Also, he only went there after years of being discouraged by general surgeons such as yourself but after multiple failed hernia surgeries by these same general surgeons. I asked for a copy and watched my surgery during recovery. As a specialist, I am not allowed tobill OHIP to seepatients without a referral from another doctor, and so we see the double standard growing. Studies show that half of all recurrent hernias develop many years after the original repair. At the mid point of the second week, I had searing, stabbing pain at the surgery site. Other operators. Unfortunately I believe their actual holistic approach was outdated sometime during the cold war. We have a full range of activities in addition to organized exercise, to make recovery enjoyable, including billiards, shuffleboard and a putting green. Im left asking the question do I fix it now or after pregnancy? We have just reviewed 400 consecutive patients from 4 years ago and our recurrence rate is 2%. I would like to see much more transparent reporting and rating of all surgeons & hospitals & clinics. 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. The buddy system helps to reduce stress and anxiety and prepares you for a confident recovery. This is an excellent blog. and a less wait time surgery would be quite worth it. Train operators. During the first week if I was too active Id feel soreness but with a few hrs rest it went away. So firstly, it is always hard in practice to know how many surgeries it takes to be competent? That is why we offer a diet counselling service to all of our patients. Which method is the best option considering I want to get pregnant? The average North American is gaining 1-2 lbs per year, and obesity is a clear risk factor in hernia recurrence. Some of the patients will already have been through the operation and will be happy to offer reassurance and support. In Australia, the introduction of private healthcare has resulted in exactly what has happened here, albeit on a much larger scale. Its not hard to understand whats happening here. We know how to fix recurrence, but fixing mesh complications is a difficult procedure. I would say you will very likely be fine, I wouldnt worry about your decision at this point. Hernias do just get larger, and there is also the issue of not being able to travel if you dont get it fixed (pre-exisiting condition). Very interesting and enlightening article for a soon-to-be operated-on groin-hernia sufferer like me. Shouldice, like you said, does not do that kind of thing. If you would like diet counselling to help prepare for your surgery, we have a registered dietitian on staff to offer the help and support you need. Tickets cost $4 and the journey takes 38 min. 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. 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. The cost of more comprehensive programs is covered by most insurance plans. Hello lesmcc1. It helped for about 10 days and then stopped helping. Ive had mine for years (think its due to c section surgery or pregnancy) Have had it checked and been informed that it is not at the point where a repair is required. I have a right side inguinal hernia that needs fixing. State/public schools teach who theyre told to teach meaning everyone else who doesnt get to go to the private schools. C. This is why mesh is now preferred. I know once Ive been opened up there is no going back. It was recently taken over by a private company and is no longer in the hands of the original Shouldice family. Today, Shouldice Hospital performs more than 5000 . All patients will be actively screened at the front door. Only 5 days, so still too early to comment on final result, but: I slept very well there (pain meds are handed out at need, in other words you had to ask for them, after day of surgery very many forgot to ask shortly before bed and so had a bad night). On top of that, the hernia still exists, larger and more painful than ever. Success is defined by the patient as as good as new and somewhat differently by many surgeons, who would probably view that as unrealistic I am absolutely NOT suggesting a conspiracy but why mesh can be a problem is still not well understood. Im 60 and 511 @ 180lbs, so not overweight and in good health. Hi. If anything, they may even feel lucky and appreciate that money has brought them these benefits. Shouldice Hospital Hospital #1 of 506 Facility in Thornhill, Ontario 3 Doctors Call Clinic View Map & Address Unavailable Ratings Doctors Top Facilities in Thornhill, ON Shouldice Hospital #1 of 506 Sunlight Dental Clinic #2 of 506 Matlis Medical, Urgent Walk-in Clinic, Sports Medicine Clinic #3 of 506 Grandview Dental Care #4 of 506 They do this to improve success rates (which of course patients want too) to reduce fat in the tissues which, I imagine you know but others might not, is a factor with or without mesh. I am debating on having surgery on my right inguinal hernia and whether to do it at Shouldice or at my local hospital. Naturally Id like to see the same for the hospital system. Where did you end up going ? The clinic sits on luxurious grounds and offers one thing and one thing only. Anyhow, one piece of overwhelming evidence in support of going to Shouldice that I found is in the Can. Hi Tyler. Hernia repairs at the Shouldice are done with local anesthetic, no mesh insertion, and with a long stay in their hospital to recover. 