I'm interested in peritoneal srs and I'm looking into it
I found out about the Interplast Clinic.
dr. [teerapong] and [sutin] say they are going to have surgery
I wonder if it has something to do with the API.
I am conducting PPT surgery as an event specialist.
The pictures of the results are good, and I heard that people are very satisfied with the recent surgery.
It becomes a concern.
teerapong is unknown, but there is data that sutin is fine
What do you think?
So, yeah.. my father (67 years old) just got diagnosed with stage 4 gastric cancer with peritoneum metastasis. He didn't have any kind of symptoms, just during easter he got really tired. He went to work normally but afterwards he just slept, and didn't eat. That's it. He lost a lot of weight, and was badly malnourished when he finally went to the hospital 1,5 months ago. He weighed less than 110 lbs, and being just over 6 feet tall, he is basically just skin and bones.
He is really struggling with eating, as in the sight of food makes him nauseous. He doesn't have problems swallowing. We tried taking pills to combat the nausea, but they didn't help. His only symptoms still are that he doesn't want to eat, extreme fatigue and cachexia. He started taking oral S-1 chemotherapy 3 weeks ago. It didn't give him any bad side effects. Plan is to do 3 rounds (2nd round now ongoing) and after that new scans.
He now has an appointment coming up for a PEG feeding tube to be inserted to help with eating. But he also has some ascites in his abdomen, so feeding tube might not be possible to insert. The only good thing I can think of, is that he doesn't have any pain.
Does anybody have any stories as in what we are looking at during the next few months? Any experiences with PEG tube? Does it help?
What about any help with the fatigue, anything to help with that? I am hoping that if he gets feeding done with the PEG tube, it would help with fatigue and getting his strength back. He is not as hopeful as I am, some of his friends told him that "eating doesn't help with the fatigue and weakness"..
Any experiences with S-1 chemo? Does it help?
Hello, I am M1 and we’re learning about peritoneum and I’m not sure if I understand it. I feel like I kinda get it but it haven’t clicked yet. Are there any materials that have helped you understamd this tough topic?
For people who’ve had robotic peritoneum vaginoplasty, did insurance cover all of the surgery or did they only cover part of it because of the extra costs associated with RPV?
Does anyone have a link or a video for a Peritoneum dissection that was made in the US? This is for extra credit if we can find one.
We (GP) had a dog (9ish y/o M/N Boxer X) present for a follow up visit from emergency clinic. He was seen over the weekend for a distended abd. Diagnosed with gluttony bloat, no GDV or obstruction suspected. Today he presented lethargic, anorexic, and had a VERY distended abd, taut and tympanic. Hx of IMHA and arthritis related mobility issues. Chronically on NSAID, Gaba, Azathioprine. Had been waxing and waning since emergency visit, but decompensated over last 24 hrs. Today's x-rays showed dramatic pneumoperitoneum with gas distension of stomach and bowels. We referred on emergency to the specialty hospital we work closely with for ex lap, but reports are looking like o is leaning towards euth. There's likely little to do at this point since o is likely to euthanize, but I'd like to hear if anyone has seen or treated a case like this. I've never encountered anything quite like it, and I'd like to learn from it. This pt is near and dear to me. He was the first dog I followed / learned IMHA tx with and I get so excited to see him every year for his annual. He was at one time a sketchy boy and we bonded quite a bit during all his follow up lab visits. I'm a little heart broken and would love any insight. TIA.
My father (63) was recently diagnosed with stage IV colon cancer, and his liver is in such bad shape that he can only receive a reduced dose (30%) of chemotherapy (he has done two cures). Bilirubin levels are high, and increasing (120), and he has very visible jaundice. The oncologists are evaluating whether treatment should continue every 14 days or so.
I am writing this post to see if anyone has any experience with this type of diagnosis, especially in regards to how it affects general health when the end is approaching? If his health keeps deteriorating, what is that going to look like?
The doctors have been very clear about the severity of his diagnosis. I met the oncologist before my dad did. He told me that - based on the CT scans and the blood tests - it was too late to do anything, and that my dad only had a few weeks left to live. We then went together to tell this to my dad, but after meeting my dad, the oncologist changed his mind, and decided to put my dad on a reduced dose of chemotherapy. He did so because he found my father to be in better physical shape than what he expected according to the scans and test results.
