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. I will really appreciate your informed feedback and sincerely hope that maybe more folks will follow your lead in helping make society better informed. My personal experience is that my husband moved a piano for me 20 years ago. It was originally founded during World War 2 to allow for young men to have their hernias repaired before going off to fight. When I went for my pre-op. 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. may be involved. The standard of care now is to do hernia repairs with mesh, a plastic like substance which allows for less pain (if inserted properly), earlier return to work, and decreased recurrence rates. Today, Shouldice Hospital performs more than 5000 . And yes, Shouldice cherrypicks their cases, perhaps because they can. View Map We are currently accepting patients in our Examination Clinic by appointment or limited walk-ins on a first-come, first-served basis. It is important that you are not carrying excess weight around your abdomen. Have had it checked and been informed that it is not at the point where a repair is required. Critiques are always welcome because it can make people think out of the box. We joked about standing by the front door and dropping our pjamas for the new intake. If the damage is so bad in a patient that suturing is no longer plausible then a mesh could be deemed suitable in these circumstances. Toronto is known as a wonderful getaway destination for those who enjoy world-class theatrical productions or professional sports. That is why we offer a diet counselling service to all of our patients. Thank you for putting so much valuable information over here. Ive had mine for years (think its due to c section surgery or pregnancy) You see the full range of personalities there. 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. The technique was designed by Dr.Edward Earle Shouldice and became popular when he opened his hernia hospital in 1945 and his technique has attracted patients from all over the world. Sorry to hear that John. 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. Maybe if its a simple small hernia, Shouldice is a good choice, but otherwise, too clandestine for healthcare. EMR should allow for reporting of all surgical complications and feedback to the surgeons on their complications, including how many of their hernias recur. In the US though most general surgeons wont do it the old way or with disolveable meah for fear of reoccurance. Having to go in the day before surgery and staying 4 nights seemed odd in this day and age. It is virtually impossible to find any real data on Shouldice. 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. Impossible to lose the weight. [2] Contents 1 History 2 Work 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. If you are unable to submit this document in advance, you will be asked to complete it upon arrival at the clinic. A version of this commentary appeared in the Vancouver Sun, Huffington Post and iPolitics.ca. Im not sure what you mean by *elective* with regards to hernias except that I imagine they like many surgeries mostly dont need to be done on an emergency basis. Unlike most hospitals, delicious meals are prepared fresh in our dining room daily, providing the healthy nutrition you need to promote healing. That is frustrating for you. They can walk in, and be called in to be seen by the doctor without having to wait for long. The rigidity of the program is old school military in nature and does not seem to be keeping pace with evolution. I have been refused appointments many times (non-hernia related), this is their prerogative, this is how they minimize their risks and headaches. Or is it because, here it comes, that dangerous phrase Weve always done it this way? The rate of this risk varies, you say it is low, but the risk exists. Length of stay is ridiculous not to mention the Bill for said stay Once youre admitted to the hospital, youll meet other hernia patients. Femoral hernias are tricky sometimes whether mesh is used or not. To increase the text size, press and hold down the command key on a Mac or the windows key on PC, then press the plus (+) key. According to another surgeon I saw mesh isnt likely to cause all of the issues it does in other portions of the body (erosion mainly) and said in his experience 1 year isnt that uncommon to feel mostly back to normal. Following this summers logging and landscape work I will report the status of all three repaired hernias. I dont understand why it should annoy you or any other surgeon if a place does *easier* surgeries that can be done efficiently. What would be your expectation about how the recurrence would be repaired, and the likelihood of developing chronic pain afterward? Here is a run down of my thoughts. I have seen these numbers elsewhere also. This is part of the problem with our record keeping. Recovery done at home, pain meds prescribed, incisions very tidy, standard sutures, little to no swelling or bruising. He chose the hospital. 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. Procedure Choose your surgeon carefully. 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! Visitors will not be permitted in the patient rooms. 2 The Lichtenstein procedure was learned from a book, 10 instructional videos, and personal communication with Irving L. Lichtenstein, MD. I believe every patient has to make their own decision. They weigh the risk to both. Success rates should indicate level of difficulty/complications/etc but why as a patient should I not be happy for surgeons to develop specialty areas or clinics for easier surgeries that do not need to be supported by the larger and more costly structure of a full hospital? 