Desarda Repair Research Articles

Desarda Versus Lichtenstein Repair for Primary Inguinal Hernia in Men: Results of A Randomized Control Trial

Inguinal hernia is a very common surgical problem for which mesh based technique particularly Lichtenstein repair is considered as standard. However, it is not free from some major and bothersome complications. Desarda technique of non-mesh hernia repair invented by the Indian surgeon is claimed as low cost tension free procedure with promising results. The objective of the study is to evaluate the feasibility of Desarda procedure in country like Bangladesh as a treatment of primary inguinal hernia in men by comparing with Lichtenstein repair in terms of various parameters. One hundred and sixty male patients between ages of 18-70 years with uncomplicated primary inguinal hernia were initially randomized to perform the one of the two procedures in every alternate patient. Outcome were measured and analyzed. A total of 100 patients were finally studied with a follow up of 2 years. Operative time and immediate postoperative pain were significantly less in Desarda arm. Cost and foreign body sensation were also in favour of Desarda group. There was no recurrence in either group. Desarda repair is easy to perform and takes less time. It is cost effective with a comparable clinical outcome to standard Lichtenstein repair at least in short term. Faridpur Med. Coll. J. Jan 2019;14(1): 20-26

Tension free, mesh free inguinal hernia repair: a prospective study of Desarda’s technique

Background: The Desarda repair for inguinal hernias is a new tissue-based technique. Application of the external oblique muscle aponeurosis in the form of un-detached strip has been established as a new concept in tissue-based hernia repair.Methods: A prospective study was conducted among 126 cases with 148 inguinal hernias repaired by Desarda’s technique for a period of 3 years in Dr. B. R. Ambedkar Medical College and Hospital, Bangalore, Karnataka, India. The details pertaining to duration of hospital stay, pain, ambulation and complications were recorded.Results: The mean age of the patients was 38.4 years. Mean operating time was 62.5 min for unilateral and 123 min for bilateral hernias. About 97.8% patients were ambulatory within 6.42 hours and were freely mobile within 19.26 hours after surgery. About 96.4% patients returned to work within 6-14 days. About 91.26% patients were discharged on same day. The mean hospital stay duration of the patients was 1.11 days. Postoperative pain on movement out of bed was described as mild and tolerable in 92.6% patients on day 1. Two patients had seroma that subsided on its own. There were no long-term complications, recurrence of the hernias or chronic groin pain.Conclusions: The results of this new technique (Desarda repair) using continuous absorbable sutures appear promising. The continuous suturing saves time and just one packet of suture material without mesh saves cost.

Evaluation of Desarda Technique in Inguinal Herniorrhaphy

Background: Desarda technique for hernia repair is emerging technique for inguinal hernia repair known for its low-cost procedure, less recurrence rate and feasibility of the procedure. Aim of the work: was to evaluate treatment of inguinal hernia with this method in terms of various operative and post-operative parameters. Patients and methods: The present study included 100 male patients, presented to Al-Hussain University Hospital, for elective repair of uncomplicated inguinal hernia, during the period from March 2015 till November 2018. All the 100 patients subjected to Desarda non mesh tissue repair. Results: Mean operating time was 45.25±12.55 min. There were no intraoperative complications. Postoperative pain according to VAS (Mean) on day 2 was 3,12. While mean VAS was 1.28 and 0.12 after one week and one month respectively. No patient had discomfort for more than 15 days after this repair. No chronic pain, sensation of foreign body and no recurrence was observed. Patients were freely mobile within 18-24 h after surgery. The mean hospital stay was 1.87 ± 0.78 days. Patients returned to their day-to-day activities within 6-14 days (mean: 8.62 days). Conclusion: The above data were in favour of Desarda repair, compared to other inguinal hernia repairs. This is a simple operation to do, does not require prothesis or complicated dissection of the inguinal canal. is preferably indicated in young cases, infected surgical fields or in the presence of financial limitations or patients refusing mesh or with history of mesh rejection in another site.

English

English

Desarda vs lichtenstein technique for the treatment of primary inguinal hernia

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.

