Inguinal Hernias and Hiatal hernias

[Aub]

I wrote earlier about having hiatal hernia surgery.  But I have had about 4 inguinal hernia surgeries on each side and they are starting to bother me. I contacted the last surgeon who did the hernia repairs on the left and right groin and he is willing to do another surgery to see if he can get rid of the pain for good.
This would make my eight and ninth surgery if he tried to fix the right and left side.  I have always been very active for my age (55) and into Lindy Hop and Charleston and regular dancing also.  Each time I have the surgeries, I have no pain or things seem to be progressing very good until about a month into the post surgical process, the pain comes back and then after a say 6 months it becomes intense.  The last time I found a supposedly good hernia specialist.  I told him the story over the phone and he says I should come back. (This is out of town).  It sounds like on the left side, he would suspect a femoral hernia which he believes is causing the pain and on the right he may just try putting in a new mesh which he says is quite difficult. He does open surgery and does a proceedure called modified Shouldice but it sounds like he may just use a standard mesh repair.  It seems like everytime they do these exploratory proceedures, they find something amiss, like the mesh had become unattached and retracted, or a small hernia somewhere.  I was born with a right groin hernia.  This may be hard to answer, but do you think it is possible to have a collagen disorder that causes a weakness in that area?  Also, there is a doctor at the Lichtenstein Institute in LA where they invented the standard mesh.  He takes cash only.  But he recommends cutting the nerves in a triple neurectomy.  And would also repair any hernias he sees.  I don't think surgeons in my state want to deal with hernia pain/or recurrent hernias for liability reasons even if they think there is a hernia.  I am in a lot of pain and discomfort so I may postpone having the hiatal hernia surgery as I am a 90% better.
What are your thoughts?

[Kevin Pho, MD]

I am not a surgeon, so my insight into this question is limited.  

If there is suspicion of a collagen disorder (i.e. relapsing polychondritis) you can consider a referral to a specialist for a possible biopsy.  

As for the cash-only surgeon, I am not familiar with that procedure.  You can consider a second opinion at a major academic medical center before proceeding.  Generally, in difficult cases like this, it is wise to obtain several opinions before proceeding with treatment.  

This can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[surgeon]

There have been some studies to suggest people who get multi-recurrant hernias may (some of them) have collagen disorders. It's certainly unusual to have had so many recurrances. Not everyone who has pain after hernia repair has recurrance, which may be why the LA doctor is discussing nerve-cutting as well. No hernia repair method, and no hernia surgeon who's done enough of them came claim 100% perfection. But if you have the means, and given the unusual situation and the reluctance of the local surgeon, seeing the one in LA makes sense.

[Aub]

It seems to me after reading about these so-called colligen disorders and odd syndromes like ehrlers-danlos, etc. that they usually manifest themselves in several ways that are visible in appearence (not just internally).  There may be some ear deformity, skin changes, etc.  I don't have any of these.  Also, as time goes on, you would usually see an external manifestation.  That is why I am convinced all of my hernias are caused by incompetent repairs (which could also mean incompetent surgeons).

[janeinpain]

Hello,

I had an inguinal hernia repaired in 1995 (laproscopic) after a c-section in 1995 and never felt quite right ever since...my father had two hernias repaired on each side (4 hernias total in his life), my brother had one repaired on his right side and my sister had one repaired during her first trimester of her second pregnancy also on her right side. My question is, are hernias a weakness that are hereditary? Also, I am reading on this thread about collagen issues and hernias...what does that mean? What are symptoms of a collagen disorder because I do have other issues that I feel stem back to the hernia repair? Thanks!!!

[Aub]

There is a doctor in Los Angeles at the Lictenstein Hernia Institute named Dr. Amid.  He specializes in neurectomies where they cut the nerves.  He is sort of the king of all hernia surgeons as he has been there and done that.  Maybe performed as many as 35,000 surgeries.  But sometimes the inguinal canal is distorted after surgery and it affects some and not others.  Please call Dr. Amid.  I may go there myself.