600 Highway 7Thornhill, Ontario905-881-26002.5 miles from the hospital. I can NOT for the life of me understand the following: I discuss chronic pain issues with patients before surgery and try and make sure the nerves are away from the repair. It doesnt matter what method you have these days the recurrence rates are all about the same,low. They have permanent audit staff and know their outcome details. A: The Shouldice repair is named after Dr. Edward Earle Shouldice (1890-1965), the Canadian surgeon who invented the technique in the 1940s. The question of the morality of rich families being able to afford private schools, hence their children receiving a higher quality of education is not likely to lay heavily on the mind of any concerned, least of all the children. They weigh the risk to both. I have just been chastised online for daring to criticize the Shouldice clinic on Twitter. At the mid point of the second week, I had searing, stabbing pain at the surgery site. I have heard of one fellow returning to the gym and heavy squats within 2 months of his op which DOES seem to be tempting fate, so some patients may not be helping themselves. Our registered dietitian will develop a personalized weight loss program for you and show you how to make healthy food and exercise choices. Oddly general surgeons have recommended neurectomy though the pain clinic doctors I saw were highly against this type of procedure. Now I have mesh and been having issues with it since (6 months) I would of rather rolled the dice on the hernia reoccurring the old fashion way than having something put in me that no one can get out and continues to be an issue. I dont know where you got your information that the Shouldice doesnt use mesh but this is incorrect. Could you take a closer look at the Desarda technique and make some comments in the same way you did with the Shouldice techinique? Pain clinics are full of patients who have had open mesh repairs. There are some awful stories out there. The food was better than I expected. Is your problem scar tissue? It was then allowed special licence by the Ministry of Health to continue operating. We regret that we cannot make reservations on your behalf. Would you please share with me what kind of hernia you had. Chronic groin pain after hernia repair is a concern, no question. Also billing data was used for the study, which is a notoriously inaccurate way to study surgical outcomes. 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! 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. 5. shouldice offers a social experience. My hernia is fixed and I have a verbal confirmation that I could lift weights directly after surgery. Staff is helpful but not pleasant or friendly. Having been an aircraft accident investigator I provide this comparison/critique in a strictly evidentiary way based on my experiences and observations from having had both procedures. I know once Ive been opened up there is no going back. Relaxing views and an estate-like setting are an important part of the total Shouldice experience and help to stimulate the bodys own natural abilities to heal. Im left asking the question do I fix it now or after pregnancy? Its not hard to understand whats happening here. Founded in 1945, Shouldice Hospital is the world's leading centre of excellence in abdominal wall hernia repair. Is my scar larger than it could have been with a mesh repair? I dont understand why it should annoy you or any other surgeon if a place does *easier* surgeries that can be done efficiently. His hernia is now the size of a basketball. There are many companies which manufacture mesh (hundreds) and yes they like to make money. As a surgeon with intimate knowledge of hernia repair, does the actual technique have a solid, anatomical basis and biological plausibility? Well, I had my right side hernia done 4.5 weeks ago at the local hospital, mesh method. There are definitely many who travel to Shouldice from the USA, where last I heard it runs somewhere around $6500 paid out of pocket for an inguinal hernia repair and the multiple night stay in a facility that supposedly feels collegiate. Hernia repairs at the Shouldice are done with local anesthetic, no mesh insertion, and with a long stay in their hospital to recover. If their procedure was outdated/inappropriate in anyway, then why are they still in business helping 7000 healthy, wealthy and skinny people (morale issue again) per year have pain free and hernia free lives? We go to physicians expecting a solution to a problem, expecting, sometimes, an unreasonable outcome, expecting physicians to be more than human, expecting them to always do the right thing. Have had it checked and been informed that it is not at the point where a repair is required. Ive tried this though for me personally, it made it worse for me so they are leaning towards it rubbing on my nerves. (sorry if i made any writing mistakes, English is not my first language). The fears of chronic pain and lack of research into Shouldices 99% effectiveness claim are overrated. I do not feel Shouldice does an honest job of their success rate, but they are not the only place or surgeon to do that for sure. There have been many mesh products that have been recalled over the years. Pick a curve, any curve (say, the red one). Should Clinic volumes necessitate due to physical distancing restrictions, you may be asked to wait in your car - please bring a cell phone to allow us to contact you. And If I wasnt beginning to suffer the effects of cabin fever, and didnt have a life to get back to, I was almost sorry to leave to return to the UK. I cannot recall a patient ever having been in hospital for 5 days after elective hernia repair. There is some evidence that using generalistsis a cheaper, better way to run a health care system and I believe that. Poor nights sleep (roommate having pain, snoring, up through the night for pain meds, temperature check by nurse at some point, etc). In my opinion Justin you could have got 10 opinions and with a different surgeon had the same unfortunate result. 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. Or that you are cynically making a play for a vast damages pay out. Straight out of a horror film, dim, blinky lights, cold and overall not very reassuring. You may be regret waiting some but better to wait an added week or month than have chronic pain as I do. What would be your expectation about how the recurrence would be repaired, and the likelihood of developing chronic pain afterward? Different policies will exist. Im traveling from the US and paying the entire bill myself (my insurance does not cover non-emergency out of country surgery). Id be curious to see some data comparing patient outcomes for slim patients at Shouldice vs the rest of the system. 