Hi, I am the diabetic obese patient with an abdominal hernia. Mesh has become widely adopted because it decreases recurrence rates of hernias, not due to concerns about chronic pain. The class action lawsuits in the US are concerning to me. It was then allowed special licence by the Ministry of Health to continue operating. Shouldice - The best no mesh hernia repair for inguinal hernia. I understand that they likely inflate their success rates by choosing ideal patients, but I do not have the technical skills to actually evaluate the efficacy of the proposed mechanism of repair. I wonder if a nerve block might be the answer. However, it is also undeniable that the chance of a hernia recurring over time is reduced when mesh is utilized appropriately and on the right patient. I had my surgery done at Soldice 5 days ago. Not that hard to understand why their academic achievements are always lower than private ones. 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 am quite disappointed in myself for not having done a thorough investigation prior to my Shouldice fix. Hello Justin. At Tar, It seems to be the same, or slightly worse than the common open mesh repair. Now I have mesh and been having issues with it since (6 months) I would of rather rolled the dice on the hernia reoccurring the old fashion way than having something put in me that no one can get out and continues to be an issue. Showered and dressed first thing. Large ventral/incisional hernia repair or complex abdominal wall reconstruction- different story. Thanks for the comment and info. (As does everyone). Dr. Shouldice developed his innovative technique during World War II, to help young men who were unable to enlist in the military because of their hernias. Are you willing to be more specific about the nature of your problems post op? I have had a right side inguinal hernia for 1.5 yrs and am scheduled for mesh repair locally end of May (bumped from mid-May). Just frustrating and agree with you on the best I later found out that my friends younger brother had a repair done at the small hospital and has no complications after 8 months with mesh and I went to the one in the area that is considered the best Ive just come to expect the worse I think I have a cloud that just fallows me around :p LOL. The surgeon indicated that when they went in to operate they discovered I actually had two hernias (one direct and one indirect) and he repaired both. Designed exclusively to meet the needs of hernia patients, Shouldice is a fully licensed, 89-bed surgical hospital. My hernia is very small and only appears after I have been working-out or stand for a long period of time however I have a constant dull pain in the groin area/lower abdomen area (heaviness feeling) My fianc and I also love to travel and travel insurance seems to be an issue. http://www.ctvnews.ca/health/growing-concerns-in-canada-over-surgical-mesh-usage-recalls-1.3372733, Well, when the media shows the issue its because is over represented. But sometimes recurrences do happen. The data we need are the rates for chronic pain which is very hard to come across for any of these techniques. Want fast and effectively perfect hernia repair? I agree with everything that you say. This should be broken down into smaller samples to isolate by type of procedure or severity. Unfortunately I believe their actual holistic approach was outdated sometime during the cold war. I dont understand why it should annoy you or any other surgeon if a place does *easier* surgeries that can be done efficiently. 2016 Feb;59(1): 19-25. Do you have any other suggestions for me? I also saw the ambulance chasing lawyer ads in the US regarding mesh failures. More and more often, hes having flare ups where the blood supply to his groin is being blocked. 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. Also billing data was used for the study, which is a notoriously inaccurate way to study surgical outcomes. I . Patients are required to be within 20 % of their ideal body weight, and are refused surgery at the Shouldice if they do not meet this criteria or lose the weight. It seems like a roll of the dice. You dont find Drs in NY doing hernia repairs without the mesh. If I had an unhappy patient who did not want to have surgery with me again, I would refer them on for a second opinion. Laparoscopic repairs are reported to have the lowest occurrence of chronic pain in the papers that I read. Its certainly an interesting place. We provide a lifetime of support to all our patients through our annual follow-up program. 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. Shouldice Hospital is a bit of curious place. I am very happy with the outcome and am glad I didnt go for a mesh repair. I agree there is an absence of definitive evidence one way or the other, and that some surgeons seem to possess Olympian detachment when confronted with inconvenient statistical irregularity. In the USA most Drs wont even do a simple hernia repair without mesh even if youre ideal for a non mesh surgery. Various proposals are set forth for expanding the capacity of the hospital. I will stop by here at the 6 month point to provide another update. It has lots of windows and a bunch of couches and chairs to relax in, a television and plenty of magazines and newspapers to flip thorough. Shouldice, like you said, does not do that kind of thing. (Wait time "explodes" the closer utilization gets to 100%! I would say you will very likely be fine, I wouldnt worry about your decision at this point. I know once Ive been opened up there is no going back. This is an excellent blog. Having said that, if you have your hernia repaired without mesh (by Shouldice or anyone else), and it recurs, you can have another surgery at that point. This expedited recovery time is due to the level of active physical rehabilitation that Shouldice Hospital expects from their patients. 