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. I have only good things to say about the Shouldice! From studies (which are few and far between), they both apparently have the same amount of chronic pain sufferers. The fears of chronic pain and lack of research into Shouldices 99% effectiveness claim are overrated. I will miss the black squirrels. Thirty five is a fair number if done completely by the surgeon in question I would think. Based on my experience thus far, I would recommend Shouldice to those who are considering it. Naturally I did not wait and had a laparoscopic mesh insertion operation in November in one of the major hospitals around the GTA. colonel frank o'sullivan interview; beverly hills high school football The hospital also. 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). My doctor wants me to lose 50 lbs and ive tried but I cant and I have never found diets to be successful. I would love to see their numbers as well, but that is unlikely to happen soon. 1/2-5/8 of flesh mounded above the underlying muscular tissue fix. She suggested that the nerve fibre regrowth in the skin layers around the surgical site may be causing the sensitivity. I absolutely follow up all my hernia patients. 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. That's a lot of lost revenue, so it's understandable for practices to schedule as many patients as they can to mitigate the financial losses from missed appointments. On another topic, but those expenditures offer a glimpse as to why medical bills are the primary reason for personal bankruptcy in the USA. Should Clinic volumes necessitate due to physical distancing restrictions, you may be asked to wait in your car - please bring a cell phone to allow us to contact you. 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. I had my hernia repaired there on Nov 2nd. The day after and two days after the operation I walked around the Shouldice property which helped with circulation and recovery. I got a colleague to do it, with mesh, and a general anesthetic, as day surgery, in one of our local hospitals. The collegial environment of you and your co-wounded seems to be a plus for most. The food was good. At Shouldice, we have one of the largest databases on hernia repair in the world. 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). Do not use mesh, It can or will disintegrate in time like me and a friend too. I had researched the different techniques and decided I would rather have small surface area non-magnetic stainless steel sutures vs a plastic mesh. I can still thankfully work but havent been able to exercise without being in major groin pain. Normally, there is no extra charge for semi-private rooms if youre covered by OHIP. Somehow he would be entitled to weeks of paid leave with the hospital option due to healing times for their style of treatment whereas with the Shouldice option hed be back at work in a few days. We have provided this list as a courtesy to our patients and their guests. I was wondering what your thoughts were on the actual Desarda technique, not just the website. Dr. Yunis and staff accommodated my physical disability, handicap. (LogOut/ Thinking logically, implanting foreign materials in your body is a matter of concern. So this big beach ball he will bring to his death. Hi there what do you believe offers the least chronic pain for hernia surgery (inguinal)? Go for the weight loss and then go for the surgery!! 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. To ensure the safety of our employees and patients, do not come to the Clinic if you are feeling unwell, have any COVID-19 symptoms, or have come into contact with anyone suspected of having COVID-19. We provide a lifetime of support to all our patients through our annual follow-up program. To decrease the text size, press and hold down the command key on a Mac or the windows key on PC, then press the minus (-) key. The issue is really about the size of the facial defect vs the risk of recurrence with and without mesh. Surgeons need to do emergency work or perforated appendicitis, gangrenous gallbladders, and blocked bowels (sometimes stuck in hernias) would not be dealt with, and patients would die. 4. shouldice offers a 4 day vacation. 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. Or is it because, here it comes, that dangerous phrase Weve always done it this way? And then there are quite a few who seem to think the hospital is a hotel and taken in that light their comments are a little peculiar it was warm, clean, spacious. From the group I saw (30 of us), virtually everyone was doing much better after the surgery. Sounds like he needs a repair, although you dont need to worry about blood supply usually. Do you yourself know how many of your hernia surgeries fail? My room mate (who had 10) yelped a few times, but he didnt strike me as a complainer. 