But Im glad you had a good experience and outcome. 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. 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. It was named after E.E. Waiting room (20min wait time), examination (15-20min), waiting room for accounting office (5-15min), accounting office (10min), nurse station for blood check (5-10min), surgery (45min), recovery (3days) . I am not going to comment on specific cases, just generalities here. Sounds like he needs a repair, although you dont need to worry about blood supply usually. Choose your surgeon carefully. Impossible to lose the weight. I think 3 or 4 tomorrow in fact. But I wonder if I will be told I need to have mesh after all. The nursing staff was a mixed bag, as would be expected anywhere. 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! 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. Sorry to hear that John. 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. Likely some of all three. colonel frank o'sullivan interview; beverly hills high school football Without insurance, an open hernia surgery is easily $20,000+ if not more in the states. We have provided this list as a courtesy to our patients and their guests. When I went for my pre-op. 65 Minthorn BoulevardThornhill, Ontario905-707-65332 miles from the hospital. You are right, there is not a lot of good information for women in your situation. My room mate (who had 10) yelped a few times, but he didnt strike me as a complainer. So five days in hospital must be better than no days in hospital, right? So while I agree with patients having to lose weight for some surgeries, I cannot on a practical level be that picky about it. We were guests at the Shouldice Hospital last year. 80%| 10. 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. That is not my opinion, it is just a proven over and over medical fact. Ive had other friends have a nerve block and it helped them for months so it is hard to know the amount of help it may give you. Mesh CAN be a nightmare if not inserted properly, and maybe I would be able to get away with not using in a very slim patient, but I consent patients thoroughly to all the risk factors. Absolutely not. In fact, the vast majority of hospitals would offer hernia repair. Other operators. My father needs a hernia operation. Suppose you had a recurrence after a tissue repair. The doctor in Quebec told him to lose 30lbs and he did but while waiting his hernia became even larger. I have acknowledged in the comments above the rare but real risks of mesh insertion. Would you go to a dentist or have any other surgicla procedure done without knowing a thing about the surgeon? The median waiting times for cataract surgery ranged from 24 days in Italy to over 250 days in Poland. An article I just read after using your suggested search term called Inguinal Hernias: A Current Review of an Old Problem mentions recurrence rate at a specialized center (Shouldice hospital) being 0.7% to 1.7%, but Shouldice technique done at a general hospital with a general surgeon was as high as 15%. Dr. Yunis and staff accommodated my physical disability, handicap. Id be curious to see some data comparing patient outcomes for slim patients at Shouldice vs the rest of the system. Is the mesh currently being used the same product that has been on the Toronto news where they move around internally after coming loose? Monday to Friday - 6:00 pm to 8:00 pm Saturday & Sunday - 10:00 am to 5:00 pm. Migration can happen . The techniques used by the hernia specialists at Shouldice dramatically reduce the risk of recurrent hernias to approximately 1% over a lifetime. 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. Chronic groin pain after hernia repair is a concern, no question. So this is a tricky situation. The type of surgery that Shouldice accomplishes is best suited for a set of conditions: the patients particular physical condition. As for the staples, I had 16 and having them removed I hardly felt a thing. On top of that, the hernia still exists, larger and more painful than ever. By the time my son was 10 and we moved to Peterborough his hernia was the size of a pineapple infact it looked like he had a bag in his pants! The Shouldice procedure was learned from personal observation at the Shouldice Clinic, a book, 9 and instructional articles. I had a large bruise in the center of my abdomen below the belly button from the surgery and that has now gone away. Given the choice, Id choose a hernia comeback. Change), You are commenting using your Facebook account. This should be broken down into smaller samples to isolate by type of procedure or severity. Personally, I have a walnut sized umbilical hernia and am within the upper bounds of the ideal physical category. If you are unable to submit this document in advance, you will be asked to complete it upon arrival at the clinic. Taxi from Toronto to Shouldice Hernia Centre. Is this because Shouldice thinks this is good care? One patient told me he didnt want to go back to Shouldice with his recurrence because he couldnt afford it. Study is here- older and from 2004. While I do like my patients to rest after surgery, they dont need to do it in a hospital setting. Thanks for sharing your experience, Kram. The Shouldice Clinic is a private clinic operating in the Toronto area which has been open for decades. Shouldice also offers a variety of services to help you prepare for your hernia operation and improve your recovery. EMR should allow for reporting of all surgical complications and feedback to the surgeons on their complications, including how many of their hernias recur. There are many reasons why mesh is used and many people do fine with it. shouldice clinic wait times. Shouldice is the gold standard of no-mesh hernia repair. He never admitted to any pain and shortly before my son was born developed an I augurales hernia. I would like to see much more transparent reporting and rating of all surgeons & hospitals & clinics. 