Pure tissue technique, according to yourself and other general surgeons, has the risk of recurrence. This is so important, but our electronic medical records do not allow that to happen at this point in time. Snorers were a problem for one or two, so much so for one patient that he got himself moved, but most of us did not have that problem. Shouldice Hernia Centre - Wikipedia I do everything I want without restricting myself. And yes chronic pain is an issue which needs to be better studied in terms of techniques to prevent it and treatments. Two questions: (1) do you think a surgeon who did 30 laparoscopies in residency and 5 shortly after in private practice is sufficiently experienced to do bilateral inguinal hernia repair with the TEP method? I suspect looking into that would be very difficult indeed. The limited walk-in spaces are available on a first-come, first-served basis. shouldice clinic wait times - dice-dental.asia Now as a confession of a conflict of interest here, I am a general surgeon who does lots ofhernia repairs at a hospital about an hours drive from the Shouldice. They can walk in, and be called in to be seen by the doctor without having to wait for long. Sharing the experience with a bunch of other patients was a big plus in my opinion. Surgical Wait Times Diagnostic Imaging Wait Times (CT and MRI) Ontario Health is an institution under the Freedom of Information and Protection of Privacy Act, 1990 (FIPPA), and has policies, procedures and practices in place to ensure that its collection, use and disclosure of personal information is in accordance with FIPPA. Drs. It was originally founded during World War 2 to allow for young men to have their hernias repaired before going off to fight. 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 was referred to a surgeon by my pcp and met with him shortly after my pcp said I had a hernia. We are currently accepting patients in our Examination Clinic by appointment or limited walk-ins on a first-come, first-served basis. The staples are removed (one half at a time) over the two following days. Although operations are performed only five days a week, the remainder of the hospital is in operation continuously to attend to recovering patients. I went into general surgery because its well, general. I have to say, the experience was excellent. I dont know where you got your information that the Shouldice doesnt use mesh but this is incorrect. So yes, that is you, the taxpayer, footing the bill for unnecessary care being provided by a private company. 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.. The problem is that the mesh industry is so powerful it is impossible to get anything published that doesnt involve a mesh. 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. That is tough. I havent made the decision yet myself, Shouldice or mesh. I have just been chastised online for daring to criticize the Shouldice clinic on Twitter. 5. shouldice offers a social experience. A Shouldice Repair is usually done under local anaesthetic and conscious IV sedation making it an exceptionally safe procedure with virtually no complications. Considered the same as Shouldice. 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. More and more often, hes having flare ups where the blood supply to his groin is being blocked. Shouldice Hernia Repair | Center for Hernia Repair Which method is the best option considering I want to get pregnant? Most general surgeons will tell you that they cannot get patients to lose weight before surgery, and that has certainly been my experience. Hernia repairs can be done without a general anesthetic at other locations as well- I routinely do mine without a GA. Why Canada should care about the Shouldice Hospital deal There are many companies which manufacture mesh (hundreds) and yes they like to make money. Shouldice Inguinal Hernia Repair Post-op Instructions Surgery You have just undergone surgery to repair an inguinal hernia. Recovery done at home, pain meds prescribed, incisions very tidy, standard sutures, little to no swelling or bruising. Youll be able to walk out of the operating room and, by the next morning, youll start a well-structured and supervised exercise routine. You are correct, I lived in Australia and know even gap fees can bankrupt people with insurance. By the way, my sister is an RN at HHS who recommended Shouldice from what a Doc recommended to her. Why? I am debating on having surgery on my right inguinal hernia and whether to do it at Shouldice or at my local hospital. over 30 years and thousands of repairs we have redone 3 for pain The last was 2 weeks ago and already he is pain free. And I agree that we need to have tracking of surgical outcomes to verify the success of various techniques, whoever does them and whereever they are done, but making everybody do emergency & other more involved surgeries doesnt address that. I had minimal bruising and swelling, and am mostly back to normal a few days after surgery. But it might also just be for efficiency. Shouldice.com A pioneer among for-profit surgery clinics in Canada has been sold to a private health corporation for $14-million, ending a family-owned dynasty that played a unique role in the. They dont call it the Shouldice Experience for nothing. When I went for my pre-op. Regarding the Weve always