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. Princess of Wales Theatre Royal Alexandra Theatre CAA Ed Mirvish TheatreCAA Theatre, 7750 Bayview Avenue,Thornhill, Ontario,Canada L3T 4A3View Map, Tel: 905-889-1125 Fax: 905-889-4216 Canada: 1-800-291-7750 U.S./International: 1-855-328-3423 postoffice@shouldice.com, Shouldice Hospital is committed to excellence in serving all patients including people with disabilities.Learn More. I am quite disappointed in myself for not having done a thorough investigation prior to my Shouldice fix. Also billing data was used for the study, which is a notoriously inaccurate way to study surgical outcomes. Not only are metrics regarding the likelihood to recommend and the overall satisfaction with the experience negatively impacted by longer wait times, but increased wait times also affect perceptions of information, instructions, and the overall treatment provided by physicians and other caregivers. I know 2 other people who have gone up for repair both of which are now well over 30 years on the repair without issue also.. Take care safe travels. The techniques used by the hernia specialists at Shouldice dramatically reduce the risk of recurrent hernias to approximately 1% over a lifetime. Best. Sadly once you get the mesh and have issues with it the medical community doesnt know what to do. Designed exclusively to meet the needs of hernia patients, Shouldice is a fully licensed, 89-bed surgical hospital. I briefly looked at the website, and I would have the same concerns as with the Shouldice, namely that recurrence rates for hernia repairs without mesh would be unacceptably high unless in a highly selected (skinny) population in North America. 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. Thanks. Answer: Yes, but I was at the higher end of the range and one other fellow in our intake was even worse. Informed consent is crucial. Seventy years of existence can be touted as a measure of success and justification for the status quo Smith-Corona felt the same way about the typewriter. Oddly general surgeons have recommended neurectomy though the pain clinic doctors I saw were highly against this type of procedure. You are correct, we should have much better reporting systems than we do. Sheraton Parkway600 Highway 7Richmond Hill, Ontario905-881-21211-800-668-0101Call hotel for special Shouldice rate.2.5 miles from the hospital. SHOULDICE HOSPITAL CLINIC DETAILS 7750 Bayview Avenue, Thornhill, Ontario. 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. Your stay at Shouldice includes a number of patient services to enhance your care and comfort: Weve followed up with our patients for many decades and time has proven that the patient-focused, Shouldice approach is the key to a complete and successful recovery. .1st operation to save my life. Your kidding yourself trying to talk anyone into not going here for a repair Both the surgeons i had had well over 10000 repairs and the first one was nearing 30000. Mesh or the Shouldice method? 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. There have been many mesh products that have been recalled over the years. A good analogy is to compare mesh implants to the education in a public school and then, Shouldice, the equivalent of a private, fee paying school. I had a large bruise in the center of my abdomen below the belly button from the surgery and that has now gone away. The expertise of Shouldice seems hopeful and promising, and Im out of alternatives. You are correct though, there are not good studies comparing the two methods. I dont want to come off too confrontational but I am going to be blunt. I guess my point is that everyone who goes to the Shouldice is going to have a good outcome, because they are doing the slim patients. 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. 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 would not that in Canada most people are referred to a surgeon they do not really know for most procedures. My luck, the guy was a heavy sleeper and snored all night which means I could not get that much sleep during my stay. 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. If hernia repair is right for you, well set a hospital admission date that is convenient for your schedule. Its one of the great things about my job. We now have detailed records on more than 400,000 patients and maintain one of the most comprehensive database on hernia repair in the world. This should be broken down into smaller samples to isolate by type of procedure or severity. 