That was 14 days ago. Today, my dad got his second round of chemo, even though the liver tests (bilirubine, enzymes) are getting worse. Over these last 14 days, his physical condition has been quite stable. He has lost a lot of weight and is visibly very ill (stomach has come out, liver is visible, jaundice), but he eats very well, and is mentally/personality wise the same as before his diagnosis. While having a hard time walking up stairs, he can walk just fine (we usually walk for 1km / 0.6 miles once or twice per day). He remains motivated to give it his best shot, and see where that gets him. His biggest issues at the moment is lack of sleep, change in taste, and some itching.
If his liver keeps getting worse, I am expecting him to get weaker and eat less. How quickly can this occur? Can general condition (appetite, stamina, weight) say anything about the time he has left? I've moved in with him, so I can follow his day-to-day closely.
PS. If anyone has experiences with immunotherapy with this type of cancer, please share. That might be an option if chemo doesn't work.
Hi all. I'm a bit lost/distressed and would really appreciate your time.
My mum (66) just got diagnosed with Stage 4 PC which has metastatised to the peritoneum. Had her bile duct operation this week as her cancer was also blocking it. Her jaundice has gone down and she can eat with (relatively) no pain again. She will be starting chemotherapy in 3 weeks, opted for gemzar as she didn't want a stronger chemo option. This was also the oncologists' suggestion as she is pretty weak now (a small lady but she is currently weighing 36kg).
I've read through many posts here with ppl mentioning they have had / had family members who had gemzar. I'm wondering what kind of side effects she should be expecting... Our doctors told us that gemzar is a milder form of chemo, with milder side effects than others (little to no nausea, hairloss) but to expect fatigue. But i have read stories here which seem to indicate otherwise?
Any stories of people who've been through similar situations would be truly appreciated. I want to make her life as comfortable as possible at this point.
Thank you for reading!
Can somebody please help me differentiate between the 3 ? I often find myself interchanging the 3. TIA !
TL;DR: The lining of a neovagina does change and adapt to it's environment and the type of lining that you have dictates how much adaption happens and how quickly. With a 'full-thickness' skin graft it will adapt to resemble mucosa. With split-thickness it is possible for the graft to completely change into mucosa, but not always. With peritoneal it is a certainty. So in summary the difference between peritoneum and a normal skin graft is really how quickly it adapts to the environment, but some adaption will always happen.
As some of you may have noticed from all posts I've made lately I've made it my mission to understand the science of SRS, in particular the always hot topic of the neovagina lining. There is a lot of confusing information out there and I know many of us have a mental picture of a literally skin lined neovagina which is not mucosal and therefore in our minds not optimal. That's why so many of us are so interested in the 'new' peritoneal pull through procedure, which in theory at least is supposed to create a mucosal internal lining rather than a 'skin' lining of standard techniques.
But there's a lot about this picture that doesn't add up. For example - peritoneal pull through is not in fact new at all and has been around for many years... but if that's the case and if it so clearly better than a skin-lined neovagina why don't world leading surgeons like Chett and Suporn offer it? Also why do the surgeons who do offer it only do so as a back up option when there isn't enough existing material? Similarly why does everyone (at least every anecdotal story and pic I've ever come across) report that the inside of their neovagina 'feels like the inside of their cheek'?
To try and understand what's going on I taught myself a bit about the science of skin grafting. I read a medical book for students on grafting techniques, I learned about oral skin grafts (a more common surgery which faces a similar problem) and I read up on MRKH syndrome, which is when someone is born with a vulva but no internal vagina.
To cut straight to the point, I learned that:
- There are different types of skin graft, including 'split-thickness' and 'full-thickness'. The latter includes all the layers of the skin whereas the former only includes the top most layers.
- "It is the underlying stroma that influences the phenotype of the overlying epithelium." In other words it is the deeper skin layers that decide what 'type' of skin the outer mo
It feels like someone scraped the outside of all my organs cause they did. Does this rather disconcerting sensation go away? I’m in a lot of pain.