4) Shouldice ONLY carry out this operation, meaning they are presumably highly skilled and also experienced in avoiding nerves during suturing, thus improving chances of post-op pain free life. Hard to be critical regarding matters of efficiency without data descends into rhetoric pretty quickly. Surgeons need to do emergency work or perforated appendicitis, gangrenous gallbladders, and blocked bowels (sometimes stuck in hernias) would not be dealt with, and patients would die. Its not much. Critiques are always welcome because it can make people think out of the box. The Bassini repair, named after Dr. Edoardo Bassini who developed it in the 1880s, was the first efficient repair for inguinal hernia. There is a sunlit caf for reading and relaxation and a cheerful common room, where patients often gather for a friendly game of cards. For over 75 years the Surgeons and staff of Shouldice Hospital have dedicated themselves to repairing abdominal wall hernias; it's all we do, having performed over 400,000 successful hernia repairs using our natural tissue technique without the use of surgical mesh and its serious complications. Id stick to an open or lap repair with mesh applied externally. . Anyone can look up what a surgeon in Ontario gets paid to fix a hernia. Standard and mandatory wake up is 0530 for all. 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. and then he has the audacity to tell me that I cant feel the mesh and that the pain is also in my head. The example of my coworker is different. From what I understand well above 90% of Inguinal Hernia operations are successful, and that this is considered to be a routine operation by the medical profession. I went back to work in less than 48 hours and I am very happy with my scar. She examined the surgery site and indicaed that my incision site was in good condition without any signs of infection. The biggest problem with the Shouldice hospital is you cannot choose your surgeon and like anywhere there are good ones and bad ones. Many didnt even know their surgeons name. This is why they went to Shouldice in the first place, in the Toronto area it has a kind of mythical acclaim. My husband went in, doctor said lose weight and i will do it. It is very painful to walk, stand, cough, sneeze, laugh, use the washroom in any capacity and expect from the bruising that this will carry on for atleast another week. I can still thankfully work but havent been able to exercise without being in major groin pain. Please call 905-695-4911 to book a time. The techniques used by the hernia specialists at Shouldice dramatically reduce the risk of recurrent hernias to approximately 1% over a lifetime. In addition to issues of capacity and organizational analysis, describes a well-focused, well-managed . The patient management system (PMS) will schedule appointments, and patients arrive right in time after getting a status update via SMS or Whatsapp. Obviously varies. There were no significant differences in chronic pain, complications and post-operative stay. You share good times with the people you meet there. I did not get a reply what so ever until September 2014 advising me that they can operate on me. Sheraton Parkway600 Highway 7Richmond Hill, Ontario905-881-21211-800-668-0101Call hotel for special Shouldice rate.2.5 miles from the hospital. He has no idea why or how it happened but didnt feel he really cared. 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. I am scheduled to have a right side repair done at Shouldice next week. 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. 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. I have had a right side inguinal hernia for 1.5 yrs and am scheduled for mesh repair locally end of May (bumped from mid-May). Im 60 and 511 @ 180lbs, so not overweight and in good health. The Shouldice Hospital has been a family-run private enterprise since its founding in 1945 by Dr. Edward Shouldice, who developed a reliable technique for repairing hernias during World War II.. The average North American is gaining 1-2 lbs per year, and obesity is a clear risk factor in hernia recurrence. It seems like a roll of the dice. 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 my surgery done at Soldice 5 days ago. Lot of disparity in the anecdotal evidence (my understanding has been that in at least once instance a patient was offered a days long recovery at Shouldice vs weeks long at a hospital, and that has been constant with my knowledge of their reputation in general). It helped for about 10 days and then stopped helping. . The Hospital was founded in 1945 and performs over 7000 hernia repair operations a year. Too risky. Want fast and effectively perfect hernia repair? We know how to fix recurrence, but fixing mesh complications is a difficult procedure. It seems you did your research thoroughly and are maybe one of the unfortunate ones. My experience was extremely positive and I would not hesitate to return there. That is not my opinion, it is just a proven over and over medical fact. A groin which has been operated on for hernia will never feel the same as before the hernia repair, but for the vast majority of patients they will be aware if their repair, or have to take medications for it. I have a consultation in 6 months to decide if I am eligible for surgery (I can tell you now I am) at a local hospital. and a less wait time surgery would be quite worth it. It seems to be the same, or slightly worse than the common open mesh repair. 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. I also have not had good outcomes with the medical community. They have been quite successful with it. A tearing feeling (like being stabbed) from bowel movements is prevalent; on the positive side, I had my first pain free sneeze this morning. I had two hernias repaired in November last year. Here you will find current wait times for Niagara Health's Emergency Departments and Urgent Care Centres. 