John B Bundrick MD is now publishing in Mayo Clinic Proceedings about the Carnett's maneuver to save abdominal wall pain problems, the common abdominal cutaneous nerve entrapment problem, from going to unnecessary neurectomies & surgeries January 2011;86(1):70-74. But it's too late for many patients that the Surgery Department at Mayo Clinic has butcherized over the last 20 years. Dr. Carnett's original article was written in 1926, but the Mayo Staff has never taken it seriously - never gotten the message.
In fact, the Mayo Surgical & Plastic Departments - under Dr. Michael Sarr (Chief of General Surgery) - have been fast-tracking these patients to unnecessary neurectomies and painful mass closure defects for years now - decades of unnecessary surgery for the money. These procedures are done without patient consent, the Chief of Plastics will turf women to Sarr without doing an exam himself (a FMG resident is what you get - the guy is lazy and FMG ridiculous), and Sarr thinks this all one big joke. [continued below]....
Dr. Sarr & his Department threaten that they can't operate unless you do it tomorrow, and these nerve syndromes take months to resolve - but they should not be operated on as the nerve inflammation only spreads to the rest of the abdominal muscles. You question and question, he says that this is not the way that Mayo does it.
Dr. Sarr promises one thing, and then gets too much wine or whatever at night and forgets what he promised - Sarr spends the day drinking coffee watching the patient be mutilated by a 3-month woman intern who should never be in a surgical case that is a re-do. A woman intern who was told not to do ANY PART OF THE PROCEDURE - but she's aggressive & without a conscience. Sarr comes in after the procedure foggy-brained lying his head off - he can tell lies, change charts, and do any negligence in the surgical book - and get away with it.
Sarr doesn't bother to see the patient before surgery, lies that he removed a 'neuroma,' and then you stink like the medical student's cologne for being groped under an anesthesia that you said 'No' to. Groped by a black student - who should not have been in the room as he did not know the case - at Mayo Clinic. Black students don't have to know the case.
Anesthesia puts you under without an anesthesia consult - Dr. Sarr has arranged this. The nursing staff doesn't look that there is no consent - and lets the procedure happen. The anesthesia guy comes after you that he will 'watch' you - watch you be mutilated with no consent, no ethics, no checklist, and no discussion.
Sarr does not have to discuss - neither do the nurses or anesthesia. They want you to sign without glasses, contacts or clothes - which is unethical and against any hospital policy anywhere. Sarr then will try to collect for this, but the Mayo Clinic can't get paid for the OR time, the path or lab work, the anesthesia - but Sarr will try to get the $ - despite being told to 'stand down.' Dr. Sarr needs to return all insurance monies for these procedures, and Mayo Clinic needs to see that he does. The patient is still mutilated even with Mayo recognizing that a mistake was made.
The reason that you say 'No' to anesthesia, is that otherwise the surgeon - a sober one - can't recognize or localize the source(s) of pain before cutting (to mark) or intra-operatively - to know what to do - if the pain is over the neural foramen, you close and treat conservatively - you think. A first rule of SURGERY is that you NEVER cut into any swelling that you have not tried to study first.
Sarr just rips everything apart as he doesn't mark anything, brings in 'help' who have never seen the patient, and he cuts everything 'normal.' No Carnett's required. The 'help' at Mayo is not required to know the case, to read the record, to stop the procedure if there is no consent. Honors is for a student that does those things - a student who stops a procedure with no consent - not for a student who harms a patient.
There is a specific exam for this cutaneous nerve entrapment that is in the article by William Applegate MD from The Permanente Journal/Summer2002. This article pdf can be found at xnet.kp.org/permanentejournal/sum02/acnes.pdf - for Mayo students willing to read. Dr. Applegate gives a simple diagram that can be copied and put into any chart - which is what the intern should be doing - not cutting when she can't cut. Dr. Sarr doesn't read, or think that he has to do the exam - he talks about the 'glory of Mayo Clinic' and you will argue with him for an hour and he'll get to do what he wants - which is criminal. You think that you've gotten through to him, and he's on another planet.
Dr. Sarr fools around when he sees you as a patient, does not do a good exam because he 'is the Mayo Clinic,' and plays with the boys - the medical students & residents. He's a Sandusky with a twist. You agree to a 5-minute procedure without anesthesia, and he orders you knocked out (like assault), and does a procedure WITHOUT YOUR CONSENT - and says that he can do this.
Dr. Bundrick you know this goes on, the Chief Counsel Jill Beed-Smith says that Dr. Sarr can do this. And no thinking physician can send any patients with abdominal wall pain problems to Mayo Clinic until there is an end to this nonsense - your real case studies do not read like your article. No woman patient is ever that well treated - they are abused.
All the woman patients unnecessarily surgerized have to have the common mass closure repaired, and will sue you for referring to Mayo Clinic. Jill Beed-Smith has no plans to arrange that the women patients who had neurectomies of 'normal' nerves get their abdominal walls repaired. Jill Beed-Smith needs for Dr. Sarr to do this to her - you need it done to yourself to get the experience.
