Desarda Repair Research Articles

When and why Desarda repair: Evaluation of the efficacy of Desarda technique in the management of inguinal hernia

When and why Desarda repair: Evaluation of the efficacy of Desarda technique in the management of inguinal hernia

The Current Status of Open Inguinal Hernia Repair in Adults: A Narrative Review

Open inguinal hernia repairs can be divided into mesh-based repairs and sutured based repairs. Mesh-based repairs are the most popular open inguinal hernia repair with the Lichtenstein repair being the most common surgical procedure. The sutured based repairs are not commonly performed with the Shouldice repair being the most popular repair, but the Desarda repair is slowly emerging as a viable sutured based repair. We have conducted this review article to look the current state of the varies types of repairs for open inguinal hernia repair including their complications and recurrence rate. We also looked at the effect of chronic pain in open inguinal hernia repair.

An Update on Open Inguinal Hernia Repair in Adults: Review Article

Open inguinal hernia repairs are a common general surgical procedure, and it can be divided into mesh-based repairs and sutured based repairs. Mesh-based repairs are the most popular open inguinal hernia repair with the Lichtenstein repair being the most common surgical procedure. The sutured based repairs are not as commonly performed with the Shouldice repair being the most popular repair, but the Desarda repair is slowly emerging as a viable sutured based inguinal hernia repair. We have conducted this review article to look at the varies types of mesh based and sutured based repairs for open inguinal hernia repair including their complications and recurrence rate. We also looked at the effect of chronic pain and the role of antibiotic prophylaxis in open inguinal hernia repair.

Comparative analysis of Desarda and Lichtenstein Inguinal Hernia Repair Techniques

Background: Inguinal hernia repair is the most commonly done procedure on the surgical floor these days. Objective: The study aims to evaluate and compare two different inguinal hernia repair techniques in terms of preoperative and postoperative measures. Methods: A comparative cross-sectional study was conducted in the department of Surgery, Aziz Fatimah Hospital from June 27, 2021, to March 02, 2022, using a consecutive sampling non-probability sampling technique. The demographic profile and characteristics of the hernia along with per operative and post-operative variables were collected and analyzed in SPSS 25 using the independent t-test. Results: The patients admitted for the elective inguinal hernia procedure in the ward underwent two routinely done surgical procedures. The mean age of the study population was 37±11 years. The mean age and standard deviation of patients in Group A (Desarda repair) were 36.43±11.01 years and 37.43±11.05 years of patients in Group B (Lichtenstein repair). Less mean operative time and days to return to daily life activities were seen in Group A (Desarda repair) patients compared to Group B (Lichtenstein repair) patients. Moreover, the estimated cost of the Desarda operative procedure was also much less compared to the Lichtenstein repair. Conclusion: The inguinal hernia repair technique Desarda is considered to be more effective and economical than the Lichtenstein repair in terms of per-operative and post-operative measures with less mean operative time, early return to normal activities, and cost-effectiveness.

SP9.11 Comparison of non-mesh Desarda technique versus Lichtenstein technique for inguinal hernia repair: A systematic review and meta-analysis of 14 comparative studies

Abstract Background The aims of this systematic review and meta-analysis were to compare non-mesh Desarda technique (DT) with the standard mesh-based Lichtenstein technique (LT) for inguinal hernia repair. Methods A systematic literature search for comparative studies comparing between DT and LT was conducted using electronic databases and Google scholar service. Studies were evaluated for hernia recurrence, post-operative complications, and time to return to work. We pooled the data using fixed effects model and random effects model after assessing the heterogeneity among the included studies. Results A total number of 14 studies were included in this meta-analysis with a total number of 3673 patients divided between Desarda group (n=1794) and Lichtenstein group (n= 1879). There was no difference in terms of recurrence between the Desarda repair and Lichtenstein repair group [P = 0.47]. There was a significant lower rate of overall post-operative complications [P=0.0001], seroma [P=0.0002] and (SSI [P = 0.03] in the Desarda group. The two groups showed comparable results for haematoma [P=0.12], scrotal oedema [P=0.25], and testicular atrophy [P=0.15]. Moreover, Desarda group was associated with shorter operative time and return to work when compared to Lichtenstein group, [P=0.01] and [P=0.008], respectively. Conclusion DT and LT were found to have comparable results in terms of hernia recurrence rate, haematoma formation, and testicular atrophy. However, DT is superior to LT in terms of reducing postoperative mesh-attributed complications, such as SSI and Seroma formation besides shorter operative time and return to work. We recommend performing a well-designed, large cohort RCT to evaluate the cost-effectivity and impact in less economically developed countries.

