Desarda versus Lichenstein technique for primary inguinal hernia treatment: one year results of a randomised clinical trial

Authors

  • Pinak Pani Dhar Department of General Surgery, Silchar Medical College and Hospital, Silchar, Assam, India
  • Upasana Mohanty Department of General Surgery, Silchar Medical College and Hospital, Silchar, Assam, India
  • Raman Kumar Shankar Department of General Surgery, Silchar Medical College and Hospital, Silchar, Assam, India

DOI:

https://doi.org/10.18203/2349-2902.isj20202578

Keywords:

Desarda technique, Lichenstein’s repair, Inguinal hernia

Abstract

Background: The ideal operation to treat inguinal hernia is still far to define. The Shouldice method and other tissue-based techniques are still acknowledged to be acceptable for primary inguinal hernia repair according to European Hernia Society guidelines. Desarda’s technique, presented in 2001, is an original hernia repair method using an undetached strip of external oblique aponeurosis. This randomized trial compared outcomes after hernia repair with Desarda and mesh-based Lichtenstein techniques.

Methods: A total of 42 participants (40 males and 2 females) were randomly assigned to the Desarda (group 1) and Lichtenstein (group 2), 19 vs 23 respectively. The primary outcomes measured were recurrence (for maximum follow up of 1 year and minimum of 5 months) and chronic pain. Additionally, operative time, early and late complications, foreign body sensation, and return to everyday activity were examined in hospital and at 7, 30 days, and 6, 12 months after surgery.

Results: During the follow-up, one recurrence was observed in Desarda group after 10 months of surgery. Chronic pain was experienced by 10.5% and 8.7% of patients from groups Desarda and Lichtenstein respectively. Foreign body sensation and return to activity were comparable between the two groups. Operative time was less in Desarda group. There was significantly less seroma production in the Desarda group.

Conclusions: The results of primary inguinal hernia repair with the Desarda and Lichtenstein techniques are comparable at the 1 year follow up. The technique may potentially increase the number of tissue-based methods available for treating groin hernias. 

Author Biographies

Pinak Pani Dhar, Department of General Surgery, Silchar Medical College and Hospital, Silchar, Assam, India

Asssistant Professor, Department of general surgery

Upasana Mohanty, Department of General Surgery, Silchar Medical College and Hospital, Silchar, Assam, India

3rd year post graduate trainee, department of general surgery

Raman Kumar Shankar, Department of General Surgery, Silchar Medical College and Hospital, Silchar, Assam, India

3rd year post graduate trainee, Silchar Medical College & Hospital, Silchar ,Assam

References

Primatesta P, Goldacre MJ. Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol. 1996;25:835-9.

Desarda MP. Inguinal herniorrhaphy with an undetached strip of external oblique aponeurosis: a new approach used in 400 patients. Eur J Surg. 2001;167:443-8.

Desarda MP. New method of inguinal hernia repair: a new solution. ANZ J Surg. 2001;71:241-4.

Desarda Versus Lichtenstein Technique for Primary Inguinal Hernia Treatment: 3 years Results of a Randomized Clinical Trial. World J Surg. 2012;36(5):984-92.

Desarda MP. Inguinal herniorrhaphy with an undetached strip of external oblique aponeurosis: a new approach used in 400 patients. Eur J Surg. 2001;167:443-8.

Desarda MP. New method of inguinal hernia repair: a new solution. ANZ J Surg. 2001;71:241-4.

McArthur LL. Autoplastic suture in hernia and other diastases. JAMA. 1901;37:1162-5.

Ravitch MM, Hitzrot JM. The operations for inguinal hernia I Bassini, Halsted, Andrews, Ferguson. Surgery. 1960;48:439-66.

Grant AM. Open mesh versus non-mesh repair of groin hernia: meta-analysis of randomised trials based on individual patient data (corrected). Hernia. 2002;6:130-6.

Horstmann R, Hellwig M, Classen C. Impact of polypropylene amount on functional outcome and quality of life after inguinal hernia repair by the TAPP procedure using pure, mixed, and titanium-coated meshes. World J Surg. 2006;30:1742-9.

Desarda MP. Physiological repair of inguinal hernia: a new technique (study of 860 patients). Hernia. 2006;10:143-6.

Mitura K, Romanczuk M. Comparison between two methods of inguinal hernia surgery Lichtenstein and Desarda. Pol Merkur Lekarski. 2008;24:392-5.

Desarda MP, Ghosh A. Comparative Study of Open Mesh Repair and Desarda’s No-Mesh Repair in a District Hospital in India. ECA Afr J Surg. 2006;11(2):28-34.

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Published

2020-06-25

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Original Research Articles