Status of self-medication among the patients attending outpatient department in selected private hospitals in Dhaka city

Background: Inguinal hernia is a common problem and its repair is one of the most commonly performed procedures in general surgical practice. Several methods have been developed including Lichtenstein’s repair. Among these Lichtenstein’s repair has been standard technique for last few decades. In recent time a new procedure “no mesh Desarda hernia repair” has emerged as a recognized operative method for inguinal hernia repair.
 Objectives: This study was conducted to evaluate the outcome of Desarda technique in repairing inguinal hernia.
 Methods: This was a single centered descriptive study to see the outcome of inguinal hernia repair by Desarda technique in both elective and emergency surgery carried out in the Dept. of Surgery, Sher-E-Bangla Medical College Hospital, Barisal from August, 2015 to July, 2016.
 Results: A total of 100 patients underwent Desarda repair for inguinal hernia including primary/recurrent and elective/ emergency cases. Variables includes age, type of surgery, operating time, post-operative complications, post-operative pain, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Mean age of patient was 48.9±9.07 years. Mean operating time was 43.72±9.64mins. Majority (54%) of the patient experienced mild post-operative pain on first day, measured in VAS score. Ten percent of patients developed different post-operative complications like wound infection (2%), seroma formation (1%) and scrotaledema (7%).
 Conclusion: In this study, it is revealed that no mesh Desarda repair for inguinal hernia was associated with less operating time, less post-operative pain, less post-operative complications, short hospital stay, zero recurrence rate, no chronic groin pain and performed in emergency cases also. So, it is safe and most reliable technique for all type of inguinal hernia surgery.

Repair of inguinal hernia by Desarda technique in both elective and emergency setting

Background: Inguinal hernia is a common problem and its repair is one of the most commonly performed procedures in general surgical practice. Several methods have been developed including Lichtenstein’s repair. Among these Lichtenstein’s repair has been standard technique for last few decades. In recent time a new procedure “no mesh Desarda hernia repair” has emerged as a recognized operative method for inguinal hernia repair.
 Objectives: This study was conducted to evaluate the outcome of Desarda technique in repairing inguinal hernia.
 Methods: This was a single centered descriptive study to see the outcome of inguinal hernia repair by Desarda technique in both elective and emergency surgery carried out in the Dept. of Surgery, Sher-E-Bangla Medical College Hospital, Barisal from August, 2015 to July, 2016.
 Results: A total of 100 patients underwent Desarda repair for inguinal hernia including primary/recurrent and elective/ emergency cases. Variables includes age, type of surgery, operating time, post-operative complications, post-operative pain, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Mean age of patient was 48.9±9.07 years. Mean operating time was 43.72±9.64mins. Majority (54%) of the patient experienced mild post-operative pain on first day, measured in VAS score. Ten percent of patients developed different post-operative complications like wound infection (2%), seroma formation (1%) and scrotaledema (7%).
 Conclusion: In this study, it is revealed that no mesh Desarda repair for inguinal hernia was associated with less operating time, less post-operative pain, less post-operative complications, short hospital stay, zero recurrence rate, no chronic groin pain and performed in emergency cases also. So, it is safe and most reliable technique for all type of inguinal hernia surgery.

Comparison of outcome of Desarda versus Bassini repair in management of complicated inguinal hernia

Background: Complicated inguinal hernia is a common problem faced by surgeons across the world. Various methods of surgical repair have been described. It is important to identify the best repair technique of inguinal hernia to have better post-operative outcome.Methods: This randomised controlled study consisted of 84 cases of complicated inguinal hernias presenting to surgical emergency department of Maulana Azad Medical College. Patients were randomly allocated to two repair groups- Desarda and Bassini and various intra/post-operative parameters were compared.Results: Duration of surgery and postoperative pain scores were less in Desarda group. Time to return to strenuous daily activities was also less with Desarda repair. Desarda repair was associated with less incidence of chronic inguinodynia and post-operative complications.Conclusions: Desarda repair was found to be superior to Bassini group due to shorter duration of surgery. Patients required less analgesics following Desarda repair as compared to Bassini group. There was no recurrence in any group at four months follow up.

