9. HerniaTalk LIVE Q&A: The Shouldice Hernia Repair

[@Gi-Home]

I had my right inguinal surgery this August 31st, 2023 at Shouldice. I have been very impressed with the hospital medical staff and am recovering well. The food is excellent and the facilities and grounds are excellent.

[@stumpynubs5387]

Are you in Canada or not, If not what was cost?

[@Gi-Home]

@@stumpynubs5387 I'm based in Canada and the cost was $305 cdn per night, 4 nights total. Not sure what non-Canadians would pay, I imagine that some insurance policies could cover your costs. Good luck.

[@905jasontherevelationt.v]

⁠@@Gi-HomeI have 3 hernias and I am interested in this hospital is this all covered by OHIP ? I live in Ontario Canada. I see you said it was $300 per night do you live in this province of Ontario or are you out of province?

[@usvadi]

I had mine done at Shouldice also and feel the same way. Very satisfied. Great food. It’s a resort.

[@usvadi]

People from same province. The province covers the surgery. You do have to pay for the room.

[@elodino77]

I had surgery at the shouldice hospital July 19 2022. I can't say enough good things about their surgeons, staff and facilities. Having had an extremely bad mesh experience in Timmins in 2004, in the left side , I mean very very bad in Timmins ontario, I was terrified to get the right side done. I sat on it for 6 years, because of my experience in Timmins. If I could turn back the clock..oh boy. I would have avoided 2 years of agony. Here I am, 5 days post surgery, I can't believe the difference in quality. Goes to show you what proper training can do. And it is a beautiful facility with the absolute best staff on earth

[@SandyAnderson-jn1qn]

I had a golf ball sized inguinal repaired at Shouldice 7 weeks ago and had very little pain before or after surgury. The care at hospital was fantastic. I've been walking regularly since surgury and do modest stretching. I am now getting some dull pain in my testicle and intermittently above where the surgury was done in the same abdominal muscle. I'm not too concerned about the muscle, as i'm hoping that will sort itself out. The repair seems really nice and tight and scar tissue ridge is now starting to soften. The testicle pain is dull and intermittent so again I'm monitorng it but hoping it goes away. My bigger concern is the neuropathy I have in the entire area on the leg side of the 4-inch incision, right down to the fermoral crease. Totally numb and at first the neuropathy was very uncomfortable, just like with shingles, which I had 25 years ago (I'm 61). It hurt to even wear underwear for about 3 weeks. That severe discomfort has dissapated but the continues total numbness in a roughly 5 inch by 3 inch area is worrying me, plus the dull pains. I read from Shouldice that this condition is not totally unusual and can last for several months as nerves re-grow, but other men I know who had the surgury had none of this. I was not informed by the surgeon that there was nerve damage or thtat they had to do nerve shifting or repair. When should I start to be concerned that my damage will be permanent? I fear I am going to be one of these 1-3% who have chronic nerve problems. I welcome any feedback.

[@gc_758]

Hi Dr Towfigh, there was a quick allusion to marathon running at minute 45:35. I was wondering what the issue was as I plan on running long distances and am expecting a Shouldice repair soon. Does this form of physical exercise place patients at a greater risk of reoccurrence down the line? Furthermore, is a mesh recommended for high level athletes?

[@herniadoc]

Exercise is great. Use of mesh is related to more than just whether there are athletes.

[@gc_758]

I see, thank you for the prompt response. Perhaps the question is whether a tissue based repair (eg: Shouldice Hospital) will withstand repeated strenuous effort over time ? Many thanks

[@EricPresleyElvisE]

Great learning experience, thank you. My surgery is next week. At Miami Hernia Center. I have a large left inguinal hernia he said will take about two hours surgery..

[@herniadoc]

Sounds good. Best of luck!

[@EricPresleyElvisE]

@@herniadoc Thank you, Still watching and learning from your videos. Have a great weekend. E

[@905jasontherevelationt.v]

Do you think laparoscopic surgery is better for incisional hernia’s? I’m a male in his 30’s midline above the bellybutton one beside bellybutton and at old ileostomy site

[@herniadoc]

depends on the patient and hernia itself. There is no right answer.

