Sorry, I have just found out that in 2005 already, British Hernia Centre claimed to be a pioneer of the tension free mesh method (mesh, local anesthesia, no laparoscopic technology) which it deemed its preferred hernia repair method in most cases. Does its commendation still hold water today? Have surgeons in HK adopted the method? Kindest Regards
李泓暉
醫生回覆
Most surgeons in Hong Kong nowadays use tension-free mesh repair to treat hernia. It could be done by conventional open method, or laparoscopic method. Open mesh repair could be performed under local anaesthesia, or regional anaesthesia, or general anaesthesia. Laparoscopic mesh repair has to be performed under general anaesthesia.
會員#20455 Carmen
屬於邊種肛瘺？
病患者男 - 35歲
李泓暉醫生，你好~ 謝謝你先前回應，我想詳細問，如磁力共振報告講(An intersphincteric fistula track is seen running from near 5 o'clock position from lower anal level. it runs posteriorly and medically and open at buttock natal cleft near 6 o'clock position. No evidence of abscess collection is noted. The fistula tract shows enhancement after contrast suggestive of active inflammation.)我屬於什麼肛瘺？手術會用串線引流、人工膠水黏合、肛門瘻管內視鏡、皮瓣，邊種？手術價錢幾多？
It is not understandable that laparoscopic hernia surgery with mesh is commended by the medical professionals for being much superior to open and mesh surgery, but the recurrence rate of laparoscopy surgery is double that of open surgery, for example, 2% vs 1%.. Why?
If the skills and experience of the surgeons are crucial, how can concerned patients get such information of the individual surgeons in order to alleviate some of their anxiety?
李泓暉
醫生回覆
Thank you for your question. I don't know where you got your data, but laparoscopic surgery for hernia carries the SAME risk of recurrence compared with traditional open surgery (0.5% according to literature).
Laparoscopic surgery wound is smaller than traditional surgery, and there may be less post operative pain, otherwise there is no significant difference in treatment outcome. Therefore, laparoscopic hernia surgery is not much superior to traditional surgery, and it is recommended only in recurrent or bilateral hernia cases.
You are correct that the skills and experience of surgeons are crucial, but there is no objective way to compare who's better than who. In general, hernia surgery is not complex, and most qualified surgery specialists in Hong Kong have enough experience.
李泓暉醫生(男)