A randomized controlled study comparing the outcome of laparoscopic totally extra peritoneal repair versus Desarda repair in the management of inguinal hernia

Background: Desarda repair is a technique of a tissue based tension free mesh free inguinal hernia repair, shown to be comparable to the standard Lichtenstein repair. Till date, no study has been done comparing Desarda repair with laparoscopic total extra peritoneal repair (TEP), hence this study was planned.Methods: The prospective randomized controlled study was done over a period of 18 months, and included a total of 50 patients, randomly allocated into 2 groups: TEP (group 1) and Desarda repair (group 2), 25 in each group, and followed up for a period of 1 year.Results: Chronic inguinodynia, including groin stiffness showed a statistically significant difference between the 2 groups (p=0.02). Foreign body sensation (16% in TEP group and none in Desarda group) and recurrence rate (12% in TEP group and none in Desarda group) did not show a significant difference. The operating time in the Desarda group (66.8±20.35 minutes) was significantly less than TEP group (78.6±11.86 minutes), with p<0.01. There was no significant difference in terms of post-operative pain scores (VAS scores) at five time points, post-operative analgesic requirement, hospital stay and return to normal daily routine activity or work and post-operative complications. Desarda repair was also found to be much more economical.Conclusions: The present study establishes the potential benefits of Desarda repair over TEP in terms of shorter duration of surgery, lesser incidence of chronic inguinodynia and lesser cost of the procedure, along with the avoidance of mesh related complications.

Desarda’s versus Lichtenstein technique of inguinal hernia repair: a comparative study

Background: Inguinal hernias rank among the commonest of all hernias and surgery is the only definitive treatment. We analyzed the outcomes of desarda tissue based repair in comparison with the standard Lichtenstein tension free mesh repair of primary inguinal hernia.Methods: A total of 164 patients were randomly allocated into two groups, Desarda (group D) or Lichtenstein (group L) (80 VS 84, respectively). The primary outcome measures were chronic groin pain and recurrence during the follow up period. Secondary outcome measures included operating time, post-operative pain scores, duration of post-operative hospital stay, time to return to basic physical activity and to work, foreign body sensation, and post-operative complications.Results: During two year follow up, no recurrence was detected in each group. Operative time was significantly less in the Desarda group (28.91±5.82 min as compared to 34.07±8.63 min in the Lichtenstein group). Postoperative day 1, day 3 and day 7 groin pain was more in the Desarda as compared to the Lichtenstein group. Basic physical activity, chronic groin pain, cost, seroma formation, foreign body sensation, were also significantly less in the Desarda group.Conclusions: The successful primary inguinal hernia repair without mesh implantation can be achieved using Desarda tissue based repair, as it is effective as the standard Lichtenstein tension free mesh repair. Shorter operative time, early return to basic physical activity, lower cost, less chronic groin pain, less foreign body sensation are potential benefits of Desarda repair and can be preferred for inguinal hernia repair.

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

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.

A Comparative Study of Desarda Repair and Lichtenstein (Mesh) Repair for Inguinal Hernia

Background: Inguinal Hernia is very common problem and the most common operation performed is Lichtensteins repair, but primary tissue repairs are still being developed. In this study we evaluated short term results of Desarda repair versus Lichtensteins repair (Mesh repair) for primary inguinal hernia. Objective: To compare the short-term results of Desarda technique with Lichtenstein’s technique in terms of mean operating time, post-operative scrotal hematoma formation, surgical site infection and time to resume physical activity. Study Design: Prospective study. Settings: Surgical Unit-V, Faisalabad Medical University, Faisalabad, Pakistan. Duration: 11 months from 21-03-2018 to 17-02-2019. Methodology: A total of 138 patients were operated in our unit during the study period and were allocated into two groups randomly: Group A (Desarda) and Group B (Lichtenstein) included 62 patients and 72 patients respectively. The primary outcome measures were Operating time, post-operative scrotal hematoma, surgical site infection and Time in days to return to Normal activity. Results: During the follow up period, Mean Operating time in Desarda group was 38.29 minutes and 44.30 minutes in Lichtenstein group (p value 0.004). 93.5% patients resumed routine activities on 1st Post-operative day in Desarda group whereas in Lichtenstein group 92.1% patients resumed routine activities on 1st Post-operative day (p value 0.745). In Group A Scrotal Hematoma was developed in 4.8% patients and in 1.3% patients in Group B (p value 0.22). Surgical site Infection was seen in 1 patient in Group A (1.61%) and 1 patient in Group B (1.31% p value 0.88). Conclusion: Our study concludes that Desarda repair is superior to Mesh repair in terms of operating time and the results of Post-operative complications in both techniques are statistically insignificant.

