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Question about TIR
Posted: Mon Oct 17, 2011 4:03 am
by carolynm
So, theoretically, since I'm entrapped at the SS ligament, I could use the TIR approach (according to Dr. Dellon's chart that Shawn has posted on fb). Why is it that Hibner does not offer that surgery? And Violet, where were you entrapped since I believe you used this method? Who wants to fly to France? I can't think of anything more miserable right now.
TIA,
cari
Re: Question about TIR
Posted: Mon Oct 17, 2011 5:20 am
by Violet M
Cari,
Theoretically you might have success with the TIR but it appears that more and more docs are feeling the TG approach is the way to go -- with Dr. Conway and Dr. Vancaillie starting to do the TG. The TIR does not have as good of visualization as the TG and it's my understanding that since it requires an endoscope in some cases and is a more blind approach, it is not as easy to perform. Also, there is the risk of damage to the levator plate and the surgeon goes through a highly vascular area so there is a risk for hemorrhage. With some of the TG surgeons sparing the ST ligament now, the main advantage I can see to the TIR is that you don't have the large incisions. But when your main concern is to end the pain, incisions may not be the primary concern -- although some patients have had major problems with the incisions/muscles healing after the TG.
I was entrapped at the ligamental grip, alcock's canal, and sacrotuberous ligament at the falciform process -- on both sides. There weren't as many surgery options 7 years ago and honestly, I feel very lucky to be doing as well as I am. You're right, the trip to France was brutal. I took a lot of drugs.
Violet