A Randomized Controlled Trail of Desarda's Repair with Lichtenstein Repair in the Management of Inguinal Hernia

A Randomized Controlled Trail of Desarda's Repair with Lichtenstein Repair in the Management of Inguinal Hernia

Comparison Between Short Term Outcomes of Lichtenstein and Desarda Repair for Inguinal Hernia

Desarda repair for inguinal hernia repair came into being in 2001 and was an alternative to the Lichtenstein repair where mesh placement is necessary. The procedure is thought to be simple, reproducible and avoids the complications of a mesh and thus favorable for resource limited countries. Aim of the study was to compare short term outcomes of Lichtenstein versus Desarda repair for inguinal hernia in terms of mean post-operative pain and frequency of post-operative wound infection, scrotal edema and hematoma. Methodology: This RCT was conducted at Surgical Unit I, Fatima Jinnah Medical University, Lahore. Diagnosis of inguinal hernia was confirmed on clinical examination and per-operative findings. Two groups were formed with one undergoing Desarda repair and one Lichtenstein repair. Post-operative scrotal edema and hematoma formation, pain scores and wound infection were recorded and evaluated for both groups. Results: The overall incidence of scrotal edema was 5.0% (n=3) with 6.7% in Lichtenstein group and 3.3% in Desarda repair group. The overall incidence of hematoma formation was 0% (n=0), and the overall wound infection rate was also 0%. The overall mean for pain score for all study participants was 2.73 S.D 1.36. Mean pain score in Desarda repair was 2.13 S.D 1.30 and 3.33 S.D 1.15 for Lichtenstein group (p-value 0.001). Conclusion: Desarda repair is an economical repair especially for resource-limited countries and should be undertaken in place of a Lichtenstein repair where mesh cost and availability poses a problem. The Desarda repair has a better morbidity profile than the Lichtenstein repair and with more data generation may have a place to become the standard open inguinal hernia repair technique. Keywords: Desarda Repair; Lichtenstein Repair; Short-term outcomes

OC-112 OUTCOMES OF EMERGENCY INGUINAL HERNIA SURGERIES PERFORMED BY TRAINEES AT A TERTIARY CARE HOSPITAL- AN AUDIT OF 43 CASES

Abstract Background An audit was performed to identify the outcomes after emergency inguinal hernia surgeries performed by trainees at our hospital from April to December 2022. Methods The prospectively maintained database of a single clinical unit of the Department of General Surgery of our institute was reviewed. Outcomes such as the types of surgery, SSI, length of hospital stay (LOH), re-exploration, long-term pain, recurrence, and other parameters were reviewed. Results 43 cases were reviewed. The mean age was 58.4 years. The mean symptom duration was 3.47 days. 16 (37.2%) patients had obstruction and 11 (25.5%) patients suffered strangulation. 25 (58.1%) patients required laparotomy apart from local exploration. Hernioplasty was done in 10 (23.2%) patients. Bassini was done in 10 (23.2%), Lytle's in 10 (23.2%), and Desarda repair in 23 (53.6%) patients. The mean operating time was 116.92 mins and the average blood loss was 93.7ml. 4 (9.3%) patients developed SSI, and 1 (2.32%) patient required mesh explantation. 1 (2.32%) required re-exploration and there was 1 mortality. The mean LOH was 4.33 days (2.32%). 20.93% of patients had long-term pain and none had a recurrence. Conclusion Patients getting operated on by trainees had a comparable mean operative time, more blood loss (53.7ml vs 22.0ml), more long-term pain (20.93% vs 1.2%), slightly more wound complications (9.3% vs 6.74%), comparable LOH, and comparable recurrence and mortality rates, when juxtaposed against reported literature. Surgical training should hence focus on meticulous dissection and identification of nerves to reduce blood loss and long-term pain.

