Outcome of Desarda repair in incarcerated inguinal hernia repair: experience in university hospital

Abstract

Background: Synthetic mesh based hernia repair is usually avoided in contaminated and dirty inguinal hernia repair to minimize the risk of infection. Desarda’s technique is a tissue based inguinal hernia repair method which avoids the use of prosthetic mesh. So this study was conducted with the aim to observe the outcome of Desarda’s technique in incarcerated inguinal hernia repair as an alternative procedure to mesh repair.Methods: This study was conducted in Emergency surgery department KGMU Lucknow. Total 30 patients with incarcerated inguinal hernia were included. Patients with recurrent hernia were excluded. Desarda repair was done in all patients. Patients were followed for 1 year to assess the outcome.Results: The mean age was 52±3 years. Mean operative time was 55±5 mins. Total duration of hospital stay was 4-16 days. Mild to moderate pain observed more frequently on 3rd and 7th post-operative day. Complication rates were found to be SSI (6%), seroma (3%), and recurrence (3%). Time taken to return to daily basic and work activities was 3 (3-5) and 15 days respectively. Patients’ subjective assessment of foreign body sensation done at 6th and 12th month follow up was found in 16% and 13% cases and that of abdominal wall stiffness in 23% followed by a reduction of upto 16% cases by 12th month.Conclusions: Desarda’s method is a safe, effective technique and may potentiate the use of tissue based repair for treating incarcerated, contaminated inguinal hernia repair. It has very low rate of recurrence and low cost of treatment.

Desarda repair no Mesh and Lichtenstein repair for inguinal hernia (A study of 2793 patients)

“…We noted a marked difference in the type of anaesthetic used 39% [17] concluded in their RCT that the efficacy of the Desarda technique in respect of the early clinical outcomes of hernia repair is similar to that of Lichtenstein method. However the operator in this study showed that the Desarda repair takes a significantly shorter operative time [18][19][20]. The authors therefore conclude that the Desarda repair for inguinal hernia gives the same or better results when compared with the Lichtenstein Mesh repair with shorter hospital stay, more rapid recovery and avoidance of specific mesh related complications whilst also reducing the cost of surgery.…”

Comparison between Desarda's Inguinal Hernia Repair and Lichtenstein Hernioplasty in terms of Complications, Operative time and Cost-effectiveness

“…We believe the Desarda technique is an excellent beginning point for developing an optimum strategy. 16,17 Since Desarda's approach was initially published in 2001, debates over its validity and benefits have raged, with some claiming that it is simply a modification of Andrews' method. 6 In comparison to Lichtenstein's technique, many randomized clinical studies were conducted.…”

“…18 While Lichtenstein's procedure was associated with four recurrences in an Indian hospital, Desarda technique was associated with no recurrences during a clinical trial. 17 On the other hand, recurrence was caused by the Desarda Group's newly repaired deep internal ring. The exclusion of patients with weak or thin external oblique aponeurosis probably led to the absence of weakness in the posterior wall of the inguinal canal rebuilt in our investigation.…”