Outcome of Desarda repair in inguinal hernia: a study in northern part of Bangladesh

Abstract

Background: Inguinal hernia repair by Desarda method provides a new concept of repair maintaining the physiology of inguinal canal. Repair without mesh gives another benefit of cost-effectiveness and freeing of foreign body-related complications. Objective: To observe the outcome of inguinal hernia repair by Desarda method as an alternative to most popular Lichtenstein repair. Materials and Methods: The longitudinal study was conducted from July 2012 to June 2015. A total of 184 patients with uncomplicated inguinal hernia were included in our study. After operation pain was assessed by visual analog score (VAS). In each follow-up, pain was scored and gait was assessed. Patients were seen during follow-up at 7 and 30 days, and 6, 12, and 24 months after surgery. The secondary outcomes were general and local complications, length of time to return to various levels of everyday activity, and abdominal wall stiffness in the groin area. SPSS, version 16.0, software programs were used for statistical calculation. Result: Of 184 patients recruited, 81% were men and 19% were women. Mean age was 45.42 years, SD ±10.08. A total of 63% patients in this study belong to low socioeconomic class. In the first postoperative day (POD), 73 patients felt mild pain and on third POD majority (168) felt only mild pain. Only 6.5% patients developed postoperative complications, mainly surgical site infection. A significant number of (49%) patients showed attribution of normal gait in second POD and 42% patients in third POD. A total of 98.37% patients had no complaint of chronic pain. 99% patients had no recurrence, and only 1% again developed inguinal hernia. Conclusion: As the outcome of this relatively new method is good. So, this physiologically sound technique can be widely practiced in our country as evident from our result.

Outcome of Desarda Technique in Inguinal Hernia Repair

“…Mean age was 45.42 years, SD ±10.08. 8 The mean age in current study was lesser when compared with above cited study. They further reported that at 1 st post-operative day, total 73 patients found with mild pain and 98.37% patients had no complaint of chronic pain.…”

“…Inguinal hernia repairs with this method are less expensive and devoid of difficulties brought on by foreign bodies. 5,6 In their study on Desarda's repair published in2016, Roy and coworkers found that the majority of patients(168/168;91.30%) experienced only minor pain on the third post-operative day and only 73/73(39.67%; VAS) individuals experienced only mild pain on the 1 st post-operative day (VAS). 5 According to Bhatti and colleagues, Desarda's technique took 28.90 5.57 minutes to complete.…”

“…5,6 In their study on Desarda's repair published in2016, Roy and coworkers found that the majority of patients(168/168;91.30%) experienced only minor pain on the third post-operative day and only 73/73(39.67%; VAS) individuals experienced only mild pain on the 1 st post-operative day (VAS). 5 According to Bhatti and colleagues, Desarda's technique took 28.90 5.57 minutes to complete. 7 The rationale of this study is to evaluate the short term outcome of Desarda technique in inguinal herniorrhaphy to analyze the duration of surgery and post-operative pain until discharge from the hospital.…”

Comparison of outcomes of Desarda versus Lichtenstein repair for inguinal hernia in terms of operative time, postoperative pain and return to normal activity.

“…Most of the patients operated by Desarda repair are of low socioeconomic status. 11 Rodriguez, et al proved in his study that Desarda takes more time than Lichtenstein (48 vs. 39 min) and it was statistically significant P <.05. (6) This time is very less as compared to our study.…”

Study of Outcomes of Desarda Repair in Emergency Conditions of Inguinal Hernia

“…Abbas et al (10) reported at least twenty patients have experienced some sort of postoperative problem Pneumonias (lobar or bronchopneumonia) accounted for 20% of cases, as did sepsis syndrome (14%), and infections of local wounds (6 percent). Roy et al (11) also found comparable results, 184 cases were treated with Desarda technique, out of them 12 cases had postoperative complications, particularly 7 cases had developed wound infection, seroma was in 3 cases and hematoma in 2 cases, furthermore they reported that one patient had developed recurrent inguinal hernia.…”