OC-027 RANDOMISED CONTROLLED TRIAL OF THE DESARDA TECHNIQUE AND SUTURE REPAIR FOR OBSTRUCTED INGUINAL HERNIA

Abstract Aim Open inguinal hernia repair remains one of the most commonly performed operations worldwide. For elective surgery, mesh implantation is an established global ‘gold standard’. However, for emergency repair of obstructed hernia, non-mesh techniques may be utilised. We designed a randomised controlled trial to compare the open, non-mesh ‘Desarda’ against non-mesh suture darn repair in the treatment of obstructed inguinal hernias. Materials & Methods A prospective randomized controlled trial was undertaken between Feb and Aug 2020 at the Emergency Unit, of a busy hospital in a resource-constrained setting. To identify a true difference in operating time, a sample size of 100 patients was calculated using WHO calculator. Exclusion criteria were patients ASA 3+ or with recurrent or strangulated intestine; ethical approval was obtained from the hospital Ethics’ Committee and informed consent obtained from all participants. Randomisation was by the sealed opaque envelope method. Data analysis by SPSS version 25 using Student t-test; p-value ≤0.05 was considered significant. Results Total 100 patients were included (71 male and 29 female). Mean age of patients: 39.1 years±6.1SD. Mean operative time was significantly lower in Desarda group (50.5±1.7) compared to sutured repair (58.8±2.1SD) p=0.000. Intra-operative and immediately postoperative complications were not identified in any of the patients. Patient reported outcomes will be reviewed at the 2-year point. Conclusion In this RCT of emergency repair of obstructed inguinal hernia, Desarda's repair was safe and effective and took significantly less surgical time compared to a standard sutured darn repair. Longer term, patient reported outcomes are awaited.

AN OBSERVATION ON DESARDA TECHNIQUE OF INGUINAL HERNIA REPAIR

Background: Inguinal hernia repair is one of the most commonly performed procedure in surgical practice throughout the world. The non-mesh repair technique of inguinal hernia by Mohan P. Desarda is becoming popular nowadays. Study of the outcomes of the procedure and comparison with other workers is desirable for wider acceptance of the procedure. To study the Objective: outcomes of inguinal hernia repair by Desarda technique. This is an observational study of 32 patients with inguinal hernia repair by Desarda techn Methodology: ique carried out in Dept. of general surgery, Patna Medical College and Hospital, Patna from October 2020 to October 2022. Out of 32 patients included in the study 18 Result: right sided,12 left sided and 2 bilateral inguinal hernia was there. The mean age of study population was 42.72±12.137 years. Mean operating time was found to be 60.81±10.91 minutes. Majority (87.5%) of the patients experienced moderate pain (measured by VAS ) on the rst post-operative day which gradually decreased with the time. Different postoperative complications ; hematoma in 1 patient (3.125%), seroma in 2 patients (6.25%), surgical site infection in 1 patient (3.125%), scrotal swelling in 2 patients (6.125%) and cord swelling in 1 patient (3.125%) were seen. Conclusion: Non mesh Desarda repair of inguinal hernia repair is associated with less operating time, early ambulation, less post operative pain and complication. As it doesn't use mesh so it is cost effective also and should denitely be encouraged.

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

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.

COMPARATIVE STUDY BETWEEN DESARDA REPAIR AND LICHTENSTEIN'S TENSION FREE HERNIOPLASTY IN THE MANAGEMENT OF INGUINAL HERNIAS

Hernia repair is one of the most commonly performed general surgical procedures worldwide.Mesh based techniques particularly the Lichtenstein's tension free hernioplasty and Laparoscopic repairs were advocated for the treatment of symptomatic inguinal hernias in adults by the European Hernia Society. Lichtenstein's technique is currently the most popular and accepted technique among open mesh-based techniques. Dr.Mohan P. Desarda reported a novel technique of tissue-based repair with less recurrence. It provides a strong and physiologically dynamic posterior wall without the use of any prosthesis. Here, in place of mesh an undetached strip of external oblique is stitched to the posterior wall to strengthen it.The technique requires less complicated dissection or suturing,no mesh is needed,easy to learn and has results similar if not better than Lichtenstein repair[5].This study was undertaken to compare the results of Desarda repair with Lichtenstein's Tension free Hernioplasty in Govt.Rajaji Hospital,Madurai

