Desarda vs lichtenstein technique for the treatment of primary inguinal hernia

Abstract

Background The Lichtenstein technique (LT) is currently the most popular open mesh repair method with recurrence rates of around 4% in long-term follow-up, but the cost of the mesh may be a barrier in developing and underdeveloped countries. Also, the presence of an infection can prevent implantation of a mesh. In these settings, it is good to have the option of a simple, mesh-free repair. Desarda, in 2001, has described a new method that seems to satisfy the above criteria. Desarda technique (DT) appeared as a promising tissue-based repair that provided low incidence of recurrence without the need for complicated dissection, suturing or implanting prosthetic or foreign materials in the inguinal canal. The aim of this study was to test the hypothesis that the DT is as effective as the standard LT, allowing successful hernia repair without mesh. Materials and methods A total of 80 cases were allocated into two groups. The Desarda group (D group) had 40 patients and the Lichtenstein group (L group) had 40 patients. The primary outcome measures were the recurrence of inguinal hernia and chronic groin. Secondary outcome measures included operating time (min), time to return to normal gait and to work, foreign body sensation in the groin, and postoperative complications such as testicular edema, groin discomfort, seroma, and surgical site infections. Statistical analysis was carried out using Statistical Package for the Social Sciences. Results There was significantly shorter operating time and earlier return to normal gait in favor of Desarda repair. Complication rates were nearly similar in the two study arms. Conclusion Both DT and LT provided satisfactory treatment for primary inguinal hernia with low recurrence rates and acceptable rates of complications that were significantly less after DT. The DT may potentially increase the number of tissue-based methods available for treating groin hernias. More well-designed RCTs with longer follow-up are required for further validation of the DT.