Comparison of tension free Desarda technique with Lichtenstein for inguinal hernia repair

Background: Inguinal hernia is common surgical problem for which mesh based technique, particularly Lichtenstein repair is considered gold standard. However it has its own limitation such as foreign body sensation, wound infection, cord fibrosis, chronic pain, etc. Desarda technique for hernia repair is emerging technique for inguinal hernia repair known for its low cost procedure, less recurrence rate and feasibility of the procedure. The objective of the study was to compare treatment of primary inguinal hernia repair with these methods in terms of various operative and post-operative parameters.Methods: 64 patients included in the study and operated after randomization. Intra-operative time, local complication, return to everyday activity, post-operative pain, foreign body sensation and early recurrence were analysed.Results: 51 patients were analysed with a minimum follow up period of 3 months and rest were lost on follow up. Operative time was less in Desarda’s repair (28.24 vs. 30.88 min). Desarda repair was cost effective, return to everyday activity was early in Desarda group, there was significantly (p<0.001) less post-operative pain measured on VAS on 2nd POD, 7th POD and 1 month. No recurrence observed.Conclusions: Desarda repair is easy to perform and takes less time to perform, it is also cost effective. Desarda repair when compared with Lichtenstein was superior in terms of postoperative pain, return to everyday activity and no foreign body sensation. Desarda repair is superior to mesh based technique in terms of outcome.

A Randomized Trial. Comparing Herniorrafia Modifield Desarda Repair and Hernioplastia Lichtenstein Repair for Inguinal Hernia (Study of 1242 Patients)

Introduction: The objective of this study is to compare the outcomes of Modified Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Patients and Methods: This is a prospective randomized controlled trial study of 1242 patients having 1313 hernias operated from January 2008 to December 2018. 640 patients were operated using Lichtenstein repair and 602 using Desarda repair. The variables like age, sex, location, type of hernia, tolerance to local anesthesia, duration of surgery, pain on the first, third and fifth day, hospital stay, complications, re-explorations, morbidity and time to return to normal activities were analyzed. Follow up period was from 1-10 years (median 6.5 years). Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 52 minutes in Modified Desarda group and 42 minutes in the Lichtenstein group that is significant (p<0.05). The recurrence was 0.0 % in Modified Desarda group and 0.3 % in Lichtenstein group. But, there were 8 cases of infection to the polypropylene mesh in the Lichtenstein group, 2 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (7,0 %) as compared to Modified Desarda group (3.6 %). The mean time to return to work in the Modified Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. in Modified Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: Modified Desarda repair scores significantly over the Lichtenstein repair in all respects including re-explorations and morbidity. Modified Desarda repair is a better choice as compared with Lichtenstein repair.

