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LSH questionFrom: Richard Chudacoff (rchudacoff@mylinuxisp.com)Tue Dec 18 11:04:41 2007
The only thing my patients complain about after an LSH is the left trocar site pain. Since I use bladeless trocars I never need to close the fascia of the umbilical or right trocar sites. I'm convinced that the pain is from the facial closure. I try not to incorporate the peritoneum if using a closure device, but even on very skinny patients where I can access the fascia from above, the pain still exists. And the pain lasts about 21 days, the time of the tensile strength of Vicryl. So, my questions are two fold: (1) does anyone have any pearls for me to decrease this pain and (2) if I used something with a shorter tensile length, like Monocryl or Chromic gut, would that increase the risk of herniation?
-- Richard Chudacoff, MD, FACOG
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