It is three months since the operation
and of this writing if I had to do it all over again I would
think twice before undergoing the laparoscopic technique. As
of this time I am no where near normal or to where I think I
should be. I think I can feel the edge of the mesh and I have
odd sensations along with the fact my leg is not 100%. It makes
one wonder when my brother had a single side inquinal hernia
repair via the tension free method and he was moving ladders
around a week after the operation and I could barely walk. My
opinion is that there is a lot of hype asssociated with laparoscopic
inguinal hernia repair, although, I feel there is great progress
being made.... for that I am sure. 
ONE YEAR LATER (January 1999) Ok,
guys it's one year after the operation. My leg is about 100%
back to normal. As I look back, I found that I healed in three
separate plateaus. The first plateau was from the day of operation
out to about four months, the second plateau lasted another four
months with the last plateau beginning about eight months after
the operation. I still have problems sitting at a desk for any
extended time as the mesh cuts into my lower groin (especially,
the more I lean forward). The mesh cuts into my body on either
side of my groin in the sitting position.
Prior to my surgery, I asked the surgeon if it was possible for
me to feel the mesh in anyway inside my body. I also requested
that he use the minimum number of tacks (I read that some patients
had various problems with tacks/staples and had to have them
removed via a second laparoscopic surgery) as I knew my body
didn't accept foreign objects all that well (even a sliver in
my finger got all inflammed). My last request of my surgeon was
to cut the mesh to fit my body and repair the defect, rather
than use a one mesh fits all size syndrome. The surgeon told
me I could NEVER feel the mesh inside my body as that was impossible,
that the tacks he uses were as thin as a hair and gave me an
arrogent look when I referred to cut/fit the mesh to fit the
problem rather than just use all the 3 X 5 inch mesh as it comes
from the manufacturer. I suspect if the mesh was 5 X 8 inches,
he still would not have cut the mesh to accommodate the defect
(sorry about the sarcasm).
About six months after the surgery, (the second plateau) I went
to have my lower abdomen X-rayed at the suggestion of another
surgeon as the quality of life was just unacceptable at that
point in time. The mesh does not show up via any X-ray or radiological
methods, but the tacks do show up. When I first saw the X-rays,
I couldn't believe what I saw. The surgeon used 24 tacks (I could
count them from the X-rays) to affix two (3 X 5) pieces of Prolene
(polypropylene) mesh. Does 24 tacks sound excessive? The tacks
are spiral, but the heads are the size of rivets. The tacks were
placed on the outer fringe of the mesh segments and from their
placement it was possible to see the outline placement of the
two mesh pieces. They were placed as low as possible in my groin
on either side of my penis upward toward my belly button in a
V formation looking downward with overlapping in my abdomen area.
Now, I understand why I have problems. In my opinion, far too
may tacks were used (another surgeon confirmed this). I would
have had the surgery done the conventional method had I known
that each tack had the head the size of a rivet. The mesh was
placed too low in my groin as when sitting I feel burning/cutting
sensation of the mesh tugging at the folds (leg meets body) in
the groin area. There is no elasticity at all from the total
5 X 6 inch mesh and the numerous tacks hold the mesh without
any give or play, hence the cutting sensation. There should never
have been overlapping of the mesh as it makes it harder to bend
over and tie my shoes, etc. It doesn't take a rocket scientist
to figure out that one size mesh, or in my case, two 3 X 5 inch
pieces of mesh is not the right approach to repair all defects.
Oh, yes....I certainly can feel the mesh, or I have one great
imagination.
What have I learned from the operation that I can pass on to
you....1) In my case, the laparoscopic technique was not where
things went wrong. It was with too many tacks, improper placement
of the mesh and not trimming the mesh to meet the specifications
of the operation. Usually, the laparoscopic method is not used
for just one side as it is too expensive, especially, if you
have a HMO. I'd be careful if the surgeon wants to operate on
you laparoscopically for a hernia on just one side only (unless
you suspect a defect on the other side as well). His real motives
may be to make more money (a physician email me and told me most
insurance companies pay the same for both techniques) or to use
you as a guinea pig (his email didn't address this aspect) to
better his technique. My surgeon conducted the laparoscopic surgery
part satisfactory and I give him a passing grade for that portion
of the operation. It was his judgment, arrogance, general lack
of good technique, terrible training, common sense and lack of
listening to his patient where he failed miserably. Doctors can
avoid a lot of potential problems by listening to their patients
as physicians do not have a monoploy on "smarts." Arrogance
has no place in medicine.
2) The laparoscopic technique of mesh placement is IRREVERSIBLE
(unless it becomes infected and then the mesh can be removed
as it hasn't really adhered to the inside). Doctors never tell
you prior to surgery that they can't remove the mesh if something
does go wrong. All kinds of things can go wrong with the laparoscopic
technique (as well as with the conventional methods) and removal
is not an active option. Removal is more an option with the conventional
methods.
3) Although hernia repair is by far the most common of general
surgery, be sure you pick a surgeon who has lots of experience
in hernia repairs. I would chose a surgeon who specializes in
only hernia repairs. The horror stories I can tell you of grown
men calling me at all hours of the night crying in pain from
a hernia surgery gone wrong will convince you that not all surgeons
are competent in performing hernia surgery. (Incidently, calls
will no longer be taken).
4) I have given lots of reasons why not to go with the laparoscopic
method. However, for a two sided (bilateral) hernia repair in
the right surgeon's hands the technique is a good choice. There
are advantages and disadvantages to both techniques and I hope
I have brought to you some useful information to enable you to
make an intelligent decision. Read some other posted laparoscopic
operations that have been very successful.
As you can see from reading my guestbook, there are lots of experiences
and interest in the topic. We can all learn from each other's
experience....more so than asking any doctor as these are first
hand experiences. Many people have given their time and effort
to writing their experiences for YOU. Please return their favor
to you and likewise enter your experience into the guestbook.
(It is real educational reading). I again, thank those who gave
of themselves a few moments to ask or tell of their experience
in signing the guestbook.
Anyway, this is my experience and I can only speak for myself. I am sure there have been lots of satisfactory laparoscopic bilateral inquinal hernia repairs that have gone better than mine. If you have any comments or wish to tell about your experience, please add them to my questbook below as your comments are a help to others......thank you.
Ten years have passed since my procedure (now 2007), and the laparoscopic hernia repair technique has improved greatly. Many more physicians are now trained in the laparoscopic procedure. At this point in time, I feel the procedure is much improved with lightweight mesh and I would not hesitate to have my repair done laparoscopically with the added benefits of reduced pain and quicker recovery. One word of caution, seek out a general surgeon who specializes in laparoscopic hernia repairs and has performed at least 300 hundreds such laparoscopic repairs. There is a learning curve to the procedure and many surgeons are learning the technique today. Keep in mind that an open repair is still the standard in hernia repair, particularly, if only a single sided inguinal hernia requires surgery.