[@905jasontherevelationt.v]

@@herniadoc thank you for responding. I have laparoscopic surgery in two weeks. I’m so nervous and wasn’t sure what option was best for me but I need to trust the doctor.

[@joeblow9548]

Dr i have a groin hernia that causes burning pain from testicles all the way back to my tailbone after my last aggravation of it,,i took 2 months for that to go away but i now suffer from tailbone pain that wont go away and sitting down is severe,,can nerve pain from the hernia radiate to the tailbone,,thx tailbone

[@herniadoc]

Hernias can cause pelvic floor spasm. So maybe. But it’s not typical

[@Dave-ld3dr]

I have my consultation on December 20th.Does anyone have any idea how long it would be till the surgery?

[@ananusa7161]

Great information. If someone has a protrusion around pubic bone but feels the pain 2-3 inches away from that protrusion in the groin area, could that be a hernia? and if so, a surgeon who performs the Shouldice procedure will cut the skin near the protrusion or near the pain spot? or does the Shouldice surgeons always cut the skin for the incision at the exactly same location for every patient regardless where the pain spot or protrusion is?

[@herniadoc]

Yes. The incision will be wherever the actual hernia is.

[@ananusa7161]

@@herniadoc thank you for the quick reply! So should the pain point be where the actual hernia is or can the pain point be away from where the actual hernia is? like 2-3 inches away?

[@herniadoc]

@@ananusa7161 depends. Would require examination. But pain can radiate

[@peterc6559]

He says they are okay with severing the nerves if it means a successful repair. How can you call a repair successful if you sever nerves that were otherwise perfectly fine creating a lifetime of weakness and issues for the patient? You're solving issue A (the hernia) and creating a permanent issue B (permanent weakness from cutting nerves) by doing that. I genuinely don't understand why surgeons think this is acceptable in any shape or form. Its barbaric at best. Nerve preservation should be the #1 priority. I understand the nuances of "sometimes we cannot see them" but that should be a 0.1% occurrence where a patient is extremely obese, lots of fat obstructing vision, etc. It cannot be the norm and it is certainly not an acceptable trade off.

[@herniadoc]

The assumption that all nerve severing causes permanent weakness is incorrect

[@georgecheng5643]

Is the Shouldice technique your preferred technique for tissue-based repair of inguinal hernia?

[@herniadoc]

Depends on the patient and type of hernia.

[@georgecheng5643]

@@herniadoc Thanks!

[@fetapimp]

@@herniadoc absolutely the best tissue repair based on a all research so far

[@HeavilyMetalled]

I’m confused about the stainless steel. As one who almost died from a systemic reaction due to metal hypersensitivity… We know that stainless steel contains nickel, which is highly allergenic. This can cause type IV systemic reactions in a subset of patients just like synthetic mesh. I’m still new to researching hernia repair, but is it possible to repair a hernia with no metal and no mesh? Not asking for much. 😂

[@herniadoc]

In some situations yes

[@herniadoc]

A HerniaTalk video will be uploaded weekly every Tuesday, AKA HerniaTalk Tuesdays!

[@oli-p7r]

patient 49yr. height 177cm(5,8 feet) 180pounds recurrent inguinal hernia after failed TAPP surgery......... hernia sizes left 2cm right 2.2cm in YOUR EXPERT OPINION: can i have shouldice repairr ?????

[@herniadoc]

Not recommended. .

[@philipmacracj5715]

Is it possible/ common for discomfort to develop well after/ nearly a year after Shouldice ? I am experiencing occasional needle pains and regular sensations of pressure very similar to hernia protrusion (however no sign of bulge ) prior to surgery

[@herniadoc]

Yes bits is possible. Pain from a hernia repair 1 or more years later should be worked up for a possible hernia recurrence

[@Squiddogg]

Shouldice wants me to slim down from 215 pounds to 200 (I'm 6 foot 2). That's proving difficult -- and they said the hernia can reoccur if I regain the weight. So it seems like permanent, sustainable weight loss is requirement for a Shouldice hernia repair.

[@herniadoc]

For any tissue repair.