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Which specialist surgeon is best for chronic incision pain, abdominal wall

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Chronic Pain
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Posted 6/13/2015 9:51 AM (GMT 0)
Hello, Im having surgery next week with a general surgeon. My problem is one year ago I had a lap surgery for kidney problem on my right side, ever since this surgery one year ago, Ive had constant dull pain on right upper quadrant, my lower cheat area. At first I didnt know where pain was coming but now I know it starts from one my incisions at my lower chest area and spreads horizontally across to the right. Pain is very superficial, either my skin or the muscle layers. Ive been told maybe theres scar tissue near the incision or nerve entrapment, something related to that incision basically.
I have tried all other things to fix pain, except surgery.
Im scheduled with general surgeon next week but Ive been told conflicting things regarding whether I should see general surgeon, thoracic surgeon, plastic surgeon or neurosurgeon. Which one would be more likely familiar to this abdominal wall, incisional pain? I will be gettingg surgery out of country and time is not a problem, Im sure any of those specialists will be able to accomodate me, but I would just like to know which one makes more sense? Thanks
Thanks

Post Edited (upjo) : 6/13/2015 4:01:12 AM (GMT-6)

Posted 6/13/2015 11:35 AM (GMT 0)
Well being as how you don't know what exactly is causing the problem it's hard to say what specialists you should use. However a thoracic surgeon isn't going to be as apt as say a general surgeon mainly because his area of expertise and experience is in dealing with the organs of the chest, heart, lungs, etc. Neuro is only going to be as good as the diagnosis, meaning if they find a entrapment he's your best shot, also likely going to be your most expensive for a maybe it's this or that. Plastic surgeon if he's board certified, specializing in more trauma repair versus reconstruction and elective beautification types of procedures would be a good choice. Were it me general would be my choice unless I had access to one of the types of plastic surgeon's I mentioned and certainly do your homework and research making sure whichever you chose they have no malpractice case or litigation against them in their history.

Remember this type of explatory procedure could backfire leaving you with more scar tissue and nerve damage as we have warned you any procedure can so I would certainly want the best man with the scalpel I could find.

Good luck
Posted 6/13/2015 1:53 PM (GMT 0)
Thanks for replying, one other thing I forgot to ask, what do you think would be better if its laparscopic or open incision? Reason I ask is if its lap and they put trocar, wouldnt they just go straight to my abdominal cavity and miss the problem if its just under my skin muscles or fascia? So in this sense its better to go like open incision and go down step by step?
I asked the lap surgeon and he said nothing will be missed, we will see everything. But I still feel its better if they make small cut and see, maybe they wont even have to cut all the layers if problem is found near my muscles.
But letss see I will post how it goes
Posted 6/13/2015 11:30 PM (GMT 0)
Are you sure you need surgery? If there's a trapped nerve there's a test - injecting a local anesthetic.

ceaccp.oxfordjournals.org/content/early/2014/05/19/bjaceaccp.mku016

There are lots more sites with scientific papers. Google cutaneous nerve entrapment.

Sometimes the nerve can get loose or otherwise stop hurting by itself. I had this entrapment immediately after an abdominal surgery, but in a few days it hurt less and stopped hurting altogether in a couple of weeks.
Posted 6/14/2015 3:26 AM (GMT 0)
i tried local anestetic 8 times, my pain is more than year now, since last week or so its driving me crazy, at the moment i just wish anybody cut me open to see why i have it.
im barely making through each min, so i really need this surgery
Posted 6/14/2015 10:15 AM (GMT 0)
His correct he will see all with the lapscope, the camera view is not a direct view but rather panoramic. It has peripheral vision as well as direct so from the moment he enters he can see all directions. open surgical incisions run a much greater risk of leaving you with more scar tissue or possibly another nerve issue. Plus your healing time and infection risks are higher.
Posted 6/14/2015 1:45 PM (GMT 0)
ok thanks, that was my only concern. I will try to post back after surgery how it went.
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