4) Shouldice ONLY carry out this operation, meaning they are presumably highly skilled and also experienced in avoiding nerves during suturing, thus improving chances of post-op pain free life. Ive not had thay bad but have had issues from mesh for 9 months. Just returned from Shouldice. I have a consultation in 6 months to decide if I am eligible for surgery (I can tell you now I am) at a local hospital. Lot of disparity in the anecdotal evidence (my understanding has been that in at least once instance a patient was offered a days long recovery at Shouldice vs weeks long at a hospital, and that has been constant with my knowledge of their reputation in general). So that is a great question. I think is a matter of profit from this industry. (Wait time "explodes" the closer utilization gets to 100%! Shouldice performs, on average, 150 operations per week, with patients generally staying at the hospital for three days. 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. 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. Surgeons get really angry when people are allowed to do elective surgeries without providing on call services, which is essentially what the Shouldice is doing. Youll be able to walk out of the operating room and, by the next morning, youll start a well-structured and supervised exercise routine. The sheet says this ridge will last for several months (oh joy). 6) People continually come from all over the world to have their hernias repaired at Shouldice. For Michael:Google search Shouldice hernia failures. in sum, shouldiced uses high value, low cost strategy. On call is hard but necessary work and I , as a Royal College trained surgeon, would not be allowed elective operating time anywhere if I did not offer on call services. (LogOut/ I think it depends on the surgeon involved and what your expectations are around the surgery. Thanks. Ill lift 100+ pounds while working around the house without thinking about it. So even when you think you have done your homework on the surgeon get another opinion. It may be in part an attempt to keep a surgeon ratings list from being established, as patients are not allowed to pick a surgeon. I had my surgery done at Soldice 5 days ago. So the idea that you think there some sort of mesh industry monopoly is concerning to me. In fact, that is the only operation it performs, and it performs a great many of them. The question of the morality of rich families being able to afford private schools, hence their children receiving a higher quality of education is not likely to lay heavily on the mind of any concerned, least of all the children. Its worth a try on the appeal process though.. Again best of luck.. I have been taking hot baths daily and massaging the area, but it doesnt seem to help. 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. They stick to what they know but when they need to be different for the better of their patient they dont know how to and rather than referring their patient to one that would be better for the patient. Could you take a closer look at the Desarda technique and make some comments in the same way you did with the Shouldice techinique? I applied to Shouldice and was refused surgery for my inguinal hernia. 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! Which must annoy surgeons who use only mesh). Like you, I will flying from US and I am not sure how well those stainless steel sutures behave at airport scanners or other body scanners / MRI scanners ?? But sometimes recurrences do happen. The other day I split a bush cord of firewood and my shoulder was sore but not my groin. Authors Anna Bradshaw 1 , Sarah Raphaelson. In this respect, mesh in the future could still have a place but as a last resort rather than the first thing the surgeon grabs! I would even love to go there and observe their technique, but they are not in the business of educating surgeons, just skimming off our business. It was named after E.E. I returned to work with some discomfort but progressed to feel quite comfortable. It was originally founded during World War 2 to allow for young men to have their hernias repaired before going off to fight. I did that search, and Im not sure if I saw exactly what you saw, but yes even though Shouldice method (performed at the Shouldice hospital specifically) has a very low recurrence rate, certainly mesh will have the lowest recurrence rate. Hopefully you find an answer. I do not believe in the argument that the Shouldice doing so many repairs allows for more hernias to be repaired in our public system. Kyle, 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. We know that people often find it challenging to manage their weight, especially when they have a hernia that restricts their ability to exercise. When you say walnut size that may mean the size of the sac which can and often is larger than the actual hernia itself. The vast majority will accept the surgeons advice and do not seek out second opinions or options for their surgery. Lets start with the Pros Hes certainly not done growing. Do the same for a reduction in u from 0.80 to 0.70. The more you weigh and the more weight you gain after hernia repair, the more your risk of recurrence rises. And while I agree with you on many of the double-standard, private taxing points surrounding Shouldice, I disagree that general surgery or mesh related surgery is in any way a better option. Change). We use this information to refine our surgical techniques and document the success of our hernia repairs. Also, I would check w your insurance company before travelling. Dr. Shouldice graduated from the Univ of Ottawa Fac of Med,Univ of Ottawa Fac of Med in 1979. MeSH terms Adolescent Adult Age Factors I would suspect you will look back at the experience with a fondness when it is all over even I also drove up both times. 