate click here. Im probably an anomaly in the hernia world, but my story is horrific and Im still passing through it. It could be scar tissue or it could be the actual implant rubbing on the nerve. A skim off of the healthy and the wealthy to the private system, leaving the public system to deal with the emergency, unhealthy, and poorer patients. The huge incision ripped internally and of course I wanted to choose the BE ST surgery clinic to repair it so it would not happen again. My luck, the guy was a heavy sleeper and snored all night which means I could not get that much sleep during my stay. Presumeably some patients have a higher sensitivity to foreign body implantation (testing for that must be possible, but rarely spoken of, although different materials for the mesh are being developed) and inept insertion technique (inexperience, tiredness, simple error?) Hi. Food was above what was expected of hospital food. I would say you will very likely be fine, I wouldnt worry about your decision at this point. Ive had friends who had surgery with the best and have come out messed up. Toronto Transit. my surgeon said it was mostly a bunch of people complaining looking for money. Shouldice also offers a variety of services to help you prepare for your hernia operation and improve your recovery. I went to see my family doctor as I live too far from Shouldice to visit. I went into general surgery because its well, general. I am very happy with the outcome and am glad I didnt go for a mesh repair. The short time before my surgery I couldnt find anything definitive saying mesh was good or bad. Very good points Tony! Oddly general surgeons have recommended neurectomy though the pain clinic doctors I saw were highly against this type of procedure. I have recently had a consult at Shouldice and had some concerns. Do you yourself know how many of your hernia surgeries fail? The repair is based on the Bassini repair with some modification. York Region Transit. The Shouldice clinic admits patients the day BEFORE their surgery. Do you have any other suggestions for me? I have had one for four years and besides some soreness at the end of the day, I am not in constant terrible pain. The Shouldice Clinic is a private clinic operating in the Toronto area which has been open for decades. My husband went in, doctor said lose weight and i will do it. Maybe a freedom of information request needs to be filed so accurate comparisons can be made. How long ago was your surgery? It was originally founded during World War 2 to allow for young men to have their hernias repaired before going off to fight. There are definitely many who travel to Shouldice from the USA, where last I heard it runs somewhere around $6500 paid out of pocket for an inguinal hernia repair and the multiple night stay in a facility that supposedly feels collegiate. You are right, there is not a lot of good information for women in your situation. The worst things said seem to be about the dcor of the hospital, the way the nurses and doctors treat you/pillows too small/beds like rubber etc. Placed in a room with patient who had surgery the day prior. We encourage you to take advantage of these beneficial patient programs. To do less would be to jeopardize the positive end result. Mesh CAN be a nightmare if not inserted properly, and maybe I would be able to get away with not using in a very slim patient, but I consent patients thoroughly to all the risk factors. Certainly everybody who is having a hernia repaired should carefully discuss the pros and cons of using mesh- its a very individual decision and patients deserve to be well informed. I do everything I want without restricting myself. 5 weeks after surgery, my scar looks pretty much healed and I expect it will fade with time. They do the surgery anyways. The first consultation is walk in which for me meant a 3 hour wait in a run down old estate living room. Just returned from Shouldice. The techniques used by the hernia specialists at Shouldice dramatically reduce the risk of recurrent hernias to approximately 1% over a lifetime. Different policies will exist. The Shouldice clinic was purchased as an estate in the early 50's, so it definitely has that old, historic feel to it. A lot of nerve damage occurred to my femoral nerve, and the mesh they have inserted is extremely painful. It is located in Toronto, Ontario, Canada north of Highway 401 on Bayview nearer to Highway 407. Beds and pillows are absolute garbage ( bring yourself a sleeping bag for the floor for a more comfortable sleep) I had my first one done at Shouldice (10 yrs ago) and no issues with it unless I do a lot of hiking or lifting and then maybe a bit of soreness in the left groin. It is supposed to be better than Shouldice. They have been quite successful with it. Laparoscopic repairs are reported to have the lowest occurrence of chronic pain in the papers that I read. Id stick to an open or lap repair with mesh applied externally. My husband was asked to lose weight for the surgery but still was not skinny. That was a bit odd. Sharing the experience with a bunch of other patients was a big plus in my opinion. But it might also just be for efficiency. Relaxing views and an estate-like setting are an important part of the total Shouldice experience and help to stimulate the bodys own natural abilities to heal. I see that you are anti-Shouldice but wonder how much of that is based on procedure/method and how much is related to you not liking that they get to do only elective and cherry pick. One thing Ill add, is a problem with the Shouldice technique is that its complicated for a surgeon who is not very experienced with it. At