done it this way aspect? It seems like a roll of the dice. In fact, I believe in less than a decade the medical profession will be inundated with increasing problems from meshes installed in patients 20+ years pervious and will be forced to go back to training their surgeons to the standard they were at pre-1990s, before mesh became mainstream, when hernias were repaired the way they should still be getting repaired today suturing. That is simply how medical innovation for medical products in our capitalist society works. He takes the time to explain everything to you, during the consultation, before the surgery, and after the surgery. The first consultation is walk in which for me meant a 3 hour wait in a run down old estate living room. Or is it because, here it comes, that dangerous phrase Weve always done it this way? The literature on incisional hernias is where the use of mesh was first tested. Shouldice Hospital Experience : r/Hernia - reddit They told me they were being charged much less at Shouldice than they would have paid out of insurance in the US. Shouldice Hospital (formerly Shouldice Hernia Centre) is a private hospital at 7750 Bayview Avenue in Thornhill, Ontario, Canada. About Shouldice Hernia Clinic | Hernia Repair and Treatment Hospital Canada Informed consent is crucial. I asked multiple times to my surgeon prior to the operation on chronic pain and other complications. Showered and dressed first thing. I also read that portion with more issues with smaller females, which worried me as Im only 53 and 117 lbs. Id stick to an open or lap repair with mesh applied externally. Doctors and nurses very knowlegdeable, and covered by OHIP. It is nice to have met your surgeon before any surgical procedure though. I have put off surgery for four years because of concerns with mesh. Improving patient satisfaction with wait times - PubMed My first week after surgery at Shouldice wasnt too bad. may be involved. 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! We have provided this list as a courtesy to our patients and their guests. I tell women who may get pregnant after a repair that there is a higher risk of recurrence of the hernia because of the stretching of the abdominal wall with pregnancy. Staff is helpful but not pleasant or friendly. I had two hernias repaired in November last year. If hernia repair is right for you, well set a hospital admission date that is convenient for your schedule. 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. That is why Im looking at surgery but here in the US my surgeon says mesh is the only option and that he will be using a medium (as opposed to ultra light) mesh with plenty of overlap to repair the hernia. Straight out of a horror film, dim, blinky lights, cold and overall not very reassuring. What Diet Is Prescribed by Shouldice Hospital for Hernia Repair? The repair is based on the Bassini repair with some modification. I hope that is helpful. Other operators. Once youre admitted to the hospital, youll meet other hernia patients. So I am 4 days post surgery from Shouldice.My tackle is extremely bruised so I can not say that I will maintain objectiveness. She suggested that the nerve fibre regrowth in the skin layers around the surgical site may be causing the sensitivity. The wait times were significantly higher than normal. The cost of more comprehensive programs is covered by most insurance plans. Also, you didnt say if your two hernias were repaired laproscopically or open. Show More. Also, I find there is a lack of information on hernias in fertile women and how to treat. That was a bit odd. Mesh does reduce the risk of recurrence but does not make it zero. I would think you could fix it now and get pregnant right away without worry. cleveland clinic hillcrest hospital map; 27th division cemetery; columbia pfg bahama vs tamiami; shouldice clinic wait timessam quek strictly come dancing. 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. I would love to see their numbers as well, but that is unlikely to happen soon. Though a significantly smaller hernia than the 2015 inguinal hernia the incision was two inches longer (6) and the incision was closed by puckering/pinching the skin on either side by 1/4-5/16 and secured with stainless steel staples, i.e. I discuss chronic pain issues with patients before surgery and try and make sure the nerves are away from the repair. Their holistic approach on the brochure makes alot of sense. Female were nearly 3% of included patients. Over the past two decades this small 90-bed hospital has averaged 7,000 operations annually. Not to mention youll be competitive with Shouldice. Mesh has become widely adopted because it decreases recurrence rates of hernias, not due to concerns about chronic pain. Answer: Yes, but I was at the higher end of the range and one other fellow in our intake was even worse. The facilities are dated, the food horrible, and you may not get the surgeon that assesses you. About a week later the pain had completely subsided and I had no further significant pain. We know how to fix recurrence, but fixing mesh complications is a difficult procedure. As anybody else, my concern is long term pain or discomfort and recurrence. Shouldice effectively skims off elective procedures in a very healthy, wealthy, and slimsegment of the population that is extremely motivated to get their hernias repaired atthis private clinic. My husband got discouraged and gained even more weight. 