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Inguinal hernia surgery recommendations


cven

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I must have surgery for an inguinal hernia as soon as possible so I'm looking for advice. One old thread had some information but it may be outdated by now. I've also seen recovery times mentioned that varied from 3 days to 4 weeks.

I'm in Bangkok now but have lived in and have friends in Chiang Mai, Lampang and Phuket and have no problem traveling elsewhere if there is good reason to. I can have Thai friends come with me to translate, though that may not be an issue, as all the medical professionals I've dealt in the past had very good English.

Apparently, what I need is open mesh surgery. I don't really want to return home for it as, most likely, an equivalent level of care can be found here. It seems to be quite a common procedure, albeit not one without some risk.

Any help much appreciated.

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Yes about one month for total recovery. You just need to be careful for a while afterwards. In 2015 it cost me about 25,000 baht at a public hospital about $700. Did not have any problems. Just make sure you get a set price before you do it just in case they suddenly decide to add extra fees. A basic private room should be about 1,000 baht a night. The doctor i spoke with knew what was wrong the same that did the surgery.

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Bangkok Hospital 1 night stay, 130 000 baht. You can walk immediately after the surgery, i was doing smoking runs an hour after waking up.

 

First 2 days little pain but nothing major, but for some reason still walking slow, after 3 days walking normal, may have slight pain. I did not take any pain medication, even though was given enough for 10 days.

 

From memory on 4th day, i was already taking my 6 dogs out for walks

 

From memory, can not carry anything over 5kg for 3 months at least.

Edited by BestB
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It seems the recovery period for this procedure can vary greatly. My 75 year old dad had it done and was up and about the next day and working in his garden three days after. When I had mine done at 40, I was miserable for almost a week, a very painful recovery. Hoping your procedure goes well and wishing you a speedy recovery.

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Over 12 months since I had this type of hernia.

 

Having experienced no symptoms to date, the doctor advised me that I should defer surgery unless I experience any symptoms and/or the hernia gets any larger.

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A general surgeon at just about any hospital can do this.  A government hospital will cost probably under 30k but there will likely be a wait list.  This is an elective procedure so usually no rush, not sure why you sat it has to be done as soon as possible? 

 

Private hospitals, depending on which one, 100 - 150,000 and can do it within a few days of initial doctor visit.

 

Prices assume no complications. 

 

Dr. Narongsak Chongsiri at St Louis hospital (private but non-profit, on Sathorn Rd) repaired my nephew's inguinal hernia a while back and we were happy with him.   http://saintlouis.or.th

Cost I think 80,000 but this was about 120 years ago so likely 100k now.

 

As for recovery time it depends on the patient and also what you mean by recovery. If you mean able to walk out of the hospital unaided, eat and so forth, 1-2 days. If you mean able to engage in all normal activities including light work, 1-2 weeks usually but may be longer if having to take pain killers.   If you mean able to engage in heavy lifting and sports,  more like 4- 6 weeks and check with surgeon first.

 

In the West this is usually a day surgery, in Thailand they will keep you 1-2 nights. 

 

Most people go back to work after 1-2 weeks unless their work involves heavy physical exertion.

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Thanks for all the replies.

Big difference in the recovery times alright. I guess I was thinking in terms of being able to engage in normal activities, carrying nothing heavier than a laptop. I'm 51 and not very active, but I'm not carrying any extra weight.

I'll query those places and ask for the total price upfront in each case.

Thanks, Sheryl. Like Anchadian, I've had the hernia for a while, around a year, but it's become painful and much larger in the last two weeks, so I have to get it done as soon as possible. I acquired the hernia as a result of coughing violently with a chest infection last year.

Thanks again to all for the advice and for the best wishes.

 

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36 minutes ago, cven said:

I'll query those places and ask for the total price upfront in each case.

I'd be interested in knowing what you find out about prices, as I need to have the same surgery, though not as immediately as you seem to need.

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1 hour ago, cven said:

Thanks for all the replies.

Big difference in the recovery times alright. I guess I was thinking in terms of being able to engage in normal activities, carrying nothing heavier than a laptop. I'm 51 and not very active, but I'm not carrying any extra weight.

I'll query those places and ask for the total price upfront in each case.

Thanks, Sheryl. Like Anchadian, I've had the hernia for a while, around a year, but it's become painful and much larger in the last two weeks, so I have to get it done as soon as possible. I acquired the hernia as a result of coughing violently with a chest infection last year.

Thanks again to all for the advice and for the best wishes.

 

You'll be able to engage in many normal activities pretty much right after you get home, limitation will be incisional pain and this is very individual.  Initially you'll move a bit slowly but still be ableto do most things, and gradually over 1-2 weeks back to normal.

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I advise researching the negative effects of mesh repair.