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. 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. Hi thanks for your article. For a reduction in u from 0.90 to 0.80 on the x-axis, find the associated reduction in wait time Tq (on the y-axis). 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! People seem to either love it or hate it. and then he has the audacity to tell me that I cant feel the mesh and that the pain is also in my head. Mesh does reduce the risk of recurrence but does not make it zero. It is supposed to be better than Shouldice. Shouldice performs, on average, 150 operations per week, with patients generally staying at the hospital for three days. Most patients I know of that go to Shouldice go there specifically for the expert all-tissue repair, the classic old fashioned hernia repair sutured with their own tissues. The buddy system helps to reduce stress and anxiety and prepares you for a confident recovery. It you want a manicure, a pedicure, an espresso in the pre op room and general pampering go to a Beverly Hills clinic; This place is all about a lasting repair at a reasonable price (my bill was much less than the initial quote) with minimal fuss, and, critically, NO MESH. The goal is to help patients lose weight so that fat no longer hangs from and weakens the abdominal muscles, helping the surgery to go more smoothly. Hard to be critical regarding matters of efficiency without data descends into rhetoric pretty quickly. 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. The patient management system (PMS) will schedule appointments, and patients arrive right in time after getting a status update via SMS or Whatsapp. 905-695-4967 * smahdavi@shouldice.com Cindy Giroux - Business Development Manager 905-695-4908 * cgiroux@shouldice.com: Leave jewellery and other valuables at home. Visitors will not be permitted in the patient rooms. Hi, I am the diabetic obese patient with an abdominal hernia. The typical Shouldice patient only experience s 5 days of required recovery time after their surgery, while hernia patients from other institutions typically experience 10 days of recovery time. Regarding the Weve always done it this way aspect? Our registered dietitian will develop a personalized weight loss program for you and show you how to make healthy food and exercise choices. Ive contacted Shouldice and would much rather prefer not having a foreign object inside of me, especially given that this is my first ever surgery. Long initial waits for assessment, then flows like a manufacturing process. It was originally founded during World War 2 to allow for young men to have their hernias repaired before going off to fight. 7750 Bayview Avenue, Thornhill, Ontario. In fact, one would expect Shouldice to have better outcomes as they select patients who are at lower risk for recurrence before the surgery. 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. Maybe a freedom of information request needs to be filed so accurate comparisons can be made. Tell me about it..I had an accident at work. Being in hospital has its own set of complications, with hospital acquired infections, pneumonias, blood clots in the legs or the lungs, and other problems. So why would you do so for an inguinal hernia repair, a surgery that is far from simple and fraught with potential serious complications, mesh or no mesh. Is it because they make lots of money off the patients and the taxpayers? From a patient and voter point of view, I dont see why all surgeons need to do emergency or on-call work. The facilities are dated, the food horrible, and you may not get the surgeon that assesses you. 3 weeks after surgery, I was starting to return to running, but still avoided lifting anything heavy. They are not sure what the issue for me is caused by. The amount of money being drained away by this clinic from the public system is opportunity cost, not just for hernia repairs, but all healthcare spending. I do everything I want without restricting myself. Authors Anna Bradshaw 1 , Sarah Raphaelson. Can you share any more details about your experiences if you dont mind. 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. I would ask your family doctor for a referral to a general surgeon who does hernias from incisions to discuss the pros and cons of a repair in your situation. I wonder if they know about him, or does he go into their success pile? Your hernia will need to be fixed, no question. It was then allowed special licence by the Ministry of Health to continue operating. Thank you so much for your time. Do the surgery again big deal! Best of luck. Sonesta Suites355 South Park Road, Thornhill, ON L3T 7W21-800-SONESTA1-800-766-3782. Do you have any other suggestions for me? https://www.ncbi.nlm.nih.gov/pubmed/10452261. They do not deserve the reputation they have. Our current career opportunities are outlined below. My biggest concern is chronic pain, and of course it will be quite some time before I know if thats going to be an issue. We never rush you through surgery and send you home the same day; thats very stressful for both patients and their families. At Tar, I got a colleague to do it, with mesh, and a general anesthetic, as day surgery, in one of our local hospitals. I had minimal bruising and swelling, and am mostly back to normal a few days after surgery. Your post here changed my life, my plans, in a good very good way. It was recently taken over by a private company and is no longer in the hands of the original Shouldice family. This is why they went to Shouldice in the first place, in the Toronto area it has a kind of mythical acclaim. Yes, some implants are great achievements like one of my friends who is 38 and got a pacemaker at 29, but I believe others have no place when they can be avoided with proper training. The "first" reduction in Tq is much greater!) I am also not a fan of the idea of Centres of Excellence. The idea that high volumes of doing one thing only makes you better at it. Im traveling from the US and paying the entire bill myself (my insurance does not cover non-emergency out of country surgery). When needed, a hernia weight loss diet is individualized for each . They say Im an unusual case, but 2 years after having an inguinal hernia repaired at Shouldice I am still suffering from nerves entangled in scar tissue. The issue is really about the size of the facial defect vs the risk of recurrence with and without mesh. Complications after a mesh surgery can drive the cost of a simple hernia repair into the hundreds of thousands of dollars. Found a surgeon in Sarasota, Florida who does non-mesh hernia repairs (Shouldice). In the Shouldice clinic, the average time off work after repair is 8 days, and 4 weeks is the maximum time patients are authorized to return to heavy labor. Is my scar larger than it could have been with a mesh repair? So far no issues at all from the surgery or related to the reasons for the surgery. 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. Hello Justin. But the patient should be made clear of the longstanding post-op, well documented issues of the real probability of chronic pain. One might wonder why you could not find a surgeon in New York willing to do a repair without mesh- are all of these surgeons incompetent, immoral, or both? Im on the fence with going back to Shouldice or going with the local doctor. Employees should be trained and equipped to manage waiting customers, communicate information, and resolve issues. 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 sympathize with you and your husband. Staff was decent, Now the Cons 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. [2] Contents 1 History 2 Work Shouldice, a brilliant surgeon who revolutionized inguinal hernia repair by developing a dependable, no mesh technique back in 1945. They dont call it the Shouldice Experience for nothing. However, these hotels have NOT been inspected by the Shouldice Hospital staff. I dont think it has been around that long. I would address your concerns with the operating surgeon. Last week, the family that owns Shouldice Hospital announced that it would like to sell its facility to Centric Health, a for-profit company traded on the Toronto Stock Exchange.. Shouldice, a Southern Ontario facility renowned for its care of patients with hernias, was founded by a surgeon in the . http://Www.desarda.com. The other thing about hernia repairs is that recurrence rates have always been very hard to measure. You dont know till you try it if it is going to help or not. Discover the Shouldice Experience We offer a complete and holistic recovery program that promotes healing and a rapid return to normal activities. Shouldice Hospital is a great place to work. DO NOT EAT OR DRINK ANYTHING, including water, after midnight the night before the procedure unless instructed otherwise by your surgeon. There were no significant differences in chronic pain, complications and post-operative stay. Lets start with the Pros They do not have to do emergency general surgery, ever, how convienient. We regret that we cannot make reservations on your behalf. Look for nih data. 2) No tacks or staples inside the abdomen to further the chance of nerve damage. I have constant pain of some kind from stabbing to just dull along with foreign body sensation. Having said that, the risk of recurrence is much higher with umbilical and epigastric hernias in pregnancy than with groin hernias. (LogOut/ Are hernias covered by OHIP? I am so glad to read this. View Map We are currently accepting patients in our Examination Clinic by appointment or limited walk-ins on a first-come, first-served basis. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); The problem with Shouldice or The most dangerous phrase in the English language- Weve always done it thisway., http://www.ncbi.nlm.nih.gov/m/pubmed/15243743/, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2727805/, https://www.ncbi.nlm.nih.gov/pubmed/10452261, http://www.ctvnews.ca/health/growing-concerns-in-canada-over-surgical-mesh-usage-recalls-1.3372733. The sheet says this ridge will last for several months (oh joy). No kidding Shouldice will have better results than me when they do not have to operate on an obese diabetic at midnight who is dying from a piece of blocked gangrenous bowel in his hernia which they wouldnt fix electively because he was too heavy! Understandably, patients like their surgeon to appear omniscient and surgeons rather like that, too (jokes about the God complex). I despise shoultice because they refuse to operate on any patients over weight. Mesh reduced the risk of postoperative urinary retention compared to non-mesh (eight studies, 1539 participants; RR 0.53, 95% CI 0.38 to 0.73, I2 = 56%, NNTB = 16, moderate-quality evidence . Which method is the best option considering I want to get pregnant? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2727805/. Well keep in touch every year and offer you an opportunity to have your hernia repair checked and monitored by our surgeons. 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. 2. Mesh has become widely adopted because it decreases recurrence rates of hernias, not due to concerns about chronic pain. He has no idea why or how it happened but didnt feel he really cared. This is so important, but our electronic medical records do not allow that to happen at this point in time. Overall, I am pleased with both the experience and the outcome. All Drs are well experienced and trained. My email is attached here if you would like to email me! Or it isnt the mesh itself so much as the insertion procedure? Laparoscopic and robotic inguinal hernia repair procedures performed by qualified . Do your homework and make an informed decisiongood luck. Change). I dont know where you got your information that the Shouldice doesnt use mesh but this is incorrect. 