DESARDA'S VS LICHTENSTEIN'S TECHNIQUE IN INGUINAL HERNIA REPAIR : A COMPARATIVE STUDY

Background: About 75% of abdominal wall hernias are inguinal hernias, with a lifetime risk of 27% in men and 3% in women. Lichtenstein's hernia repair was favored and became the gold standard of open tension-free hernia repair. However, the use of synthetic prostheses can result in new clinical problems. In order to reduce the incidence of complications and postoperative dysfunction, the tissue-based groin herniorrhaphies has re-attracted the attentions in recent years. In 2001, Dr. Mohan Desarda proposed a solution which involves use of a strip of external oblique aponeurosis to strengthen the posterior wall of the inguinal canal.(1) To compare the Aim: post-operative complications, short-term outcomes and recurrence rate for one year between Lichtenstein's and Desarda's technique. Materials And Methods: This is a prospective, randomised study (ODD – EVEN basis) in GSVM Medical College, LLR & Associated Hospitals, Kanpur (UP). 100 patients in two groups with 50 patients in each group: Group A (Lichtenstein's repair) and Group B (Desarda's repair). Outcomes were assessed on the basis of recurrence (with regular follow ups at one month, three months, six months and one year); Operating time; Cost of procedure in total; Post operative course (post operative pain, induration, redness of operated site, post operative wound infection rate. discharge time or hospital stay). Out of 100 patients majority of Results: patients were having right sided indirect hernia. The duration of the surgery was statistically less in Desarda group (53.68±20.21) than Lichtenstein (68.4±53.68) (p<0.05). The pain was signicantly lesser in Desarda group than Lichtenstein groups (p<0.05). The duration of hospital stay was signicantly lower in Desarda group (p<0.05). Seroma Formation was major complication in Lichtenstein group followed by Hematoma Formation, Surgical site infection and recurrence whereas in Desarda group seroma formation was found in only 2 patients and recurrence was in only 1 patient (association of complications in both groups was found to be statistically signicant (p<0.05)). The result of the Conclusion: inguinal hernia treatment with Desarda technique are comparable to results of Lichtenstein surgery. Desarda technique do not use mesh, this makes Desarda repair cost effective and easy to learn. Patients after Desarda's procedure get sooner ambulatory than Lichtenstein mesh repair.(2,3). Recurrence rate is more in Lichtenstein's group although the association was insignicant.(3,4). Hence, Desarda's no mesh repair is favorably comparable with Lichtenstein's mesh repair.

Feasibility and outcome of tension-free Desarda repair for treatment of complicated inguinal hernia

Feasibility and outcome of tension-free Desarda repair for treatment of complicated inguinal hernia

A Comparative Study of Desarda's Technique with Lichtenstein Mesh Repair in Treatment of Inguinal Hernia

Introduction: European hernia society (EHS) published a guideline that recommended Lichtenstein method for inguinal hernia repair. Currently Lichtenstein method is considered the most popular method. Desarda repair technique was used for the first time in 2001 which is still not considered as a standard tissue-based technique for inguinal hernia repair. We compared Desarda's technique with Lichtenstein mesh repair technique in treatment of inguinal hernia repair. Objectives: To compare the outcome of standard mesh-based Lichtenstein technique with the tissue based Desarda technique in terms of pain. Materials and Methods: After taken approval from hospital ethical committee, 250 patients were enrolled in the study. Enrolled patients were divided into two group. Group A underwent hernia repair through Desarda technique & group B will underwent hernia repair through Lichtenstein technique. Post-operative pain was assessed on day 7 and 30 by using visual analogue scale. All information was recorded on a pre-designed Proforma. The collected data from the patients through Proforma’s was entered in SPSS. Results: 250 patients were included in our study with mean age distribution 42.18+10.34 year. 82.8% patients were males while 17.2% were females. Mean SD of operative time for both groups (Desarda Group vs Lichtenstein Technique) were 23.41+ 0.17 vs 24.18 + 0.66. 111) patients (89%) 92 felt mild post-operative pain who were subjected to Group A while 14 (11%) patients suffered moderate post-operative pain with Mean SD 2.46+0.30. 88% patients felt post-operative pain who were subjected to Group B while 15 patients (12%) felt moderate post-operative pain with Mean SD 2.46+0.18 thus giving us almost same results as found in Group A. Conclusion: The results of inguinal hernia treatment with both Desarda and Lichtenstein technique are similar. So, we conclude the Desarda repair is as effective as the standard Lichtenstein procedure, allowing successful hernia repair without mesh in terms of pain. Keywords: Desarda's technique, Lichtenstein mesh, inguinal hernia