10 Royal Orchard Blvd, Thornhill, ON L3T 3C3 Get directions. Even with insurance in the USA, high deductibles and co-insurance means hernia surgery is still a very hefty expenditure well into the thousands, it could easily be the price of a Shouldice repair, but performed by someone with not nearly the expertise. We are currently accepting patients in our Examination Clinic by appointment or limited walk-ins on a first-come, first-served basis. my surgeon said it was mostly a bunch of people complaining looking for money. At this point I am out $980.00, I am more sore than I was at the same time following two mesh repairs, the in-hospital conditions/regimen were not as conducive to recovery as being at home. So far no issues at all from the surgery or related to the reasons for the surgery. Since 1945, we have been gathering data from our follow-up examinations. Tickets cost $4 and the journey takes 38 min. For a reduction in u from 0.90 to 0.80 on the x-axis, find the associated reduction in wait time Tq (on the y-axis). No-show patients cost around $200 per unused time slot, and the average no-show rate for most U.S. practices hovers around 20%. The Shouldice Clinic outside of Toronto, Canada has demonstrated extraordinary safety and durability with their technique. Stop smoking for a least 2 weeks before your surgery. Sadly neither Shoultice or any surgeon will perform the surgery. I would address your concerns with the operating surgeon. Im not happy about Shouldice being sold to a private company but I do not see that your critique of their prior history is based on any accurate or well-analysed information. The median waiting times for cataract surgery ranged from 24 days in Italy to over 250 days in Poland. A Shouldice Repair is usually done under local anaesthetic and conscious IV sedation making it an exceptionally safe procedure with virtually no complications. Shouldice Hospital recommends a healthy diet for hernia repair, and one that focuses on achieving an acceptable body weight. In a socialized model of healthcare, allowing some hospitals and surgeons to absolve themselves of this emergency work is unfair and leads to their claiming to have better outcomes. 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. View Map We are currently accepting patients in our Examination Clinic by appointment or limited walk-ins on a first-come, first-served basis. Shouldice Hospital is a great place to work. Same in the US. To the wife of the husband with the augurales hernia. I had the Shouldice repair a week ago and am doing quite well. 3) Shouldice use sutures only, minimising foreign material being implanted into body, hence minimising most of afore mentioned risks associated with nerve damage. 600 Highway 7Thornhill, Ontario905-881-26002.5 miles from the hospital. 6) People continually come from all over the world to have their hernias repaired at Shouldice. 905-695-4967 * smahdavi@shouldice.com Cindy Giroux - Business Development Manager 905-695-4908 * cgiroux@shouldice.com: Is the mesh currently being used the same product that has been on the Toronto news where they move around internally after coming loose? So I am 4 days post surgery from Shouldice.My tackle is extremely bruised so I can not say that I will maintain objectiveness. Go for the weight loss and then go for the surgery!! Reilly's, a disused bar, was barricaded up by the rebels, and it . My Aunt diagnosed with Hernia disease recently. Last year, it had a record year and performed nearly 7,500 operations. Im not a medical professional of any sort, but Im capable at measuring time the first two (father and neighbour), went to Shouldice and returned within 48 hours and their usual routines somewhat ecstatic about the result, and with no need to revisit the surgeries since. Having to go in the day before surgery and staying 4 nights seemed odd in this day and age. Is this a factor? . I had even specifically asked not for mesh or one that is chemically compatible with tissue and got one that wasnt as it is cheaper for them, hospitals, to use one, which has been shown to cause chronic inflammatory response and pain. The staples are removed (one half at a time) over the two following days. Ill lift 100+ pounds while working around the house without thinking about it. Best of luck Dean. Thinking logically, implanting foreign materials in your body is a matter of concern. I doubt it- they are simply following standard of care which they are required to do by their licensing bodies. 4. shouldice offers a 4 day vacation. Dr. Shouldice graduated from the Univ of Ottawa Fac of Med,Univ of Ottawa Fac of Med in 1979. Maybe a freedom of information request needs to be filed so accurate comparisons can be made. Poor nights sleep (roommate having pain, snoring, up through the night for pain meds, temperature check by nurse at some point, etc). Other operators. My hernia was considerably large and very uncomfortable (both surgeons recommended it get repaired soon as it was quite large and at risk for obstruction in the future) in fact, I was no longer able to play sports anymore. Surely theres an advantage to exclusive, specialized hernia repairs that general surgery wouldnt necessarily encompass? A version of this commentary appeared in the Vancouver Sun, Huffington Post and iPolitics.ca. mjk funeral home obituaries; san jose state university graduate programs deadlines Men umschalten. 