Posted by Jeff C. on May 25, 2009, 9:54 am, in reply to "Re: referral info for Hernia MD"
24.39.221.X
I can't answer your question about when a triple neurectomy is necessary, but I can tell you about my experience with it. I had a mesh patch and plug, with lots of pain off and on for three years before removal, and I had Dr. Goodyear do the removal and repair surgery. He did a triple neurectomy at the same time, much as Amid and others do. Amid has a slightly better percentage rate of success than Goodyear -- about 70% vs. 60% when the plug is involved, and much higher when only mesh is involved -- but I live on the east coast. The rationale behind the triple neurectomy, as you probably know, is that once you're in there you might as well do a total job, rather than having to go in again, another time, which produces even more scar tissue. They also believe, and often quite correctly, that the source of much post-herniorrhaphy pain is nerve entrapment or damage due to poorly done surgery or physical stress/strain after the initial surgery. My operation did NOT reduce my pain (the plug had come loose and was moving and there were two meshomas, two trapped nerves, and lots of scar tissue), but I can tell you that the triple neurectomy is no big deal. It sounds scary and severe, but when done well it produces a very modest loss of surface sensation at the site of the surgery, and it does not interfere with normal activity and important sensation in that general area.
Hope this helps...
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