Hi all,
Apparently the fantastic Dr. Hibner is no longer using cadaver tissue to repair the ST ligament but instead cutting a "Z" incision into the ligament which keeps it intact but allows it to stretch out if indeed the ligaments are too tight.
I have researched this method myself and it has been proven to be very successful in carpal tunnel surgeries. The groups who had a Z incision and ligament intact had less scar tissue than those with simple transection.
I think this sounds very promising and shows how dedicated Dr. Hibner is at perfecting his TG technique.
I live too far from the US to consult with him but I can already say I am a huge fan and wish there were more surgeons doing his approach!
Cheers
Hibner ST ligament new method
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Sydneysufferer
- Posts: 18
- Joined: Mon Apr 23, 2012 3:39 am
Hibner ST ligament new method
26yo/F/Australia
March 2012 - PN symptoms after long period sitting - PGAD and urinary frequency.
Ceased sitting - total symptom relief after 5 months
April 2012 - Initial palpation of pudendal nerve on examination led to some rectal pain.
May 2012 - MRI: entrapped left pudendal nerve superior to ischial spine and narrowed interligamentous space on right hand side w/ no definite entrapment.
October 2012 - Recommenced sitting and symptoms returned.
Exploring clinical options here and overseas.
March 2012 - PN symptoms after long period sitting - PGAD and urinary frequency.
Ceased sitting - total symptom relief after 5 months
April 2012 - Initial palpation of pudendal nerve on examination led to some rectal pain.
May 2012 - MRI: entrapped left pudendal nerve superior to ischial spine and narrowed interligamentous space on right hand side w/ no definite entrapment.
October 2012 - Recommenced sitting and symptoms returned.
Exploring clinical options here and overseas.
Re: Hibner ST ligament new method
Dr. Hibner has been doing the "z" type incision for about 1.5 years. On very rare occasions he still uses cadaver tissue if he can't repair the patients ligament without it.
2/07 LAVH and TOT 7/07 TOT right side removed 9/07 IL, IH and GN neuropathy 11/07 PN - Dr. Howard
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
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Sydneysufferer
- Posts: 18
- Joined: Mon Apr 23, 2012 3:39 am
Re: Hibner ST ligament new method
Haha woah... am I late to the party or what?!?!
I was going off an e-mail from him where it seemed like it had only been a recent development! Well, in case anyone else on the boards didn't know, here's some old info on a new thread!
I was going off an e-mail from him where it seemed like it had only been a recent development! Well, in case anyone else on the boards didn't know, here's some old info on a new thread!
26yo/F/Australia
March 2012 - PN symptoms after long period sitting - PGAD and urinary frequency.
Ceased sitting - total symptom relief after 5 months
April 2012 - Initial palpation of pudendal nerve on examination led to some rectal pain.
May 2012 - MRI: entrapped left pudendal nerve superior to ischial spine and narrowed interligamentous space on right hand side w/ no definite entrapment.
October 2012 - Recommenced sitting and symptoms returned.
Exploring clinical options here and overseas.
March 2012 - PN symptoms after long period sitting - PGAD and urinary frequency.
Ceased sitting - total symptom relief after 5 months
April 2012 - Initial palpation of pudendal nerve on examination led to some rectal pain.
May 2012 - MRI: entrapped left pudendal nerve superior to ischial spine and narrowed interligamentous space on right hand side w/ no definite entrapment.
October 2012 - Recommenced sitting and symptoms returned.
Exploring clinical options here and overseas.
-
helenlegs 11
- Posts: 1779
- Joined: Fri Sep 17, 2010 9:39 am
- Location: North East England
Re: Hibner ST ligament new method
Glad you mentioned it (both of you 
) I didn't realise there was such a thing as a Z incision. PN'ers will look like they have been 'attacked' by Zoro 
Thanks,
Helen
) I didn't realise there was such a thing as a Z incision. PN'ers will look like they have been 'attacked' by Zoro Thanks,
Helen
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.
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Sydneysufferer
- Posts: 18
- Joined: Mon Apr 23, 2012 3:39 am
Re: Hibner ST ligament new method
Haha too right Helen!
I think it's called a Z but looks a bit more like this:
http://www.rcsed.ac.uk/fellows/lvanrens ... ateral.jpg
I wonder if this method would change the pelvic stability but to a lesser extent i.e because the ligament would naturally become stretched?
I think mine needs a bit of stretch in it to be honest.
Gosh I WISH the specialists here would just get on the phone to Hibner and say "what's your technique, gimme a list of the stuff I'm gonna need" and then try things that way. Or at least let a good clinical trial come out that might convince them to update the Robert technique as well.
I think it's called a Z but looks a bit more like this:
http://www.rcsed.ac.uk/fellows/lvanrens ... ateral.jpg
I wonder if this method would change the pelvic stability but to a lesser extent i.e because the ligament would naturally become stretched?
I think mine needs a bit of stretch in it to be honest.
Gosh I WISH the specialists here would just get on the phone to Hibner and say "what's your technique, gimme a list of the stuff I'm gonna need" and then try things that way. Or at least let a good clinical trial come out that might convince them to update the Robert technique as well.
Last edited by Sydneysufferer on Sat Oct 27, 2012 1:47 am, edited 1 time in total.
26yo/F/Australia
March 2012 - PN symptoms after long period sitting - PGAD and urinary frequency.
Ceased sitting - total symptom relief after 5 months
April 2012 - Initial palpation of pudendal nerve on examination led to some rectal pain.
May 2012 - MRI: entrapped left pudendal nerve superior to ischial spine and narrowed interligamentous space on right hand side w/ no definite entrapment.
October 2012 - Recommenced sitting and symptoms returned.
Exploring clinical options here and overseas.
March 2012 - PN symptoms after long period sitting - PGAD and urinary frequency.
Ceased sitting - total symptom relief after 5 months
April 2012 - Initial palpation of pudendal nerve on examination led to some rectal pain.
May 2012 - MRI: entrapped left pudendal nerve superior to ischial spine and narrowed interligamentous space on right hand side w/ no definite entrapment.
October 2012 - Recommenced sitting and symptoms returned.
Exploring clinical options here and overseas.
Re: Hibner ST ligament new method
Dr. Hibner learned the "z" incision technique from Dr. Aszmann in Austria. It allows him greater access to the nerve and thus can decompression more of the nerve.
2/07 LAVH and TOT 7/07 TOT right side removed 9/07 IL, IH and GN neuropathy 11/07 PN - Dr. Howard
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
Re: Hibner ST ligament new method
Sydney, I'm glad you posted 'cause I learned something new. 
Violet
Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
Re: Hibner ST ligament new method
Here is the link to the thread where I mentioned the "z" incision, May 2011.
http://www.pudendalhope.info/forum/view ... =17&t=1331
http://www.pudendalhope.info/forum/view ... =17&t=1331
2/07 LAVH and TOT 7/07 TOT right side removed 9/07 IL, IH and GN neuropathy 11/07 PN - Dr. Howard
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
Re: Hibner ST ligament new method
Thanks for refreshing my memory, nyt. 
I remembered someone posting about his new ST ligament protocol but I didn't remember about the Z or that Aszmann had taught him this.
Violet
I remembered someone posting about his new ST ligament protocol but I didn't remember about the Z or that Aszmann had taught him this. Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.