Hi all! I'm currently scheduled to have SRS with Dr. BBL in the fall, and I'm wondering if any former patients of hers (or anyone else!) might have the answer to a question I've been wondering about for a long time about how much peritoneal tissue she uses.
So her technique is a hybrid method where she does a standard penile inversion for the vaginal canal, adds to it using whatever scrotal tissue is left over from making the labia majora, and then caps off the end of the vaginal canal using a peritoneal flap. During the whole process, most of the tissue isn't completely detached, so it maintains its original nerve connections/sensation, which is one of the reasons why the penile skin is used for the vaginal canal.
However, my understanding (which I concede may not be correct!) is that the scrotal graft is completely severed from its original nerve endings, so it's functionally no different than a regular skin graft at that point. So I guess my question is: why does she choose to use that scrotal tissue instead of more peritoneal tissue? I do understand that the peritoneum has an actual purpose in the body and at a certain point there's an upper limit to how much tissue can be taken. But based on what I've seen other surgeons do, it seems like there's a decent amount that can be used? When I asked Ting about how much he uses for kids who went on blockers, it was a really huge amount, and I know that Wittenberg is now doing full PPT on people who transitioned as adults.
Ideally I'd want my current parts to be used entirely for my vulva, and my vagina to be made entirely out of peritoneum. But at the very least, I'd like to get as much of my vagina to be peritoneum as possible. So I'm just wondering if anyone has any insight into this. Thanks!
I’m submitting my medical release papers to get started!! I can’t wait cause I heard all 3 were good but I’ve read on the two main ones that did have issues that vagina wasn’t right not so much with Pang. Who would you choose?
Nothing can stop our big Dijk
I know that there are only 1 or two SRS surgeons who will do peritoneal grafts; the main one being Jess Ting in NYC. I know that he started doing them because of the research one girl did, and apparently he has the assistance of a Dr Iskandar to perform the grafts.
SO, Does anyone HAVE the research/links do it?
Really I'm wondering why this method isn't becoming more widespread, and it seems like any surgeon should be capable of adapting this technique, no? Not only would I like to read it for myself, but I'm also wondering if it would assist other surgeons with adopting the technique.
So I had an SRS consult with Maurice Garcia and Alexander Sinclair (seemingly my only options in the LA area; planning to go with Sinclair).
Both them expressed alot of weird vibes when I mentioned peritoneal grafting and said its not worth it (complexity, risk of complications, etc); and it seems most other surgeons avoid this technique also; even Dr. Ting in NYC.
Does anyone have an idea why this is? It seems like something that is a reasonable and simple enough addition as to just be adopted to and made standard in SRS; and I'm not sure how I feel that so many doctors are hesitant or outright refuse to use this variation.
Hey,
I'm getting SRS in NYC, and they were attempting to sell me on this new peritoneum technique for SRS. I can't seem to find anyone whom have had it done before or any reviews at all. Granted this is probably due to it being new, but still if anyone's had any personal experiences with the procedure I would love to hear it or you can DM me directly.
If I eviscerate someone (Slice open their belly), will the peritoneum fall out holding your guts, or is it attached to the abdominal flesh and need to be cut into and just your guts fall out, think as in patzi hanging in silence of the lambs, if I cut through it too, will it also fall out if it's not attached to the body?
Macht irgendeiner Chirurg in Deutschland die GaOP mit der Peritoneum/Bauchfell Methode, genauso wie in Mount Sinai Klinik in New York?
she also has signet ring cell cancer as the origin which I guess is causing the small tumors on the peritoneum. She has gone through 12 rounds of chemo and now is taking the pill(5fu)...she just got the results of her last PET scan and it shows that the tumors on her peritoneum are hot or active again. So they will be changing up her current regiment of 2 weeks on the pill and 1 week off. Probably to have chemo through the port again as well. Please if anyone has knowledge about this terminal cancer or knows if any doctors doing some testing or is well versed in this. Please reach out and help. Thank you so much. I can give you more details if you message me or comment.
Like my post title says...
Looking for input on best regional SRS GRS surgeon for MTF vaginoplasty in the New England area who also does peritoneal depth... PPT or graft version is fine...
Who y'all got?