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. The literature on incisional hernias is where the use of mesh was first tested. https://www.ncbi.nlm.nih.gov/pubmed/10452261. Most of the arguments against Shouldice here seem to have very little to do with the actual technique, pain afterwards or recurrence (irritation, I thought, at the Southfork-like set-up and possibly also at their very existence fuelling endless questions like mine: is mesh a problem or isnt it? Well, I had my right side hernia done 4.5 weeks ago at the local hospital, mesh method. She commented that the incision was very near and well done. Walk-in spaces will be provided for a limited number of patients every Monday to Friday. In my opinion Justin you could have got 10 opinions and with a different surgeon had the same unfortunate result. All three were done by general surgeons, and I can honestly say I would have been better off not getting any surgeries from the beginning. The Shouldice Clinic is a private clinic operating in the Toronto area which has been open for decades. I had little to no pain 4 days after the surgery, and other than a small scar, my groin has been perfect. The cost of more comprehensive programs is covered by most insurance plans. I have only good things to say about the Shouldice! I went back to work in less than 48 hours and I am very happy with my scar. Update to the above. Week of Surgery and Hospitalization. The Shouldice Clinic is a private clinic operating in the Toronto area which has been open for decades. Which must annoy surgeons who use only mesh). That was a bit odd. Last year, it had a record year and performed nearly 7,500 operations. 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. This is a microcosm of what happens when you introduce private interests into a socialized health care system. I tend to agree more than disagree with the surgeons comments about Shouldice with regards to their capitalistic method. Hernias do just get larger, and there is also the issue of not being able to travel if you dont get it fixed (pre-exisiting condition). Mr Dedes- there are many fine surgeons and hospitals in the GTA area which fix hernias. Any tips? I am quite sore, I am bruised from my left hip bone to my scrotum including everything in between. Ive tried this though for me personally, it made it worse for me so they are leaning towards it rubbing on my nerves. The grounds were beautiful and interior spaces quite nice. I dont know where you got your information that the Shouldice doesnt use mesh but this is incorrect. I generally will do any umbilical hernia under 1 cm in size without mesh, but that is not an absolute and depends on a lot of factors, including my discussion with the patient. The day after and two days after the operation I walked around the Shouldice property which helped with circulation and recovery. It may be in part an attempt to keep a surgeon ratings list from being established, as patients are not allowed to pick a surgeon. I had an inguinal hernia repair at Shouldice 4 days ago. I had my hernia repaired there on Nov 2nd. From studies (which are few and far between), they both apparently have the same amount of chronic pain sufferers. Monday - Friday: 9 a.m. - 7:30 p.m. Saturday & Sunday: 8 a.m. - 5:30 p.m. Closed: most major holidays . (LogOut/ One patient told me he didnt want to go back to Shouldice with his recurrence because he couldnt afford it. We all want the best, most cost effective public system but critiques must look at the whole system. 5) Their procedure has a proven track record that has survived long after the hernia mesh repair became mainstream. Most of us felt it was an efficient operation and we could see why they do things that way it was logical. 7750 Bayview Avenue, Thornhill, Ontario. Placed in a room with patient who had surgery the day prior. Registration will begin at 8:00AM and will close once we have reached the maximum number of appointments available that day. I have a rather large incisional hernia and am considering a trip to Shouldice. Update from my initial posts: Its coming up on two years (mid-Sep 17) since I had my right side inguinal hernia done by Dr Lisi in Collingwood G&M Hospital using laparoscopic surgery and mesh. 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. Thanks for your comments. They told me they were being charged much less at Shouldice than they would have paid out of insurance in the US. The Shouldice Clinic is a private clinic operating in the Toronto area which has been open for decades. Considered the same as Shouldice. I will stop by here at the 6 month point to provide another update. J. Surg. security guard 12 hour shifts aubrey pearsons oaks husband shouldice clinic wait times. The body can react to a foreign body (Plastic) Mine also is touching the nerves that run in that area. The surgeon who performed my surgery has successfully completed over 10,000 prior repairs. C. Shouldice Hospital is not responsible for these services. I traveled from NY TRYING TO AVOID the horrors of the mesh repairs. To do less would be to jeopardize the positive end result. We encourage you to take advantage of these beneficial patient programs. They will also arrange regular phone meetings to offer advice and support so that you can commit to a healthier lifestyle and prepare your body for a successful hernia repair. It is a small hospital dedicated only to hernia repair. My first week after surgery at Shouldice wasnt too bad. OUR PATIENT CARE When you come to Shouldice, you can expect to have a positive and pleasant experience. Improving patient satisfaction with wait times. and a less wait time surgery would be quite worth it. On another topic, but those expenditures offer a glimpse as to why medical bills are the primary reason for personal bankruptcy in the USA. The Shouldice Clinic has demonstrated the procedure's durability and safety with 75 years of experience. It could be scar tissue or it could be the actual implant rubbing on the nerve. Change), You are commenting using your Facebook account. I cannot recall a patient ever having been in hospital for 5 days after elective hernia repair. 