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. Reilly's, a disused bar, was barricaded up by the rebels, and it . No-show patients cost around $200 per unused time slot, and the average no-show rate for most U.S. practices hovers around 20%. I have not had to take any pain medication. However, it is also undeniable that the chance of a hernia recurring over time is reduced when mesh is utilized appropriately and on the right patient. He also reiterated that he also only does mesh unless of some other medical reason. Most general surgeons will tell you that they cannot get patients to lose weight before surgery, and that has certainly been my experience. Sounds like he needs a repair, although you dont need to worry about blood supply usually. 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? On top of that, the hernia still exists, larger and more painful than ever. When I went for my pre-op. Don, The buddy system helps to reduce stress and anxiety and prepares you for a confident recovery. Sexual activity causes no issues and my testicles are no longer sensitive. I would say you will very likely be fine, I wouldnt worry about your decision at this point. I am quite disappointed in myself for not having done a thorough investigation prior to my Shouldice fix. I have put off surgery for four years because of concerns with mesh. There is absolutely no risk involved, just a requirement for the patient to wear an orthosis. Is this a factor? I am now 4+ months postop and have chronic pain and the surgeon just looked at me dumbfounded and surprised at my last appoimtment. In addition, in my case Im 41 and 168 lbs. State/public schools teach who theyre told to teach meaning everyone else who doesnt get to go to the private schools. Secondly, I have not heard of desarda method. Train operators. Im about 2hrs from Shouldice. Thinking logically, implanting foreign materials in your body is a matter of concern. I got a colleague to do it, with mesh, and a general anesthetic, as day surgery, in one of our local hospitals. The type of surgery that Shouldice accomplishes is best suited for a set of conditions: the patients particular physical condition. Fully sedated for duration of procedure. 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. It was recently taken over by a private company and is no longer in the hands of the original Shouldice family. I dont want to come off too confrontational but I am going to be blunt. That is an important distinction. Day surgeries admitted in the morning released that afternoon. in the area have been giving me the run around on who to see so now looking to go where there is someone more specialized. A very hard ridge is forming under the incision, which the patient discharge sheet says should be expected. 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. I can accept that this is work that should perhaps be compensated at a different level because of its extra demands. I tend to agree more than disagree with the surgeons comments about Shouldice with regards to their capitalistic method. Pure tissue technique, according to yourself and other general surgeons, has the risk of recurrence. 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. 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. I would imagine a lot of people wouldnt go back to someone who wasnt successful with their surgery the first time unless it was very minor surgery. I was wondering what your thoughts were on the actual Desarda technique, not just the website. Open. Given the heightened concerns with the transmissibility of COVID-19 and the pressures on our Emergency Departments, we ask that you consider your healthcare options before visiting the hospital for non-emergency concerns. (2) do you know of the desarda method of no mesh surgery? I play sports 3 days a week, I run competitively, etc, and virtually no pain. Surely theres an advantage to exclusive, specialized hernia repairs that general surgery wouldnt necessarily encompass? Kyle, I think the most recent data is from 2012 and shows a higher failure rate at Shouldice than mesh. Of course, that is difficult work which the shouldice is not interested in. 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. Female were nearly 3% of included patients. I will really appreciate your informed feedback and sincerely hope that maybe more folks will follow your lead in helping make society better informed. And Shouldice does screen patients to make sure they have an appropriate BMI and are setup for long term success. There is a limit of 2 visitors per patient. We have just reviewed 400 consecutive patients from 4 years ago and our recurrence rate is 2%. Improving patient satisfaction with wait times. My hernias were small (umbilical and femoral) and related to pregnancies and not a previous incision. Im on the fence with going back to Shouldice or going with the local doctor. Did I have any discomfort during recovery? I hear that the wait time is up to a few years for the surgery itself. 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. Various proposals are set forth for expanding the capacity of the hospital. 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. I had a double inguinal done at Shouldice 10 weeks ago and was in a fair bit of discomfort for the first 8 weeks but am feeling much better now and am thankful I have no mesh to disrupt things down the road. 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. Here is a run down of my thoughts. colonel frank o'sullivan interview; beverly hills high school football My hernia is very small and only appears after I have been working-out or stand for a long period of time however I have a constant dull pain in the groin area/lower abdomen area (heaviness feeling) My fianc and I also love to travel and travel insurance seems to be an issue. I sympathize with you and your husband. It could be scar tissue or it could be the actual implant rubbing on the nerve. I think is a matter of profit from this industry. shouldice clinic wait times. Anyhow, one piece of overwhelming evidence in support of going to Shouldice that I found is in the Can. In summary, I have to agree with lesmcc1: the technique, the hospital/facility itself, the four day stay, the old equipment, i.e., bed, the wound closure method, etc, all point to a we have always done it this way mindset. 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! My luck, the guy was a heavy sleeper and snored all night which means I could not get that much sleep during my stay. The clinic sits on luxurious grounds and offers one thing and one thing only.