Hi Neil,
I am resident in the UK.
I am in a similar situation to you in that I need to gain a layman’s understanding of different techniques and the pros and cons of each so that I may make an informed decision.
If you go to the My NHS website and navigate to “Specialties/Consultants” you can then choose a speciality, in my case I chose “Colorectal Surgery” because that was the department that dealt with my previous surgery (ref below). You can then search using your postcode. Make sure you tick the box titled “Only view consultants with outcome data” you should then get a list of surgeons in the area of your postcode that have published data.
As I am sure you have already discovered the NHS does not seem to consider Hernia Repair as either a major topic in itself or a specialty. My rather jaundiced view is that the NHS sees Hernia Repair as something that works a lot of the time but has an unacceptably high re-occurrence rate and should only be contemplated as a last resort.
My background is: I developed an abdominal incisional hernia after surgery at the end of November 2015 to redact a section of my small intestine that had twisted and kinked. I had an infection at the wound site a few days after the operation and they had to open 50% of the wound and leave it open packing it with a seaweed compound to encourage healing. The wound subsequently healed but some weeks, months later, I’m not sure how long, I felt that something was not quite right since my “spare tyre”, which wasn’t big to start with, seemed to be getting bigger and at times it just felt "odd" in that area.
Eventually an abdominal incisional hernia was diagnosed but my GP refused to consider a repair saying the practice these days is to adopt a “watchful waiting” approach. I was not happy with that so I went for a private consultation where I was told that I had an incisional hernia in my small midline laparotomy measuring 4-5 fingers and divarication of the recti above the wound.
The private consultant recommended a repair as soon as possible as hernias only get worse over time. He said it could be repaired using the open technique with a sublay or onlay mesh or with the benefit of a laparoscopic technique combined with the open approach to remove the sac and reduce the size of the defect, this he called “the hybrid technique”. (I’m not sure I understand all the technical details here.)
As the cost of having the repair done privately was prohibitive I went back to my GP and I have at last convinced him to refer me to the appropriate NHS consultant to explore a possible repair.
I don’t know what this NHS consultant will recommend or what technique he would use but I’ve heard so much on this forum about folk who have had long term chronic pain after having had a repair using a mesh that I am cautious about that approach. On the other hand I know that the use of a mesh decreases the risk of a re-occurrence.
So, what to do? I have heard of a number of different techniques each with different re-occurrence rates, risk of chronic pain, etc. thus need to do some reliable research before my meeting with the NHS consultant on 13/12/16.
Neil, you seem to be some way down the line in your research, is there any way you could share your findings thus far with me? I believe there is a way of taking a discussion offline but I’m not sure how one does that.
Regards,
Phil