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. If I was doing only one operation, the only thing I would be is bored. At Tar, The authors looked at repairs in Ontario hospitals over a 10 year period and concluded that Inguinal hernia repair at Shouldice Hospital was associated with a significantly lower risk of subsequent surgery for recurrence than repair at a general hospital. I find this absolutely compelling evidence supporting a visit to Shouldice versus other hospitals in Ontario and, for me, I think its plausible to believe that these findings would not be dissimilar if you were to compare Shouldice repairs versus outcomes of repairs done in general hospitals in the States. However, these hotels have NOT been inspected by the Shouldice Hospital staff. I would recommend this approach (and frequently do) to anyone, including my patients. Lets pretend that there is no influence of the medical-pharmaceutical industry on advertising about certain methods and medications as well as on the purchase of the professionals themselves, as is the case in several countries. Open. 10 Royal Orchard Blvd, Thornhill, ON L3T 3C3 Get directions. Often times we do not own up to our own responsibility in the situation. 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? I do have recurrences, about 1 per year but I find since I have warned the patients about this they are usually pretty accepting of it and happy to come back to me for another repair. They have been quite successful with it. For the first couple of weeks I stayed under the 10lb limit for lifting, now I tend to lift a bit more weight but still not very heavy weight. Toronto Transit. His hernia is now the size of a basketball. The buddy system helps to reduce stress and anxiety and prepares you for a confident recovery. I had inguinal hernia repair at Shouldice in June 2017. My biggest concern is chronic pain, and the medical papers I have found do not give the Shouldice method the best score. It was originally founded during World War 2 to allow for young men to have their hernias repaired before going off to fight. Toronto Transit. Thanks Kram. A Shouldice Repair is usually done under local anaesthetic and conscious IV sedation making it an exceptionally safe procedure with virtually no complications. You may be regret waiting some but better to wait an added week or month than have chronic pain as I do. 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! Do you yourself know how many of your hernia surgeries fail? The repair is based on the Bassini repair with some modification. Its location is the former estate of George McCullagh, a publisher who created The Globe and Mail newspaper in 1936. I decided to wait and get the surgery at the Shouldice clinic, done by an experienced Shouldice-trained surgeon. You . 80%| 10. He had the choice of Shouldice or a Toronto area hospital. or skilled? 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. Id stick to an open or lap repair with mesh applied externally. It has been repairing hernias for decades. Do the same for a reduction in u from 0.80 to 0.70. So firstly, it is always hard in practice to know how many surgeries it takes to be competent? Different policies will exist. I agree with Toronto that it is hard to find any real data on the Shouldice clinic. 2. Please call 905-695-4911 to book a time. He takes the time to explain everything to you, during the consultation, before the surgery, and after the surgery. The recurrence rate with Shouldice techniques was higher than mesh techniques (OR 3.80, 95% CI 1.99 to 7.26) but lower than non-mesh techniques (OR 0.62, 95% CI 0.45 to 0.85). Shouldice I learned the name even before it had become personally relevant and noted it. Staff is helpful but not pleasant or friendly. Now some of the Shouldice clinic patients come from out of country and should be paying forall of their carebut what this percentage is, I do not know. TORONTO Shouldice Clinic Hernia Repair - August 2020 2,289 views Oct 22, 2020 27 Dislike Share Save Herve Del Norte 542 subscribers I provide a summary of my recent hernia repair surgery at the. Posted on September 8, 2011 by Ewen. 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. I had the left side done 11 yrs ago @ Shouldice and have had no issues with pain or recurrence and I dont avoid any activity, including heavy lifting. I always tell patients it takes as long as it takes to do a safe operation. Well that was 2 years ago, he did lose 45 lbs and the doctor still refused to do the operation siting that he had no place to put what was in his testicle area! 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 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. I am running 20-30km/week and have returned to normal activity. Do not use mesh, It can or will disintegrate in time like me and a friend too. Another confession, I alsomake money doing hernia repairs, but I dont make nearly as much as the Shouldice does off their patients. The biggest problem with the Shouldice hospital is you cannot choose your surgeon and like anywhere there are good ones and bad ones. About a week later the pain had completely subsided and I had no further significant pain. I absolutely follow up all my hernia patients. 0. 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. Im not happy about Shouldice being sold to a private company but I do not see that your critique of their prior history is based on any accurate or well-analysed information. To increase the text size, press and hold down the command key on a Mac or the windows key on PC, then press the plus (+) key. They do not take overweight patients, they do not take complicated cases, and they do not take hernias that are not obviously visible right at the time of surgery itself. Oddly general surgeons have recommended neurectomy though the pain clinic doctors I saw were highly against this type of procedure.