A single-blind, randomized controlled study to compare Desarda technique with Lichtenstein technique by evaluating short- and long-term outcomes after 3 years of follow-up in primary inguinal hernias

BACKGROUND: Lichtenstein tension-free repair is associated with postoperative complications and dysfunctions; hence, there is a need to look for a new hernia repair techniques while retaining its advantages. Desarda technique is a physiologic repair and essentially restores physiology of the inguinal canal. This single-blind, randomized controlled study was conducted to compare Desarda with Lichtenstein technique evaluating short- and long-term outcomes after 3 years of follow-up in primary inguinal hernias. MATERIALS AND METHODS: One hundred and twenty-three adult male patients with primary inguinal hernia (both direct and indirect) were randomly allocated intraoperatively to Lichtenstein repair, Mesh (M) Group or Desarda repair, nonmesh (NM) Group. Baseline characteristics were recorded before the surgery. Short- and long-term outcomes and patients responses on patient global impression of change (PGIC) and Prolo scale after surgery were recorded. RESULTS: Sixty-two patients were assigned to NM and 61 to M group. Surgery time was significantly higher for M group (P CONCLUSIONS: After 3 years of follow-up, Lichtenstein technique and Desarda technique results were similar. After considering the pros and cons of both the methods, a tailor-made approach is required while choosing a procedure for hernia repair.

Evaluation of Natural Tissue Reinforcement of Inguinal canal For Inguinal Hernia Repair (Desarda Inguinal Herniorraphy)

Background: Inguinal hernia repair is one of the cornerstones of a general surgery practice and is one of the most commonly performed procedures. Although there are no exact figures totaling the number of inguinal hernia repairs performed annually, it has been estimated that approximately 800,000 cases were performed annually in 2003, not including recurrent or bilateral hernias. Aim: To report our experience in recording and evaluating the short-term outcome of inguinal hernia repairs with Desarda's technique. Patients and Methods: A total of 20 adult male patients with primary inguinal hernias were randomly allocated intraoperatively to undergo Desarda inguinal herniorraphy. Results: According to our scale evaluating outcome, desarda technique is effective and safe with least post-operative complications regarding inguinal hernia repair. Conclusion: Desarda repair is easy to perform and has shown to take shorter operative time. Also, there is no need of mesh with less suture material requirement. So, this method proves cost effective than the Lichtenstein method. Desarda hernia repair was found to be superior to Lichtenstein repair in terms of post-operative pain and foreign body sensation. It can be recommended for younger patients.

Desarda versus Lichtenstein repair for inguinal hernia: a randomized, multi-center controlled trial with promising results

Background: The techniques for treatment of an inguinal hernia range from the tissue-repairs to the tension-free hernioplasty. The use of a mesh for repair not free of complications and had higher costs. The Desarda technique for inguinal hernia repair is a new tissue-based method application of the external oblique muscle aponeurosis in the form of an undetached strip has been introduced as a new concept in tissue based hernia repair. The aim of the present stusy was to compare the standard mesh-based Lichtenstein technique with the tissue-based Desarda technique.Methods: In this prospective study, patients with an Inguinal hernia who were referred and enrolled in the study for elective Desarda or Lichtenstein repair between May 2012 and November 2016 at Sohag and Assiut university hospitals, Egypt; Operation, anaesthesia, rescue analgesia and postoperative care were standardized. Patients were assessed for operation time, postoperative pain, hospital stay, foreign body sensation, complications and recurrence rate in the postoperative period on day 1, 1 week, 1, 12 and 24 months, postoperatively.Results: Of 130 patients were included in the study, 65 underwent Desarda (D) versus 65 underwent Lichtenstein repair (L) between May 2012 and November 2016 at Sohag and Assiut university hospital in Egypt. In Desserda group (D) 64 OF 65 patients were male and in Lichtenstein repair group (L) 65 of 65 were male. The patient's age for (L) Group was 40±11.69 and for (D) group was 38±11.55. As regards operative time, hospital stay, return to activity and work for or post-operative pain 24 hours and 7 days after the operation. D group was significantly lower than (L). No difference between groups regarding intraoperative, postoperative complication, mortality rate, recurrence rate, or post-operative pain six months after operation.Conclusions: Desarda repair had lower operative time, early return to basic and work activity, shorter hospital stay and less post-operative pain than Lichtenstein repair. The result of our study supports the use of Desarda repair in our hospitals as the method of choice for most of the patients due to low cost, low recurrence rate, and simplicity of repair.