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. Is your problem scar tissue? But ask yourselves this: is it really that important a year later if you slept in an uncomfortable bed for a few days if you have no chronic pain or ever have to worry about developing it? 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. 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. Large ventral/incisional hernia repair or complex abdominal wall reconstruction- different story. Discover the Shouldice Experience We offer a complete and holistic recovery program that promotes healing and a rapid return to normal activities. I applied to Shouldice and was refused surgery for my inguinal hernia. The Shouldice Clinic is a private clinic operating in the Toronto area which has been open for decades. He did get a cyst in his rear about 2 1/2 years ago, the surgeon offered to take a look. 5 weeks after surgery, my scar looks pretty much healed and I expect it will fade with time. In our small study no patient had any pain after 6 weeks. It was named after E.E. All patients will be actively screened at the front door. The more you weigh and the more weight you gain after hernia repair, the more your risk of recurrence rises. Is my scar larger than it could have been with a mesh repair? Hi thanks for your article. The surgery at Shouldice reportedly costs in the neighborhood of $5,000 to $8,000, less than a similar surgery in the U.S. that 90% of the time uses polypropylene mesh. Is this a factor? The recurrence rate for incisional hernia repair without mesh would approach 100 % for a large incisional hernia, so I (and most other general surgeons) would likely not recommend repair without the use of mesh. Walk-in Clinic - Shouldice Hospital 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. Download PDF | Shouldice standard 2020: review of the current 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. 14 Weeks with mesh. Care and service do not stop once you leave Shouldice Hospital. I also saw the ambulance chasing lawyer ads in the US regarding mesh failures. We all want the best, most cost effective public system but critiques must look at the whole system. We have provided a list below of accommodations and we have arranged special rates at some of these. (Wait time "explodes" the closer utilization gets to 100%! We have just reviewed 400 consecutive patients from 4 years ago and our recurrence rate is 2%. This is why they went to Shouldice in the first place, in the Toronto area it has a kind of mythical acclaim. shouldice clinic wait times. The type of surgery that Shouldice accomplishes is best suited for a set of conditions: the patients particular physical condition. colonel frank o'sullivan interview; beverly hills high school football I have a hernia (incisional/abdominal) that needs to be repaired, with several other smaller hernias, however, my visit to the Shouldice sent me searching for the right General Surgeon instead. Well, I had my right side hernia done 4.5 weeks ago at the local hospital, mesh method. This is critical, because one of the patients greatest fears is an obdurate, shrugging surgeon suggesting post op that there are no guarantees in life and this is all in your head. To get the best results from your hernia repair, you should be in the healthiest possible condition for your operation. I would have to see why, based on outcomes & diversity of treatments required, doctors/surgeons should have common requirements for their practice. Wait Times | Ontario Health 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. When staring down the prospect of putting a foreign substance in your body, as a patient you need to be treated with respect and provide knowledge and experience when asked. Hernia repairs at the Shouldice are done with local anesthetic, no mesh insertion, and with a long stay in their hospital to recover. The other day I split a bush cord of firewood and my shoulder was sore but not my groin. I have not had to take any pain medication. I play sports 3 days a week, I run competitively, etc, and virtually no pain. .you should see the Gigantic infection I received from them and the sutures that were coming out of my incision. Thank you for this post. He had the choice of Shouldice or a Toronto area hospital. Suppose you had a recurrence after a tissue repair. I love doing a variety of different procedures in patients of all ages, sexes, shapes and sizes. I have recently had a consult at Shouldice and had some concerns. I had researched the different techniques and decided I would rather have small surface area non-magnetic stainless steel sutures vs a plastic mesh. During the first week if I was too active Id feel soreness but with a few hrs rest it went away. Various proposals are set forth for expanding the capacity of the hospital. The sheet says this ridge will last for several months (oh joy). Conniptions in Alberta, hernias in Ontario - The Globe and Mail Based on what I know now I wouldnt do it again. Shouldice Hospital recommends a healthy diet for hernia repair, and one that focuses on achieving an acceptable body weight. In fact, one would expect Shouldice to have better outcomes as they select patients who are at lower risk for recurrence before the surgery. and a less wait time surgery would be quite worth it. Finally, I am sorry you are experiencing problems and I sincerely hope they are at the lower end of the spectrum. As for speed, I think they say it takes around 30 minutes to do the surgery, and they have a short wait list. You can travel with a hernia as long as its been 3 months since you were seen for it. While my knowledge of Shouldice is not direct, it is close to home, and entirely contrary to what you have said. 