 

Countless horror stories, numerous lawsuits vs. mesh manufacturers.

 

Mesh is a medical device - a foreign body implanted and for many causing great pain sooner or later.

 

I found someone I believe is the best surgeon for doing a non-mesh repair - his specialty -  and had him take care of.my inguinal hernia earlier this year, even though I could have had a mesh repair covered by insurance for about 1/6th the price.

He's in the US.

His other specialty is removing mesh from those suffering its ill effects.

 

Anyone planning a hernia repair should read up on this and then make an informed decision.

 

 

 

 

 

Edited by JimmyJ
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On 12/9/2019 at 6:11 AM, anchadian said:

Over 12 months since I had this type of hernia.

 

Having experienced no symptoms to date, the doctor advised me that I should defer surgery unless I experience any symptoms and/or the hernia gets any larger.

Exactly the advice I got from my GP!

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6 hours ago, JimmyJ said:

I advise researching the negative effects of mesh repair.

 

Countless horror stories, numerous lawsuits vs. mesh manufacturers.

 

Mesh is a medical device - a foreign body implanted and for many causing great pain sooner or later.

 

I found someone I believe is the best surgeon for doing a non-mesh repair - his specialty -  and had him take care of.my inguinal hernia earlier this year, even though I could have had a mesh repair covered by insurance for about 1/6th the price.

He's in the US.

His other specialty is removing mesh from those suffering its ill effects.

 

Anyone planning a hernia repair should read up on this and then make an informed decision.

I researched this very issue and found that the problems associated with the mesh method were twice those with the traditional sewing method. If memory serves me correct, the traditional sewing method had a 2.4% problem rate, compared to 4.7% for the mesh method. Apparently the mesh method was designed to be used when the traditional method failed due to the tissues not growing back together properly.

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6 minutes ago, GalaxyMan said:

I researched this very issue and found that the problems associated with the mesh method were twice those with the traditional sewing method. If memory serves me correct, the traditional sewing method had a 2.4% problem rate, compared to 4.7% for the mesh method. Apparently the mesh method was designed to be used when the traditional method failed due to the tissues not growing back together properly.

 

No, mesh is used to prevent recurrence of the hernia, the rate of which is higher without mesh. Also use of mesh is associated with overall quicker recovery times.

 

The date you cite is incorrect. For a clearer understanding of mesh vs non-mesh see below which syntheses the results from 25 different studies

 

https://www.cochrane.org/CD011517/COLOCA_comparing-surgical-groin-hernia-repair-performed-or-without-mesh

 

Vast majority of people suffer no problems associated with mesh. I am not aware if any surgeons in Thailand who do not use it.

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  • 11 months later...
On 12/9/2019 at 8:32 AM, Sheryl said:

A general surgeon at just about any hospital can do this.  A government hospital will cost probably under 30k but there will likely be a wait list.  This is an elective procedure so usually no rush, not sure why you sat it has to be done as soon as possible? 

 

Private hospitals, depending on which one, 100 - 150,000 and can do it within a few days of initial doctor visit.

 

Prices assume no complications. 

 

Dr. Narongsak Chongsiri at St Louis hospital (private but non-profit, on Sathorn Rd) repaired my nephew's inguinal hernia a while back and we were happy with him.   http://saintlouis.or.th

Cost I think 80,000 but this was about 120 years ago so likely 100k now.

 

As for recovery time it depends on the patient and also what you mean by recovery. If you mean able to walk out of the hospital unaided, eat and so forth, 1-2 days. If you mean able to engage in all normal activities including light work, 1-2 weeks usually but may be longer if having to take pain killers.   If you mean able to engage in heavy lifting and sports,  more like 4- 6 weeks and check with surgeon first.

 

In the West this is usually a day surgery, in Thailand they will keep you 1-2 nights. 

 

Most people go back to work after 1-2 weeks unless their work involves heavy physical exertion.

Thank goodness for Sheryl...always a source of actual knowledge and reliable good advice. I had a suspected inguinal hernia confirmed yesterday at Bangkok hospital in Khon Kaen and was considering the “watchful waiting” approach. I’m a fit 74 y.o, retired, with little need for heavy lifting or the like. There is however a persistent dull ache in the groin once I’m up and about, and have decided to have the op. The surgeon at BH recommended laparoscopic repair as “ today’s standard” , and the hospital’s indicative quote was 165k to 185k, including two nights stay. This seems a little steep having seen some of the costs quoted by others on this thread. My Thai wife suggests that other hospitals could be a lot cheaper. I’m also not clear as to whether the laparoscopic repair uses mesh or involves stitching, my thought process being “why such a large incision for open repair if mesh can be inserted via the much smaller cuts for laparoscopy?” Any thoughts on this or BH’s quote would be welcome.