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. Should I wait or should I see a surgeon right away? I am now 4+ months postop and have chronic pain and the surgeon just looked at me dumbfounded and surprised at my last appoimtment. I was suprised by your posting. The general surgeon I seen advised 6 weeks. This is a complex technique involving multiple overlapping sutures across two layers of muscle. For the first couple of weeks I stayed under the 10lb limit for lifting, now I tend to lift a bit more weight but still not very heavy weight. Discomfort for 3-4 days but quite tolerable. The recurrence rate with Shouldice techniques was higher than mesh techniques (OR 3.80, 95% CI 1.99 to 7.26) but lower than non-mesh techniques (OR 0.62, 95% CI 0.45 to 0.85). I can accept that this is work that should perhaps be compensated at a different level because of its extra demands. In fact, that is the only operation it performs, and it performs a great many of them. I honestly cannot think of anything much to criticise beyond, just possibly, the tendency for some staff to be satisfied with your progress in their own minds, but could convey this rather better to the patient my equipment turned black and trebled in size so I had to get a specific answer to my question: is this normal? I have to say, the experience was excellent. 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. The cost of more comprehensive programs is covered by most insurance plans. And yes, Shouldice cherrypicks their cases, perhaps because they can. It was originally founded during World War 2 to allow for young men to have their hernias repaired before going off to fight. His hernia is now the size of a basketball. My husband got discouraged and gained even more weight. But it might also just be for efficiency. I had an inguinal (opposite side) and umbilical hernia repairs done using mesh two years ago. Absolutely not. There have been many mesh products that have been recalled over the years. . The amount of money being drained away by this clinic from the public system is opportunity cost, not just for hernia repairs, but all healthcare spending. You have to follow patients for decades to know your real recurrence rate, and patients also are not likely to go back and see the same surgeon (or a clinic) once they have had a recurrence. But my main problem with this approach as a taxpayer is that this is a huge waste of healthcare dollars. He has no idea why or how it happened but didnt feel he really cared. We are committed to recruiting and retaining the most talented people and are focussed on creating a workplace where people enjoy the challenge of their career, create and engage in best practices, and are treated with respect. I find this mind boggling- this approach was abandoned in the rest of medicine decades ago. For Michael:Google search Shouldice hernia failures. Most general surgeons will tell you that they cannot get patients to lose weight before surgery, and that has certainly been my experience. Pain clinics are full of patients who have had open mesh repairs. Informed consent is crucial. Here, you can leave your busy schedule behind and enjoy a restful and relaxing recovery in fact, many people compare it to visiting a beautiful resort. may be involved. In fact, one would expect Shouldice to have better outcomes as they select patients who are at lower risk for recurrence before the surgery. The wait times were significantly higher than normal. 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? Naturally I did not wait and had a laparoscopic mesh insertion operation in November in one of the major hospitals around the GTA. Most of my comments refer to groin hernia repair and as I said at the beginning, are based on my opinion as a medical expert and fixer of hernias, not on any raw data, which of course is not available. Three delicious meals every day, plus an evening snack, An exercise program specifically designed to speed the recovery of hernia patients, Professional advice for a healthy recovery, Access to on-site massage therapy (extra charges apply). Mesh reduced the risk of postoperative urinary retention compared to non-mesh (eight studies, 1539 participants; RR 0.53, 95% CI 0.38 to 0.73, I2 = 56%, NNTB = 16, moderate-quality evidence . Im aware of the article. Thanks Kram. I have constant pain of some kind from stabbing to just dull along with foreign body sensation. The example of my coworker is different. WTF was that?. Youll be able to walk out of the operating room and, by the next morning, youll start a well-structured and supervised exercise routine. Fully sedated for duration of procedure. I had researched the different techniques and decided I would rather have small surface area non-magnetic stainless steel sutures vs a plastic mesh. 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 am running 20-30km/week and have returned to normal activity. A friend of mine had the mesh technique and it resulted in a tumour growth that was quite complicated to resolve. My first week after surgery at Shouldice wasnt too bad. The limited walk-in spaces are available on a first-come, first-served basis. Regarding the Weve always done it this way aspect? Mesh does reduce the risk of recurrence but does not make it zero. Choose your surgeon carefully. 2021 Apr 1;51(4):67-69. doi: 10.1097/01.NURSE.0000736968.01359.e0. Besides the fact that it looks weird, my only concern is that given that Im only 42, the hernia is just going to get worse better to repair the pothole now than to wait for an emergency in the future. . A lot of nerve damage occurred to my femoral nerve, and the mesh they have inserted is extremely painful. Hi. The day after and two days after the operation I walked around the Shouldice property which helped with circulation and recovery. Very very rarely will I feel a twinge of pain, but 99.5% of the time, I feel as good as new. Day surgeries admitted in the morning released that afternoon. I since switched meds and lost a bit of weight but Its so difficult to even move with a cantaloupe sized abdominal hernia. If hernia repair is right for you, well set a hospital admission date that is convenient for your schedule. Why? Drs. Sorry to hear that John. You . I went for a long walk after the surgery. Many