Feasibility and Efficacy of Desarda vs Lichtenstein Hernioplasty by Local Anesthesia for Inguinal Hernia Repair: A Noninferiority Randomized Clinical Trial

Introduction: Lichtenstein repair is a standard open technique for inguinal hernia but needs a prosthesis, increasing cost and complication. Conversely, Desarda autologous tissue repair is reported to have comparable results. This study aims to compare the efficacy of Desarda repair (DR) with Lichtenstein’s hernioplasty (LH) and establish the feasibility of operation under local anaesthesia (LA). Methods: This study was a prospective, double-blinded, non-inferiority randomized trial in patients undergoing open inguinal hernia repair under LA [NCT03512366]. The non-inferiority margin fixed was 0.5 days. The primary endpoint was time to return to the normal gait with comfort postoperative. The secondary endpoints studied were the incidence of surgical site occurrences (SSO), including recurrence. Results: The cohort comprised 56 patients (50.9%) in the DR group and 54 patients (49.1%) in the LH group. All the procedures were safely performed under LA. By intention-to-treat analysis, the median (interquartile range) duration for resuming gait post-surgery with comfort was 5 (interquartile range [IQR], 3-8) days in the DR vs 4 (IQR, 3-7) days in the LH arm (P = 0.16), thereby failing to demonstrate the noninferiority. There was no significant difference in days to return to work, surgical site occurrences, chronic groin pain, and two years recurrence rates. Conclusion: This study could not statistically prove the noninferiority of Desarda repair compared with Lichtenstein hernioplasty for resuming normal gait. Still, comparing the days to return to work, pain score, chronic groin pain and recurrence rate, Desarda repair faired equally with Lichtenstein hernioplasty, thereby highlighting its feasibility under local anaesthesia and efficacy.

COMPARISON OF LICHTENSTEIN AND DESARDA REPAIRS IN INGUINAL HERNIAS IN TERMS OF POSTOPERATIVE CHRONIC PAIN AND RECURRENS; A PROSPECTIVE RANDOMIZED TRIAL

Objective
 Patient comfort is an important factor affecting the
 outcome and success of inguinal hernia repairs.
 Mesh usage significantly decreases recurrence rate
 however, the problems due to mesh usage negatively
 affects the patient comfort. Desarda repair using the
 body's own tissues has gained importance because
 it is more physiological and has low recurrence
 rates. In this study, we aimed to compare Desarda
 and Lichtenstein repairs in terms of chronic pain and
 recurrence.
 Material and Method
 Patients who were operated on at Konya Training
 and Research Hospital between October 2010
 and February 2014 were included in the study.
 Randomization was done using the closed envelope
 method. Desarda repair was performed in the first
 group (D), and Lichtenstein repair was performed in
 the second group (L). Both techniques were applied
 as originally described. 3 questionnaires were
 used in the assessment of chronic pain. All three
 questionairres were filled before the operation, after
 first and third year from the operation.
 Results
 162 people participated in the research. There
 were 80 people in the Desarda group and 82 in the
 Lichtenstein group. The median follow up time was
 122 (96-145) months. There were 2 cases with
 recurrence in each groups. Preoperative pain levels
 were similar. The pain incidence, severity and limited
 activity were similar in the first and third years. The
 mean operation time was significantly lower in D
 group than L group (44.5±3.7 min and 56.7±2.97 min
 respectively). Complication rates were similar in both
 groups.
 Conclusion
 Desarda technique can safely used for hernia repair
 with its similar recurrance, complications and chronic
 pain rates with the most commonly used Lichtenstein
 technique. Moreover, it is advantageous with
 physiological closure of myopectineal orifice, being
 easy to perform, not containing foreign material and
 being cost-effective.