the mid point of the second week, I had searing, stabbing pain at the surgery site. In assessing them, serious consideration has to be given to the culture of the organization and the importance of preserving it in a service delivery system. I have been informed by most of the local hospitals that there is nothing they can do. Well keep in touch every year and offer you an opportunity to have your hernia repair checked and monitored by our surgeons. This makes anyones numbers on hernia repair difficult to interpret, but the Shouldices number in particular should be viewed with a grain of salt. Although operations are performed only five days a week, the remainder of the hospital is in operation continuously to attend to recovering patients. . Realistically, I am 50, 57 and 163 pounds, am I really going to lose 30 pounds and keep it off for the rest of my life? State/public schools teach who theyre told to teach meaning everyone else who doesnt get to go to the private schools. If their procedure was outdated/inappropriate in anyway, then why are they still in business helping 7000 healthy, wealthy and skinny people (morale issue again) per year have pain free and hernia free lives? I would think you could fix it now and get pregnant right away without worry. [1] The hospital specializes in hernia care. We have provided this list as a courtesy to our patients and their guests. Having said that, the risk of recurrence is much higher with umbilical and epigastric hernias in pregnancy than with groin hernias. Or it isnt the mesh itself so much as the insertion procedure? The expertise of Shouldice seems hopeful and promising, and Im out of alternatives. When you come to our clinic for an examination, Shouldice staff will welcome you and arrange for a personal consultation with one of our experienced hernia surgeons. The Shouldice Hospital in Thornhill, Ont., is world renowned for its treatment of hernias. Answer: Yes, but I was at the higher end of the range and one other fellow in our intake was even worse. I would not be likely to offer a second hernia repair (with or without mesh) to a patient with risk factors for recurrence (substantially overweight, smoking etc) unless the operation was an emergency. Of course when people go there, they are concerning about the bumps that they have so, and they do not take hernias that are not obviously visible right at the time of surgery itself. Its not hard to understand whats happening here. Its one of the great things about my job. I wish all the best to you! To see how we do a Modified Shouldice visit http://www.herniaoperation.co.uk They do not take overweight patients, they do not take complicated cases, and they do not take hernias that are not obviously visible right at the time of surgery itself. Im 60 and 511 @ 180lbs, so not overweight and in good health. I do not feel Shouldice does an honest job of their success rate, but they are not the only place or surgeon to do that for sure. There is a small hard spot just under the belly button but it is slowly shrinking, I was told this could take some time. I had a double inguinal done at Shouldice 10 weeks ago and was in a fair bit of discomfort for the first 8 weeks but am feeling much better now and am thankful I have no mesh to disrupt things down the road. The procedure may be considered simple enough to be performed by a moderately intelligent baboon, but that isnt to say there cant be considerable variation in the quality of the work done. Hernia repairs can be done without a general anesthetic at other locations as well- I routinely do mine without a GA. Are you willing to be more specific about the nature of your problems post op? This was a very informative post. One patient told me he didnt want to go back to Shouldice with his recurrence because he couldnt afford it. Having to go in the day before surgery and staying 4 nights seemed odd in this day and age. There is nothing spectacular about this facility. View Map. The authors looked at repairs in Ontario hospitals over a 10 year period and concluded that Inguinal hernia repair at Shouldice Hospital was associated with a significantly lower risk of subsequent surgery for recurrence than repair at a general hospital. I find this absolutely compelling evidence supporting a visit to Shouldice versus other hospitals in Ontario and, for me, I think its plausible to believe that these findings would not be dissimilar if you were to compare Shouldice repairs versus outcomes of repairs done in general hospitals in the States. First scheduled patients moved to pre-surgery prep. There are some awful stories out there. I have contacted the operating hospital who caused the issue and theyve decided they do not want to assist in the issue any further. Others who have had surgery at their local small hospital and everythings good. WTF was that?. or skilled? The Shouldice then also bills the Ministry of Health for each inpatient day a patient stays overnight. They were everywhere in the very pleasant grounds. Finally, I am sorry you are experiencing problems and I sincerely hope they are at the lower end of the spectrum. Tickets cost $4 and the journey takes 38 min. Change). We have a big number here, dont you think? It was originally founded during World War 2 to allow for young men to have their hernias repaired before going off to fight. There were no significant differences in chronic pain, complications and post-operative stay. I really dont want to get into a lot of detail about the complex world of hernia repair here, but the world surgical community has moved on from primary repair with lots of inpatient days and the Shouldice has not. Another confession, I alsomake money doing hernia repairs, but I dont make nearly as much as the Shouldice does off their patients. Sometimes this cost is paid out by private insurance companies if the patient has a health benefits plan, or by the patients themselves. For over 75 years the Surgeons and staff of Shouldice Hospital have dedicated themselves to repairing abdominal wall hernias; it's all we do, having performed over 400,000 successful hernia repairs using our natural tissue technique without the use of surgical mesh and its serious complications. Sounds like you are doing a great job informing yourself about your options and the risks which is great to hear. I am still avoiding heavy lifting, but everyday lifting activities (groceries, young children, etc) arent causing any issues. 