Alright, so I had GRS back on the 21st June. I had to be circumcised when I was about 6 or 7 and I wasn't left with alot of options, other than a scrotal graft. I was told that I could only get about 3-4 inches. Sadly that means unsatisfactory sex. I was given the option for colovagioplasty and instantly turned it down. Cuz reasons (which are obvious... I hope)
Recovery has been painful. There was bilateral necrosis of the labia and that resulted in me having to be sent home with a urinal catheter for about 2 months. Now I've prolapsed. Due to my shallow depth of 3 inches, they can't just repack it all in and expect it to heal, without me re-prolapsing. As a result, I'm gonna have to go under the knife again. At this point, I asked if there was a way to increase the depth. Again, I was given the colo option and asked about using the peritoneum. Mr Morley instantly shot it down. Even so I tried asking for alternatives to using chunks of bowel. Kinda worked out, since my case was quite complicated, he needed to contact Mr Thomas, just to sort out the prolapse by itself and my questioning must've gotten through. I was phoned up and told that Mr Thomas has done the peritoneum technique twice. With one success.
Ok, so that was that. I've always known that I wanted to be a girl since my first day of primary school and wanting to have sex as one ever since I've known what sex was. More so hitting teen yrs and watching other girls grow into their bodies. Yes, the success rate is technically 50%, but with data on only 2 patients. I realise that this is an experimental procedure, but hell, it seems alot better than using intestine. No bad smells, no pooping issues and the ability to self lube potentially.
Has anyone here gone through this or has any advice to offer?
Just a little medical talk for those intrested ;)
The way Roadhog's belly button sticks out and almost seems to 'inflate' when he uses his Take a Breather, makes me believe he has his peritoneum removed.
This is common with people who have had large cancerous tumors grow there. I'ts quite gruesome; if the person doesn't have a lot of fat on their stomach, you can see the intestines right through the skin O.o
Thanks in advance!!
I was wondering if anyone had insight on what to expect next.
Here are my (abridged) dad's updates for specifics:
October 3, 2012
I met with my oncologist yesterday, Tuesday afternoon, to review the results of the biopsies and additional blood tests of the week before. The tumor in the kidney proved to be cancerous. What we did not expect to hear is that the biopsy of the peritoneum and the blood work showed I had a 2nd cancer, not merely the spread (metastasis) of the kidney cancer. The pathology on the biopsy, the blood tests and the cytopathology of the fluid they drained all concluded that I also have colorectal cancer, something that did not show up in the CT scan or PET scan. Because the colorectal cancer has metastasized, it is Stage IV, which means it is not curable, but hopefully can be put into remission and watched, most likely having to be fought again at a later date.
...According to the PET scan, only my peritoneum has the metastasis and my other vital organs are clear (liver, lungs, heart, etc.). However, I am now a little reluctant to trust the PET scan and will ask my doctors regarding other tests to be sure my vital organs are clear.
The oncologist wants me to have a colonoscopy to confirm many things. I had one 5 years ago, which was clear, and was scheduled for another one in three weeks as part of my annual physical. I have had annual physicals faithfully since turning 40. This will also give them a new baseline to later see how treatment is working. This will hopefully be done Thursday.
By Friday they plan to put a port in my chest that connects to a vein. This will make drawing blood, which will be done frequently, much easier and pain free. Its other primary use is to inject medicines, namely chemo drugs.
I will start chemo therapy no later than Monday. The regimen will be every two weeks for six months. Everyoneresponds differently to chemo, so we will see how it goes for me. At any time during that period if they feel I can be off chemo for 6 weeks, they will stop it for 3, remove the kidney, wait three more weeks, then resume. I need the kidney tumor to behave, i.e. not grow, so we can focus on the colorectal cancer first as this is what has metastasized, not the kidney.
On Monday, I will have a port put into my chest for blood draws and medicine. I also need to have my abdomen drained again and will ask for the placement of a medical appliance that will make future draining painless and quick.
On Tuesday I will h
... keep reading on reddit ➡Hello, I am M1 and we’re learning about peritoneum and I’m not sure if I understand it. I feel like I kinda get it but it haven’t clicked yet. Are there any materials that have helped you understamd this tough topic?