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Laparoscopic always costs much more than open as it requires special equipment and training.  The quote you got was typical and you won't get it for much less at any private hospital.

 

Note that laparoscopic approaches do nto always work and sometimes they have ti switch to open during the surgery (in which case you still pay for the higher laparoscopic cost)

 

If cost is a constraint  I would suggest you just have an open approach. The incision is not all that large.

 

Mesh is inserted whether done open or laparoscopic. And both entail some stitches. Fewer with lap as the incision is smaller but the open one is not huge.

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Just now, Ray Ban said:

Thank goodness for Sheryl...always a source of actual knowledge and reliable good advice. I had a suspected inguinal hernia confirmed yesterday at Bangkok hospital in Khon Kaen and was considering the “watchful waiting” approach. I’m a fit 74 y.o, retired, with little need for heavy lifting or the like. There is however a persistent dull ache in the groin once I’m up and about, and have decided to have the op. The surgeon at BH recommended laparoscopic repair as “ today’s standard” , and the hospital’s indicative quote was 165k to 185k, including two nights stay. This seems a little steep having seen some of the costs quoted by others on this thread. My Thai wife suggests that other hospitals could be a lot cheaper. I’m also not clear as to whether the laparoscopic repair uses mesh or involves stitching, my thought process being “why such a large incision for open repair if mesh can be inserted via the much smaller cuts for laparoscopy?” Any thoughts on this or BH’s quote would be welcome.

 

 

Having had an inguinal hernia for three years and based in Khon Kaen I finally did mine three months ago.

 

Two years ago had many quotes.

 

BH, hospital

With a great surgeon Dr Apichat charming guy with excellent English and a listening caring attitude. quite rare here. He had previously been the surgeon at khon kaen hospital and the first to do laproscopic there.

 

My prices quoted in writing two years ago.

 

Open surgery two night stay general anesthetic. 80K.

 

Laproscopic.... 110k two night stay general anesthetic.

 

The quote they have given you is very high but not unusual for them. My work insurance at the time was looking at it so maybe my quote was lower for that reason.

 

Ratchepreuk  private hospital.

 

Open surgery only available with spinal block anesthetic.

50-60k with 2 night stay private room.

 

Sinagarind university teaching hospital.

 

Open surgery treated as a private patient no waiting time, private room two night stay.

40k.

 

Khon kaen hospital government.

 

Open surgery circa 25k with 4 night private room requested.. Waiting time 2/3 weeks.

 

Laproscopic  again 4 night private room requested  stunningly only 30 k.

 

 

When i finally got around to it I had to pay all myself and although I would of liked to have gone with BH hospital because of the great attitude of the surgeon who freely advised me on many other medical issues, i was very aware of BH hospitals creative billing policies.

 

So i opted for Ratchepreuk private hospital surgeon after a couple of consultations,,,,,, had an agreement with the doc re price and had accounts of someone who had the same op and price quote six months prior with good reports........ my final bill 58k as quoted and  now 3 months post op.

 

Hope this helps, its become a bit of an essay, if you need further details happy to help.

 

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Thanks to both Sheryl and Sapson for those replies.

The latter’s “essay” about costs is exactly the sort of detailed info. I was looking for in that regard, and saves me a lot of leg work of my own.

Also, I’m inclined to go with Sheryl’s remark some time back that is a very routine procedure that any general surgeon could perform, and that the open approach is a perfectly acceptable option. Indeed, given my layman’s understanding of what is involved....essentially a cut, patch and sew job (!)....the lap approach almost seems a bit over-complicated. After all, cosmetic considerations re the scar hardly come into it given the location !

It was Dr. Apirat who saw me the other day, and completely agree he is a delightful man. My previous experience with BH as an out-patient has been very good, so that will probably be my choice if he is happy to perform the open version of the op.

Thanks again both.

 

 

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  • 2 years later...
On 11/26/2020 at 12:25 PM, Sheryl said:

Laparoscopic always costs much more than open as it requires special equipment and training.  The quote you got was typical and you won't get it for much less at any private hospital.

 

Note that laparoscopic approaches do nto always work and sometimes they have ti switch to open during the surgery (in which case you still pay for the higher laparoscopic cost)

 

If cost is a constraint  I would suggest you just have an open approach. The incision is not all that large.

 

Mesh is inserted whether done open or laparoscopic. And both entail some stitches. Fewer with lap as the incision is smaller but the open one is not huge.

i was hoping to have laparoscopic surgery but because i had IMRT treatment for prostate cancer the surgeon recommended open incision.

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I went to Shouldice Hospital in Toronto Canada, costs in the range of 120k baht with 3 night stay.  My hernia was quite large and old.  The Shouldice method does NOT use mesh but is very strong.  People from all over the world go there as its a hospital that ONLY does hernias, check them out as an option.

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