Not the Chief of Plastic Surgery, nor Dr. Michael Sarr, from 1998 or onwards to present, feel that they have to do a Carnett's test and trial of a 2% lidocaine injection - no follow-up will be tolerated on the surgical service - Sarr & his goons have to cut - tomorrow and the push it. And they are disrespectful to the professional patient asking for a workup or a second opinion, or time to make a decision or to see someone on Medicine. Sarr has a 'special' clearance FMG woman - who will clear anything for him at any notice. Nothing goes through the regular Medicine clearance and workup.
This Carnett's test is a test that is rarely false-positive, < 5% of the time, and there is no excuse for Mayo publishing this and then not doing this when a woman MD comes as a patient. There is NO EXCUSE FOR MAYO CLINIC REMOVING NORMAL NERVES that are just swollen because of use, trauma, prior surgery, or some inflammation of prolene. Carnett's test - tensing abdominal muscles with a crunch maneuver while pressure is applied to the pain trigger zone. It's a really hard maneuver, but the surgeons pooh-pooh it. Dr. Sarr can't do it, can't say 'Carnett's.'
When Sarr then goofs, the women MD is canceled from Mayo email by the administrator, she is attempted to be sued for defamation of Sarr's character, and she will have to have multiple surgeries to correct the deformity. None of this was Mayo Clinic behavior or necessary. You will have to assure people that Dr. Sarr's maneuver is gone. There will be no post-op visits after Dr. Sarr's brief visit post-op. He has to hide these patients - and the Mayo Clinic covers up.
The common mass closure will get infected, be painful, and have to be repaired as it does not work - Sarr doesn't care, and Bundrick doesn't care - all for the money ($)
When you go to Mayo Clinic as a physician-patient, you feel that you will get the equivalent of a CME course - that the diagnostic workup will be the best in the world and what Mayo teaches - not just to get a surgery.
MD patients request that the Mayo attending take care of them, this has to be honored because MDs can write bad recommendations about interns, residents & medical student staff if mistakes happen - the lowest person on the totem poll is blamed for being in the room when they were requested specifically NOT TO BE THERE and NOT TO DO THE PROCEDURE. And what is the problem that a Mayo intern, or student, would force themselves on a woman-MD patient? This is assault when it has been requested that they 'stand down.' Things are complicated with an MD-patient; if they could fix themselves, they would have.
Dr. Michael Sarr would promise the world (any surgery that you want, he'll do, and he tells you this). Sarr will promise not to do any unnecessary surgery, and the Mayo 'promise,' has to mean something - and then just lie his head off after bringing in students, interns, & residents that don't know the case, after not doing the workup, after removing 'normal' abdominal nerves and lying that these were looking like foreign bodies, and after putting back prolene sutures in a prolene allergic woman MD.
The Dr. Sarr experience at Mayo is a nightmare, and the OR reports are fiction, but the Medicine service claims that you should get the workup of a Carnett's test and trial of conservative treatment - it doesn't happen is the fact. It probably never happens, and Dr. Bundrick knows this. The medical OR record will have to be revised several times, the intern did not know prolene from PDF suture, and there will be no end to the surgical complications of Sarr negligence. And the woman MD said 'NO.'
The Mayo Surgical Staff does not turf back to Medicine for anterior abdominal cutaneous nerve entrapment syndrome (ACNES) - they try to operate and wreck the abdominal walls of even women MDs - barely in their 40s and mutilated for life - their parents & family feel terrible. Then Dr. Sarr will not see these patients even once post-op - he lies that he does the closures and they are such bad closures that they require multiple plastic surgery procedures to repair.
Dr. Sarr operated on one woman in 1998 - without a repeat scan, with no Carnett's, not doing a thyroid panel and some of the nerve inflammation was untreated thyroid, not bringing in a plastic surgeon, and saying that he couldn't recognize her transversus muscle and had to cut it up. Dr. Sarr can't recognize the different layers of abdominal muscles - he rips them apart & destroys them - the destroyer.
The closure Sarr uses is a common mass closure deformity - this closure was only done in the 1980s in abdominal emergency surgeries - when the surgeon could not take the time to close properly. Dr. Bundrick knows this goes on, and that his own colleagues are the worst offenders of not using the Mayo clinical pearls.
The suffering has been immense when a woman MD gets a neurectomy of an otherwise normal nerve, because Dr. Sarr couldn't do even an intra-operative exam of the neural foramen. Dr. Sarr, to get surgeries, would threaten that he couldn't do them except tomorrow, would not do the scan, would promise not to do unnecessary muscle dissections - and then just lie about everything. The procedures were done without the patient consent. And the parents & families feel horrible. You never harm one person in surgery - you harm the family.
Dr. Bundrick - some women MDs that might have been writing for Mayo Clin Proc are still - after years - dealing with complications of letting Dr. Sarr near them. Even if you promised to use the Carnett's test - no one would believe anyone at Mayo Clinic - because Jill Beed-Smith would let them do otherwise. And getting a letter from Dr. Sarr's lawyer that he's going to sue you for defamation, when he admits that he had no consent to do the procedure, is a bit Kafkaesque - for regular patients or MD-patients. It's bizarre behavior that no one has time for. You need to solve the problems at Mayo Clinic before telling the world how to do things the Mayo way.