A comparative study of outcomes of Lichtenstein repair and Desarda tissue repair in patients of inguinal hernia

Background: Inguinal hernia is a very common surgical problem for which, mesh-based techniques, particularly the Lichtenstein repair is considered standard. However, problems like foreign body sensation, wound infection, cord fibrosis, chronic pain and recurrence are major concern. Desarda tissue repair (non-mesh technique), which was given by an Indian surgeon, is now being used in many countries because of low cost of procedure with very low recurrence rates. The objective of this study was to evaluate the feasibility of Desarda tissue repair at a tertiary care centre of Central India as a treatment of primary inguinal hernia, by comparing it with Lichtenstein repair in terms of various post-operative parameters.Methods: Patients between age of 18 and 70 years with primary inguinal hernia were included in this randomised controlled trial. Patients with strangulated, obstructed or recurrent hernia, surgically unfit patients and patients having unmanaged urinary obstruction, cough or constipation were excluded. Randomization was done by sealed envelope method into Lichtenstein and Desarda arm and respective surgeries were performed.Results: 90 patients were included in the study and average duration of follow-up was 15.1 months. Operative time was significantly less in Desarda arm (14.75 min compared to 21.32 min in Lichtenstein arm). Cost, incidence of seroma formation, post-operative pain, foreign body sensation and chronic pain were also significantly less in Desarda arm. No recurrence was observed in both arms.Conclusions: Desarda repair is easy to perform and takes less time to perform and proves cost effective. Desarda repair is comparable to Lichtenstein repair in terms of many parameters and superior in terms of post-operative pain and foreign body sensation and can be preferred for young patients. In infected and strangulated cases, Desarda repair can be used effectively without fear of mesh infection.

A comparative study of Desarda's technique with Lichtenstein mesh repair in treatment of inguinal hernia: A prospective cohort study

BackgroundThe Desarda repair technique of inguinal hernia repair introduced in 2001 is still not considered standard tissue based hernia repair technique. We compared the tissue based Desarda technique with standard Lichtenstein repair in treatment of primary inguinal hernia. Methods187 cases were allocated into 2 groups. Desarda (D Group) had 92 and Lichtenstein (L Group) had 95 patients. Primary outcome factor was early (<1 year) recurrence of inguinal hernia. Secondary outcome factors included operative time measured from skin incision to skin closure. Postoperative pain scores was assessed on day 1, 3, 7, 30 and 90 using Visual analogue scale. Time taken to return to basic and home activities was calculated. Cord oedema, groin discomfort, seroma, fever, surgical site infections, chronic pain, etc. were evaluated as postoperative complications. ResultsAfter a 15-month mean follow up period 1 recurrence is noted in each arm (P = 1). Operative time was 73.89 ± 12.63 min in Lichtenstein and 72.60 ± 13.89 min in desarda repair (P = 0.508). Postoperative pain was significantly less in the first 7 post-operative days in Desarda group (P = 0.09) compared to Lichtenstein group. Time taken to return to basic and home activities was significantly less in Desarda group (P = 0.001). There was no statistical difference in rates of post-operative complications among the two arms of the study. ConclusionThe results of inguinal hernia treatment with the Desarda technique are similar to the results after standard Lichtenstein operations. Desarda technique does not use a mesh. Patients after Desarda's operative procedure get ambulatory sooner as compared to the standard Lichtenstein mesh repair. Less Postoperative pain, complications similar to standardised technique. Desarda technique has the potential to enlarge the number of tissue based methods available to treat groin hernias.

Comparison of Lichtenstein inguinal hernia repair with the tension-free Desarda technique: a clinical audit and review of the literature.

Ours was a retrospective chart review of all elective open inguinal hernia repairs performed in a single unit at King Edward VIII Hospital, South Africa over an 18-month period. Comparison was made regarding duration of operation, length of hospital stay and complications such as pain, haematoma formation and recurrence between the Lichtenstein and Desarda techniques. The latter was noted to have a shorter operative time and avoided cost and possible complications of mesh usage, which are significant in resource-deprived settings. A larger comparative study with longer follow-up is needed to evaluate the wider suitability of the Desarda repair.