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. Critiques are always welcome because it can make people think out of the box. The trouble is he can barely walk with this baby between his legs. Most of us felt it was an efficient operation and we could see why they do things that way it was logical. 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?? Many of these services are provided free to our patients. They do not have to do emergency general surgery, ever, how convienient. 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 ?? "My Shouldice Story" - My hernia repair story at the Shouldice Hospital 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. Affiliation 1 Anna Bradshaw is an FNP student at . Update of previous post. Found a surgeon in Sarasota, Florida who does non-mesh hernia repairs (Shouldice). This should be broken down into smaller samples to isolate by type of procedure or severity. In order to lose the proper amount hed need to eat saw dust and exercise. Several day stats are not the norm at other hospitals, party due to the higher risk of hospital borne infections and partly to be able to service a large group of people with varying needs. My recommendation for anyone 40 and under is to NOT get mesh. Thank you for putting so much valuable information over here. Complications after a mesh surgery can drive the cost of a simple hernia repair into the hundreds of thousands of dollars. Very interesting. Naturally I did not wait and had a laparoscopic mesh insertion operation in November in one of the major hospitals around the GTA. Pick a curve, any curve (say, the red one). Most patients never met their surgeons before surgery, or saw them afterwards. Marcello..whats your point and why are you here? Taxi from Toronto to Shouldice Hernia Centre. Personally, put in a holding pattern until surgery in the afternoon. Shouldice of course sends most of the patients it sees back to where they came from, and does not have to worry about complications or ongoing issues from their repairs. It is a small hospital dedicated only to hernia repair. I was wondering what your thoughts were on the actual Desarda technique, not just the website. So do you feel that in my case atleast, it might be worth giving Shouldice a first shot or is their antiquated technique simply not worth it as the hernia will in all likelihood recur and then mesh would be the only way to go? Visitors are required to wear a mask when inside the hospital. For Michael:Google search Shouldice hernia failures. The Shouldice Hospital in Thornhill, Ont., is world renowned for its treatment of hernias. Can you share any more details about your experiences if you dont mind. (2) do you know of the desarda method of no mesh surgery? He worked at Shouldice for about a year and did several hundred Shouldice repairs. There is a limit of 2 visitors per patient. It is almost impossible for a hernia to recur through a piece of mesh. shouldice clinic wait times - oshawanewhome.ca It was then allowed special licence by the Ministry of Health to continue operating. Well keep in touch every year and offer you an opportunity to have your hernia repair checked and monitored by our surgeons. Different policies will exist. I also have not had good outcomes with the medical community. I am running 20-30km/week and have returned to normal activity. Less with lap but google complications of lap inguinal hernia repairs and you wouldnt touch it with a barge pole. Therefore, it would be more destructive to attempt to accommodate greater numbers of patients at the expense of the quality of either care or facilities. 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? The data we need are the rates for chronic pain which is very hard to come across for any of these techniques. We regret that we cannot make reservations on your behalf. 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. Thanks Kram. To me, mesh is the risk here, not hernia recurrence with pure tissue. The Shouldice will not be handing over their data anytime soon, unless forced to, I can say that with confidence. I got three different answers from Shouldice on how long I should wait to try and conceive after surgery (4 weeks, 3 months and 1 year). Of course, that is difficult work which the shouldice is not interested in. Its certainly an interesting place. Physicians cherry pick their patients. What would be your expectation about how the recurrence would be repaired, and the likelihood of developing chronic pain afterward? The rigidity of the program is old school military in nature and does not seem to be keeping pace with evolution. Ive had friends who had surgery with the best and have come out messed up. 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. 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.