Mayo Clinic Rochester John B. Bundrick MD publishes about how to handle chronic abdominal wall pain conservatively, Dr. Michael Sarr operates to spite the Medical Service - and women patients are caught in the crossfire with abdominal mutilat Rochester, Minnesota

It's all well and good that the Mayo Clinic publishes eloquent Clinical Pearls in the Mayo Clinic Proceedings - but that is not how many of the cases are really managed.

There is one particular disagreement between the Surgery Services & the General Medical Services about the treatment of chronic abdominal wall pain due to inflamed abdominal nerves.  The Surgery Service, with no literature to back up this approach, takes women to surgery and does neurectomies, and General Medical Service does a workup, Carnett's test & an injection. 

Jill Beed-Smith defends the Surgery Service doing any multilations, neurectomies, and closures that they want - for the money.  But the patients are caught in the cross-fire, some with abdominal procedures that they did not consent to - or ever want.  Procedures that Mayo Clinic has refused to undo.  Dr. Sarr will even sue the patients for defamation if they challenge his approach - which is not the same as that in the Mayo Clinic Proceedings to say the least.  Dr. Sarr's approach could not be published in Mayo Clinic Proceedings, but that didn't stop him from inflicting it on patients.  .

Patients have the 'right' to know all the options, and the most common & 'tried out' procedure or paradigm.  In this case, Dr. Bundrick wins.  And they have a right to challenge any procedure that will be deforming, involve removal of anything, and not improve the pain - Dr. Sarr's approach.

The dilemma has been reported to the Minnesota Medical Board for resolution - because patients on Surgery cannot continue getting neurectomies for no reason. 

But it behooves everyone to remember that patients get caught in these ego battles, in these surgeries without a purpose, and do not do well. 

Someone at Mayo Clinic should resolve this situation, and offer all women patients who have asked for a repair, a repair at Mayo Clinic's cost.  Mayo can't publish the case studies of the women patients that they removed nerves from - they would be laughed at, ridiculed, and cast in the light of female mutilators.  So surely there are surgeons at Mayo Clinic who would repair? 

No one asked Dr. Sarr to do neurectomies for inflamed abdominal nerves.  The literature has been clear since 1926, so why the neurectomies for the last 20 years?