COMPARATIVE STUDY OF OPEN DESARDA'S NO-MESH REPAIR AND OPEN MESH REPAIR FOR INGUINAL HERNIA

Abstract

Inguinal hernia is the most common among the hernias. The best treatment modality of it is primarily surgical. Improvements in surgical techniques of inguinal hernia repair have signicantly improved the outcomes for patients. The success rate of hernia surgeries is mostly noted by its permanence, amount of complications, cost effectiveness, and duration to return to normal activity. Though mesh repair has gained popularity among the surgical repair of hernias, it has certain limitations like availability of mesh, cost, learning curve and complications associated with it. Hence this study is being carried out to compare the effectiveness of Desarda's no mesh repair, a newer cost effective method, with the existing Lichtenstein's tension free repair, and to decide on a better treatment for inguinal hernia repair based on the results of this study. A total of one hundred and twenty patients were included in the study. These patients were grouped into group A (Desarda's repair group) and group B (Lichtenstein repair group) and randomization was done. Results of these two techniques were compared with respect to groin pain, surgical site infections,duration of hospital stay,duration to return to normal activity. There was no signicant differences regarding age, sex, type of hernia, duration of hernia in both the groups. The operation time was 49 minutes in Desarda's group and 54 minutes in the Lichtenstein group which was considered highly signicant. Over a period of two year follow-up there were no recurrences in both the groups. There were no surgical site infections in the Desarda's group when compared to Lichtenstein's repair. The occurrences of other complications like Loss of sensation over the groin, Scrotal edema, abdominal wall stiffness were not seen in Desarda's group, whereas its occurrence was highly signicant in Lichtenstein's group. The mean hospital stay was 4days in Desarda's group while it was 6days in the Lichtenstein group in those patients who were hospitalized. The current study showed that Desarda's technique is easy to learn and simple method when compared to other tissue repair techniques and requires no mesh. It can be performed under local anesthesia when patient is unt for Regional /General anesthesia and is associated with a less duration of surgery and less mesh associated postoperative complications, with a rapid recovery time.