7th battalion royal irish regiment; But sometimes recurrences do happen. A Shouldice Repair is usually done under local anaesthetic and conscious IV sedation making it an exceptionally safe procedure with virtually no complications. Impossible to lose the weight. As a surgeon with intimate knowledge of hernia repair, does the actual technique have a solid, anatomical basis and biological plausibility? Id love to send my husband there! I seem to be a good candidate for pure tissue. He worked at Shouldice for about a year and did several hundred Shouldice repairs. You share good times with the people you meet there. All private fee paying schools get to choose whom they teach, that way they get the best students and of course the best exam results. Now I have chronic pain and wondering if I should of stuck out the pain another week or two to find another Dr. for another opinion. Also billing data was used for the study, which is a notoriously inaccurate way to study surgical outcomes. Ill take my chances with mesh next time all day long. The Shouldice Hospital has been a family-run private enterprise since its founding in 1945 by Dr. Edward Shouldice, who developed a reliable technique for repairing hernias during World War II.. For Ontario residents, the Shouldice procedure is covered except for the cost of the semi-private room which is covered by many insurance plans. If someone has a hernia surgery at one hospital and then develops a complication they could easily end up at the emergency department of some other hospital having the repair done by a completely different surgeon. I had my hernia repaired there on Nov 2nd. But my main problem with this approach as a taxpayer is that this is a huge waste of healthcare dollars. I have an inguinal hernia which is more annoying than anything since I play a lot of sports (not painful), but more so I am afraid of chronic pain after the surgery. And so what if there are 15% recurrences with suturing methods! I just left Shouldice hospital after a hernia repair. So I am 4 days post surgery from Shouldice.My tackle is extremely bruised so I can not say that I will maintain objectiveness. So one last confession. Regarding the Weve always done it this way aspect? Look for nih data. The reason my wife and I offer the Shouldice op in Kent UkK is the very high incidence of chronic pain after open mesh repair. I had my surgery done at Soldice 5 days ago. Or that you are cynically making a play for a vast damages pay out. Im 27 and I have had three femoral hernia repairs in Nova Scotia, two open, and one (most recent) laparoscopic. Once youre admitted to the hospital, youll meet other hernia patients. I wish the government would impose laws about refusing patients surgeries and i wish Shoultice was audited! I have been taking hot baths daily and massaging the area, but it doesnt seem to help. Shouldice patients have said again and again, how much they enjoy the Shouldice experience. Thanks Doc for this site assuming that you are not being compensated for your posts, your time and insight are indeed epitomizing the noble cause underlying a medical professional, thank you! Ill see how it continues and report again in a month or so. Female were nearly 3% of included patients. Groin hernia repair is a day surgery procedure in Ontario (anywhere but the Shouldice clinic) with no overnight stay required, unless complications arise or in very frail or sick patients. I imagine quite a few would turn tail and run, but listen: I was NEVER in pain and it only lasted 5 days and it had to be done. Our current career opportunities are outlined below. In thinking Doctors are same as a lot of other industries. Shouldice - The best no mesh hernia repair for inguinal hernia. In summary, I have to agree with lesmcc1: the technique, the hospital/facility itself, the four day stay, the old equipment, i.e., bed, the wound closure method, etc, all point to a we have always done it this way mindset. The other day I split a bush cord of firewood and my shoulder was sore but not my groin. 00%| | Expected . 2 The Lichtenstein procedure was learned from a book, 10 instructional videos, and personal communication with Irving L. Lichtenstein, MD. .1st operation to save my life. Other operators. Success rates should indicate level of difficulty/complications/etc but why as a patient should I not be happy for surgeons to develop specialty areas or clinics for easier surgeries that do not need to be supported by the larger and more costly structure of a full hospital? The Shouldice clinic charges patients for a private room for up to 5 days (this adds up to many hundreds of dollars). Thank you so much for your time. Safe for airport scanners AND MRI. Pain is tolerable(sensation of burning/stabbing in groin) that subsides quickly with reduction of effort/strain.
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