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

Objective: To compare Desarda tissue-based repair with the traditional Lichtenstein hernioplasty in terms of complications, operative time and cost-effectiveness.
 Study Design: Comparative Cross-sectional Study.
 Place and Duration of Study: Surgical Department Combined Military Hospital, Mailsi Pakistan, from Dec 2019 to Dec 2020.
 Methodology: Lichtenstein (Group-I) and Desarda (Group-II) were randomly allocated to 140 patients with inguinal hernia, 70 in each Group, respectively. Both Groups were compared in terms of postoperative complications, cost evaluation and operative time.
 Results: The mean operative time in Group-I was 54.5±4.09 minutes, whereas in Group-II, it was 70.24±5.30 minutes. The mean cost estimated in Group-I was 4400±225 rupees, while in Group-II, it was 850±150 rupees, respectively. Desarda's repair was comparable to Lichtenstein's hernioplasty in terms of postoperative complications.
 Conclusion: Desarda's hernia repair is more cost-effective than the Lichtenstein procedure for treating inguinal hernia. Reduced surgical time, faster restoration to normal gait, and return to work are all the possible benefits of the Lichtenstein repair. Furthermore, Lichtenstein hernioplasty is a better option in patients with weak external oblique aponeurosis.

Outcome of Desarda Technique in Inguinal Hernia Repair

Objective: The objective of this study is to evaluate the short term outcome of Desarda technique in inguinal herniorrhaphy in terms of duration of surgery and post-operative pain. Material and methods: This case series study was conducted at Department of Surgery, Lahore General Hospital, Lahore from June 2021 to December 2021. Total 150 male patients of inguinal hernia having age 16-50 years were selected. Duration of surgery and post-operative pain was studied. Results: The mean age of patients was 34.86 ± 9.38 years with range of 31.00 years. The minimum and maximum age was 19.00 and 50.00 years respectively. The mean surgery time was 48.92 ± 11.13 minutes with minimum and maximum of 30 and 70 minutes. There were 11 (7.33%) patients who had no pain, 32 (21.33%) had mild, 91 (60.67%) had moderate and 16 (10.67%) had severe pain at day 1. At day 2, no pain was found in 53 (35.33%) patients. A majority of patients 73 (48.67%) were suffering from mild pain whereas moderate and severe pain was seen in 22 (14.67%) and 2 (1.33%) patients respectively. Conclusion: Desarda repair is an acceptable alternative technique for effective repair of inguinal hernia with comparable operative time and postoperative pain as observed in this study that there is minimal duration of surgery and less post operative pain especially at day 2 . The technique can be safely employed to reduce the hospital burden and morbidity related to post-operative pain following operative repair of inguinal hernia. The study will help to encourage further research on this technique as there is only sparse data available in the published local literature to date. Keywords: Inguinal hernia, Herniorrhaphy, Desarda, duration of surgery, postoperative pain.

Chronic groin pain in Desarda versus Lichtenstein hernia repair - a randomised controlled study

BACKGROUND: Chronic pain after inguinal hernia repair is a common complication. This study compared the difference between Desarda repair and Lichtenstein repair for inguinal hernia in chronic groin pain. METHODS: One hundred patients with unilateral uncomplicated inguinal hernia were randomised to either Desarda repair (n = 50) or Lichtenstein repair (n = 50) under local anaesthesia and were evaluated for pain postoperatively. Operative time, surgical complications, time to return to normal gait and work, and overall patient satisfaction were recorded. The patient was blinded to the procedure. Any pain at three months (numerical rating scale 1 or more) was considered chronic pain. RESULTS: Mean operation time was approximately 5 minutes less for Desarda (p = 0.33). There was no significant difference in terms of pain level postoperatively between Lichtenstein and Desarda groups. Twenty-two (44%) patients in the Lichtenstein group had chronic pain, and twenty-one (45.7%) patients had chronic pain in the Desarda group (p = 0.871). No significant difference was observed in haematoma formation, wound infection, recurrence rate, seroma, or foreign body sensation. The mean time for patients to return to normal gait was approximately 0.5 day earlier for the Desarda group (p = 0.29). The mean time for patients to return to normal work was comparable (p = 0.99). Desarda group had a slightly higher satisfaction rate than the Lichtenstein group (9.1%). CONCLUSION: Desarda repair is not inferior to Lichtenstein repair in the short-term concerning complications or pain.