Sen. Paul could have his surgery anywhere in the world. As a member of Congress he has subsidized healthcare (thank you US taxpayers!) and as a doctor he would have access to the clinics around the world with the best success rates for a hernia repair.
He chose Shouldice, a hospital that does not use surgical mesh in its repairs. This is the same clinic where consumer advocate Ralph Nader chose to have his hernia repaired, as he told us during an interview on his radio hour. Listen here.
The Hill reports the story on Rand Paul here. Sen. Paul will be paying for his care out of pocket. He is not able to use his US-based healthcare plan. Shouldice is a privately owned hospital that takes private payers but also is covered by the Ontario hospital plan, which covers only Canadians.
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. Complications after a mesh surgery can drive the cost of a simple hernia repair into the hundreds of thousands of dollars.
His surgery is related to an attack by a neighbor at his Kentucky home in 2017. Mr. Paul has filed a civil suit against the neighbor seeking compensation for physical pain and mental suffering.
The late Dr. Robert Bendavid was a regular on Mesh News Desk answering questions from readers about hernia repair.
Long associated with the Shouldice clinic, the renowned hernia surgeon was a past president and a founding father of the American Hernia Society, Dr. Bendavid has performed thousands of procedures and is presently associated with the Shouldice Hospital in Toronto where the natural tissue, mesh-free, tension-free procedure was developed by Dr. Edward Earle Shouldice.
He believed surgical mesh should only rarely be needed to be used on women for inguinal hernia repair, though it may be needed for femoral hernias.
TheHerniaLetter.org discusses the vigorous debate between mesh and non-mesh repairs. Dr. Bendavid in this discussion, counters the assurances by the AHS (American Hernia Society) about the safety of mesh. His comments are in the bold.
"Hernias are highly prevalent throughout the world. Over the years various surgical techniques have been employed to deal with them, and these techniques have evolved with greater understanding (?). The main aim of these techniques has been to provide an effective, safe, and durable treatment of hernias. The use of mesh reinforcement has been shown to be very effective in reducing recurrences (not true for the majority of cases if one knows Pure Tissue Repairs and as proven by the Mayo study and D. Urbach)(1,2,3).Surgeons have utilized all various meshes, synthetic, biologic and bio-absorbable meshes, as an adjunct to improve results of surgical repairs. In fact, millions of patients have had successful hernia repairs with mesh (but millions -at least 120 000 cases a year in the US alone-also have had life altering complications such as chronic pain due to erosion of nerves, vas deferens, bladder etc…. if one is to believe the stats of the EHS International Guidelines on the incidence of 12% of CPIP. The use of tissue-based “non-mesh” techniques has largely been associated with disappointing long-term ventral hernia repairs (here you mean incisional repairs, not ventral repairs. Possibly, so far, the only true statement but then again incisional hernias only make up 5% of all abdominal wall hernias and are never included in stats when the discussion is about groin repairs. Ventral hernias such as umbilical, epigastric, hypogastric -rare- should be excluded as well). However, there are surgeons and centers that employ non-mesh tissue-based repairs for inguinal hernia repair, and have demonstrated efficacy in these procedures. (knowing the incidence of chronic pain complications to be, conservatively 12% (range 3%-75%), why should pure tissue repairs not be offered as a choice to patients when recurrences are not as high?)"
MND, Dr. Bendavid tells Parliament adverse events are underreported, October 2017 (here)
MND, Hernia Mesh: The Debate and the History, October 2014 (here)
MND, Women May Not Always be Candidates for Surgical Mesh, April 2013 (here)
At the annual meeting of the American Association of Gynecologic Laparoscopists (AAGL), two leading urogynecologists debated the use of pelvic mesh versus native tissue repair in surgery.
In this Mesh News Desk podcast, Dr. Donald Ostergard talks about how to find a doctor to do pure tissue repair rather than use polypropylene mesh, tests, and treatments for SUI.