didnt even know their surgeons name. I am comfortable going to Shouldice as they do screen patients to prevent hospital secondary infections, I was able to get specialized care and not take up a bed or OR in a general hospital and they were able to take me in 3 weeks rather than the 200+ day wait in my home town. They weigh the risk to both. Ive had mine for years (think its due to c section surgery or pregnancy) Most patients never met their surgeons before surgery, or saw them afterwards. Change), You are commenting using your Twitter account. A groin which has been operated on for hernia will never feel the same as before the hernia repair, but for the vast majority of patients they will be aware if their repair, or have to take medications for it. and a less wait time surgery would be quite worth it. If this is an arguement that many surgeons feel should be addressed then of course I would be open to hearing the arguments for it but I believe our health care system should have a structure thats based on requirements necessary for delivering good outcomes for patients at the best cost. Visitors are required to wear a mask when inside the hospital. 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. From the research Ive done, nearly 70 hours of it; Shouldice offers distinct advantages over mesh repair in the following ways: 1) No concern from implant of foreign object; ie fear of allergic reaction to mesh, worry of mesh erosion over the decades and nerve damage caused by mesh. I went into general surgery because its well, general. Reading your comments put some things into perspective for me. security guard 12 hour shifts aubrey pearsons oaks husband shouldice clinic wait times. I honestly cannot recall the last time I admitted a patient the night before surgery, except when I was a clinical clerk, and that is going back a long time now. All three were done by general surgeons, and I can honestly say I would have been better off not getting any surgeries from the beginning. The standard of care when the Shouldice was formed was a primary (suture) repair and lots of days in hospital recovering from the pain of having your own tissues reamed together to repair the hernia. First time insurance paid 80 pecent That was 5 years ago and as you know us health care has changed dramatically Laat June when I had my second side done I was told nothing.. 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. 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. I will miss the black squirrels. The mesh industry is too powerful and monopolize the medical society. Thank you for your knowledge and insights re hernia repairs. The technique was designed by Dr.Edward Earle Shouldice and became popular when he opened his hernia hospital in 1945 and his technique has attracted patients from all over the world. Dr. Yunis and staff accommodated my physical disability, handicap. And it really annoys surgeons, including me. Pure tissue technique, according to yourself and other general surgeons, has the risk of recurrence. Here you will find current wait times for Niagara Health's Emergency Departments and Urgent Care Centres. However, these hotels have NOT been inspected by the Shouldice Hospital staff. Doctors and nurses very knowlegdeable, and covered by OHIP. In general looking forward to a day when performance stats for regulated professionals and their related clinics/practices will be available for scrutiny then we can all make decisions based on merit rather than hearsay or fuzzy notions of reputation etc. This makes anyones numbers on hernia repair difficult to interpret, but the Shouldices number in particular should be viewed with a grain of salt. 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. I am so glad to read this. Of course, that is difficult work which the shouldice is not interested in. Safe for airport scanners AND MRI. At least give your patients an informed choice based on your skill rather than your ignorance of anything other than mesh repair! Overall, I am pleased with both the experience and the outcome. Our first available appointment is in July of 2023. Three surgeries at two different facilities using different techniques by no means expertise in either technique. Obviously varies. Also, Shouldice website and the doctor I seen reports their procedure is tension-free however from what I read on different techniques the Shouldice repair is tension method?? I will continue to recommend the Shouldice and feel it was the right choice for me. My husband went in, doctor said lose weight and i will do it. Well that was 2 years ago, he did lose 45 lbs and the doctor still refused to do the operation siting that he had no place to put what was in his testicle area! I have a rather large incisional hernia and am considering a trip to Shouldice. Too risky. I asked for a copy and watched my surgery during recovery. I do everything I want without restricting myself. The washroom is our room was sporting a nearly unbearable urine smell. We regret that we cannot make reservations on your behalf. So firstly, it is always hard in practice to know how many surgeries it takes to be competent? I suspect looking into that would be very difficult indeed. I am still avoiding heavy lifting, but everyday lifting activities (groceries, young children, etc) arent causing any issues. I wonder what steps should I take once Im ready to see a new surgeon in Ontario? Its called cherry picking the easy cases and its exactly what Shouldice does. My hernia is fixed and I have a verbal confirmation that I could lift weights directly after surgery. You share good times with the people you meet there. In the Shouldice clinic, the average time off work after repair is 8 days, and 4 weeks is the maximum time patients are authorized to return to heavy labor.
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