Health Organization for Pudendal Education

Hello,

Under the topic "Robyn's 2 Week Update" under "Case Updates", there was a discussion about how Dr Dellon treats the STL during surgery. I said I would contact him and ask, since we had (2) differant viewpoints. Below, I have copied & pasted my email to him and his responce to my email. I hope this helps clarify his position on the STL..................Robyn

>> Hello Dr Dellon,
>>
>> I hope this finds you well.
>>
>> I need your help to clarify something for me.
>>
>> How do you "normally" deal with or treat, the Sacral Tuberous Ligament during a Pudendal Nerve Decompression Surgery?
>>
>> More specifically, are there any times that you would need to sever it ? As in totally cut it apart into (2) separate pieces?
>>
>> Most thankful,
>> Robyn..................who has not forgotten she owes you a video and a 2 week update in about 5 days.



> -----Original Message-----
> From: A Lee Dellon [mailto:aldellon@dellon.com]
> Sent: Thursday, April 07, 2011 5:15 AM
> To: Robyn Blevins
> Cc: gina@dellon.com
> Subject: Re: STL Question from Robyn
>
> Hello Robyn
>
> I have now reviewed all the papers for about 15 years on these
> ligaments and they virtually all conclude that these ligaments are not
> necessary for pelvic stability in daily activities
>
> I have consulted with the leading pelvic orthopedic surgeon who
> believes these ligaments are not critical to pelvic stability
>
> with a peripheral nerve surgery, for compression, the goal is to
> decompress the nerve where it is compressed
>
> in some people both the sacrospinous and sacrotuberous ligaments will
> need to be divided; I have not had to do that yet in some people just
> the sacrotuberous ligament needs to be divided, and I did that in
> somone one monday this week is some people perhaps just part of the
> sacrotuberous ligament may need to be divided the decision can be made
> with respect to the nerve and not related to the needs of pelvic
> stability
>
> so how are you doing
> what is better and what is not better
>
> Luiann says hello

Thank you, Robyn.
Did Dr. Dellon conduct any test on you to identify which nerve involved before the surgery? Best regards, M.

Mulan,

Dr Dellon did no tests on me other then examining my hurtful area with his hands and closely observing my stance, my walk and the way I sat.

Robyn

Robyn wrote:> I have now reviewed all the papers for about 15 years on these
> ligaments and they virtually all conclude that these ligaments are not
> necessary for pelvic stability in daily activities
>
> I have consulted with the leading pelvic orthopedic surgeon who
> believes these ligaments are not critical to pelvic stability
>
> with a peripheral nerve surgery, for compression, the goal is to
> decompress the nerve where it is compressed
>
> in some people both the sacrospinous and sacrotuberous ligaments will
> need to be divided; I have not had to do that yet in some people just
> the sacrotuberous ligament needs to be divided, and I did that in
> somone one monday this week is some people perhaps just part of the
> sacrotuberous ligament may need to be divided the decision can be made
> with respect to the nerve and not related to the needs of pelvic
> stability
>

Does anyone know if Dr.Dellon offer TIR approach if ST ligament is not involved in entrapment? It is so hard that we have this condition and have to face the ligament issue. Many thanks, M

Hi Mulan,
Dr Dellon wasn't aware of the complications which has led to Pelvic instabilty in many patients after their ligaments especially the Sacrotuberous ligament were severed or divided.I did bring to his attention the complications of dividing or severing the ST ligaments that can lead to Pelvic instability which has led in many pattients from the Houston team,Professor Robert of Nates etc and lets see if he comes up with a solution.


If you are really interested in TIR approach,you can see Dr. Bautrant in Aix En Provence,France.

All the best,
Ali

I saw Dr. Dellon this morning. He does not do the TIR approach and he is still of the opinion that the ST is not necessary for pelvic stability.

Hi Graceunderfire,
Opinions matter after 20 years of TG surgeries by Rogert Robert of Nates,the Houston team etc and so many cases of Pelvic instabilitiesi.e SIJD,Piriformis muscle syndrome,tail bone pain etc have occurred.

The main issue is that Roger Robert of Nantes,the Houston team refuse to acknowledge that any Pelivc instability occurs.

Secondly,I would like to ask his top orthopedic surgeon that how many patients has he evaluated after traditional TG surgeries by Robert or any other team who had severed their ST ligaments or SS ligaments.

All the best,
Ali

Well, I can't see any difference between the usual and Dr. Dellon's TG surgery. I can see though how over priced Dr. Dellon is, and treating such an invasive surgery in an out patient setting is, in my opinion, irresponsible.

Here is a short video which shows all the pelvic problems I have developed since my TG surgery despite my ST ligament having been repaired, but my SS ligament was cut.

http://www.youtube.com/watch?v=1iwmcCw4bAw

Maybe this will help some surgery candidates. The slicing of ligaments has hurt some patients, especially those ST ligaments which have not been repaired. I think the goal of the surgeons in this field should be to find ways to decompress the nerves without having to cut any ligaments in the pelvis.

spirit

Hi Ali,

I was not stating support of his opinion; just clarifying what he said to me. I have no desire to participate in debates. I don't have the energy for it. The last 2 weeks have been hell on earth with no lessening in site. All I can do is tell what I was told and what my experience has been. I have tried to set myself up as an authority on anything. Quite honestly, I have no clue what the hell to do at this point. I certainly do not have the money for this surgery unless my insurance company comes through. I lost my career, my home, couldn't help my last son through college, etc,etc. Dr. Dellon is proposing to do my ilioinguinal, iliohypogastric and genitofemorals for the first surgery. I wish the pudendal and dorsal were my only problems. I haven't met anyone else that has even given me an option for these other nerves, but I haven't. We didn't even go through the way he handles his pudendal surgery. So in the meantime, at least for my other nerves, the search continues unless I am lucky enough not to wake up tomorrow.

Grace under fire, I just read your post. It is poignant to read and I really hope you can find relief soon. I can't offer advice but good luck with whatever treatment you decide upon.