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. Laparoscopic and robotic inguinal hernia repair procedures performed by qualified . I wonder what steps should I take once Im ready to see a new surgeon in Ontario? In fact, the vast majority of hospitals would offer hernia repair. 7750 Bayview Avenue, Thornhill, Ontario. I am still avoiding heavy lifting, but everyday lifting activities (groceries, young children, etc) arent causing any issues. 3. shouldice provides hernia repair with a short hospital stay. I can NOT for the life of me understand the following: It is a small hospital dedicated only to hernia repair. The Hospital was founded in 1945 and performs over 7000 hernia repair operations a year. The example of my coworker is different. I did have some minor discomfort around the surgical sit, but nothing that I felt was an issue. I have been wearing the orthosis for six years. He said these were all old issues and not an issue wirh the new good mesh. 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). We were guests at the Shouldice Hospital last year. I do have recurrences, about 1 per year but I find since I have warned the patients about this they are usually pretty accepting of it and happy to come back to me for another repair. Of course, that is difficult work which the shouldice is not interested in. They do not deserve the reputation they have. So one last confession. Femoral hernias are tricky sometimes whether mesh is used or not. His hernia is now the size of a basketball. Yes, Im not overweight, which helps, but others that had lost weight for their surgery I kept in touch with had great things to say about their experience as well. (As does everyone). Please call 905-695-4911 to book a time. J. Surg. Without insurance, an open hernia surgery is easily $20,000+ if not more in the states. ( I know I already said that but they were really that bad). This is why they went to Shouldice in the first place, in the Toronto area it has a kind of mythical acclaim. I wish the government would impose laws about refusing patients surgeries and i wish Shoultice was audited! I have contacted the operating hospital who caused the issue and theyve decided they do not want to assist in the issue any further. . RobthinksIm going to Shouldice in 2 weeks. And so what if there are 15% recurrences with suturing methods! 10 Royal Orchard Blvd, Thornhill, ON L3T 3C3 Get directions. I hear that the wait time is up to a few years for the surgery itself. 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. 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. 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. [2] Contents 1 History 2 Work That may sound expensive to people from Canada or anywhere else with a cost effective health care system, but keep in mind that health care in the USA is extraordinarily expensive. It seems to be the same, or slightly worse than the common open mesh repair. He did get a cyst in his rear about 2 1/2 years ago, the surgeon offered to take a look. I was extremely excited to not have to wait a long time to get in for an operation as the hernia was making it almost impossible to drive. Ill see how it continues and report again in a month or so. There is absolutely no risk involved, just a requirement for the patient to wear an orthosis. Very very rarely will I feel a twinge of pain, but 99.5% of the time, I feel as good as new. No pain at all and I never took any of the prescribed pain meds. The general surgeon I seen advised 6 weeks. Look for nih data. 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. In addition, in my case Im 41 and 168 lbs. I live in Montreal, soon to be living in Ontario. Im not sure what you mean by *elective* with regards to hernias except that I imagine they like many surgeries mostly dont need to be done on an emergency basis. 2015 surgeries (inguinal, umbilical) performed at local Ottawa hospital by general surgeon, with some specialization in hernia repair. I went to see my family doctor as I live too far from Shouldice to visit. 1. shouldice offers reliable hernia repairs, with few relapses. As anybody else, my concern is long term pain or discomfort and recurrence. Sharing the experience with a bunch of other patients was a big plus in my opinion. Just returned to UK after Shouldice and its specifically mentioned in the folder. 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. I have recently had a consult at Shouldice and had some concerns. Usually, the time only varies by a minute per day but some days will have the same time for multiple days consecutively.
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