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 ?? 1. shouldice offers reliable hernia repairs, with few relapses. Standard and mandatory wake up is 0530 for all. Good points John. (LogOut/ 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. We are currently accepting patients in our Examination Clinic by appointment or limited walk-ins on a first-come, first-served basis. 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. 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 almost impossible for a hernia to recur through a piece of mesh. Ive had it for about 1.5 yrs now and because its not painful and really just a small bump Ive not bothered with it until last fall when I saw a local general surgeon about it and scheduled the surgery for May as I go away in the winter. No-show patients cost around $200 per unused time slot, and the average no-show rate for most U.S. practices hovers around 20%. As a surgeon with intimate knowledge of hernia repair, does the actual technique have a solid, anatomical basis and biological plausibility? Does it annoy surgeons that many many *easy* abortions are done in clinics rather than hospitals? The day after and two days after the operation I walked around the Shouldice property which helped with circulation and recovery. Don, Thanks for your comments. One year before he developed necrotizing fasciitis, extending from the right knee to the right thoracic wall resulted . Laparoscopic repairs are reported to have the lowest occurrence of chronic pain in the papers that I read. Shouldice Hospital (formerly Shouldice Hernia Centre) is a private hospital at 7750 Bayview Avenue in Thornhill, Ontario, Canada. 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. It is a small hospital dedicated only to hernia repair. My first week after surgery at Shouldice wasnt too bad. The food was better than I expected. I would not be likely to offer a second hernia repair (with or without mesh) to a patient with risk factors for recurrence (substantially overweight, smoking etc) unless the operation was an emergency. Hilton Garden Inn300 Commerce Valley DriveThornhill, ON L3T 7X3905-709-60083 miles from the hospitalTo receive a 10% discounted Shouldice rate click here. When you come to our clinic for an examination, Shouldice staff will welcome you and arrange for a personal consultation with one of our experienced hernia surgeons. Is your problem scar tissue? A Shouldice Repair is usually done under local anaesthetic and conscious IV sedation making it an exceptionally safe procedure with virtually no complications. 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. Hello lesmcc1. Polypropylene can cause many issues later on down the road research is finding and for those of us with mesh it could be a time bomb waiting to go off. The Republican lawmaker is scheduled t. 905-695-4967 * smah Im left asking the question do I fix it now or after pregnancy? The reason my wife and I offer the Shouldice op in Kent UkK is the very high incidence of chronic pain after open mesh repair. 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. I havent made the decision yet myself, Shouldice or mesh. Do the same for a reduction in u from 0.80 to 0.70. Im sure there are anomalies in either system, but like I said, Im rather surprised to hear that a place that is known for its speed (even among layfolk that have no business following the performance of hernia clinics) is being depicted as slower than public held alternatives. Very interesting and enlightening article for a soon-to-be operated-on groin-hernia sufferer like me. That was a bit odd. Registration will begin at 8:00AM and will close once we have reached the maximum number of appointments available that day. 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 other day I split a bush cord of firewood and my shoulder was sore but not my groin. Recovery done at home, pain meds prescribed, incisions very tidy, standard sutures, little to no swelling or bruising. The clinic sits on luxurious grounds and offers one thing and one thing only. Ill see how it continues and report again in a month or so. I am now 4+ months postop and have chronic pain and the surgeon just looked at me dumbfounded and surprised at my last appoimtment. Do not use mesh, It can or will disintegrate in time like me and a friend too. 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 Shouldice Hospital in Thornhill, Ont., is world renowned for its treatment of hernias. The mesh industry is too powerful and monopolize the medical society. The cost of more comprehensive programs is covered by most insurance plans. I live in West GTA if theres any way for you to recommend me to be looked at by either yourself or a trusted colleague. 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. Shouldice I learned the name even before it had become personally relevant and noted it. Most general surgeons will tell you that they cannot get patients to lose weight before surgery, and that has certainly been my experience. (2) do you know of the desarda method of no mesh surgery? I was told my mesh was new but found that it hasnt changed much since 2009 when Bard first came out with this polypropylene mesh. My personal experience is that my husband moved a piano for me 20 years ago. If I could go back Id take my chances on reoccurance hands down. At the same time, it is clear that . The staff were unfailingly courteous, even when under all-out attack by the annoying. She examined the surgery site and indicaed that my incision site was in good condition without any signs of infection. Shouldice Hospital recommends a healthy diet for hernia repair, and one that focuses on achieving an acceptable body weight.

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