Volume : VII, Issue : VIII, August - 2018

DESARDA'S NO-MESH NO-TENSION REPAIR OF INGUINAL HERNIA - IT'S MERITS AND DEMERITS

Abhishek Biswas, Pranab Kumar Mandal, Syamantak Basu, Sushil Kumar Paira

Abstract :

 Background: Inguinal herniae are the most common types of hernia encountered in the most part of the world.

Inguinal hernia remains an important health care problem . In the history of inguinal hernia surgery there have been
many methods and modification of many methods of hernia surgery . Desarda,s technique is one method of inguinal
hernia repair which does not use any mesh and is based on no–tension local tissue repair.
Aim: The objective of this study was to study the efficacy of Desarda,s technique of inguinal hernia repair and the
merits and demerits of the procedure.
Materials and Methods : It was a prospective cross–sectional instituition based observational study carried out in the
department of surgery of North Bengal Medical College in the period from January 2015 to June 2016. The study
included a total of 55 patients in the age group of 18 year to 70 year having primary uncomplicated and complicated
inguinal hernia. The final inclusion criterion was the condition of the external oblique aponeurosis. Patients with thin,
divided, weak aponeurotic fies were excluded from the study. Patients of inguinal hernia of Nyhus Class 3 and Nyhus
Class 4 were also excluded from the study. Every patient was clinically assessed and evaluated by laboratory
investigations. After a proper counseling and informed consent form got signed by the patient they were operated
under spinal anaesthesia and hernia was repaired by Desarda,s technique. After operation all the patients were
followed up for a period of 3 months to 1 year. Parameters studied were 1. Age and sex 2. Inguinal hernia complicated
or uncomplicated 3.side of hernia 4. Nyhus class of inguinal hernia 5. Time taken for the surgery 6. Time taken for
discharge 7. Pain score as per Visual Analogue Scale ( VAS ) at discharge 8. VAS score at 3 months 9. Return to basic
activity 10. Haematoma 11.Seroma 12. Surgical site infection 13. Recurrence of hernia 14.Inguinodynia – presence of groin
pain on the side of surgery on walking even after 3 months of surgery.
Results: Out of 55 patients 54 were male and 1 was female in the age group between 22 and 65 and having 25
right inguinal hernia and 30 left inguinal hernia. Out of 55 herniae operated 13 (23.6% ) were Nyhus Class 1 and 42 (
76.4% ) were Nyhus Class 2. 49 ( 89.1% ) cases of herniae were operated electively and 6 (10.9% ) were operated under
emergency setup. This study has recorded no reccurence of hernia after a follow–up of maximum period of 1.5 years
and a minimum period of 3 months. At 3 months of follow–up of 55 patients undergone inguinal hernia repair by
Desarda,s technique 5 (9.1% ) had chronic non–healing wound 4 (7.3% ) due to surgical site infection which resolved on
treatment, 1 (1,8% ) had scrotal haematoma , 1 (1.8% ) had inguinodynia managed with pregabalin and cured. The mean
operating time was 32.76 ± 5.78 mins. Most of the patients could be discharged on the second day after hernia
operation while some patients needed more time upto 5 days for discharge (2.18± 0.782 days ). The VAS score at
discharge was 23.06 ± 6.33 mm on the Visual Analogue Scale. One patient experienced chronic groin pain at 3 months
with a VAS score of 40 mm. All the patients could return to basic need activity by the second day after surgery with
a mean of 1.18 ± 0.4 days.
Conclusion: Over a perod of follow–up of 3 months to 18 months of 55 cases of Nyhus Class 1 and Nyhus Class 2
inguinal hernia which were repaired by Desarda,s technique, there was no recurrence of hernia. However a morbidity of
19.2% was recorded. The commonest complication noted was surgical site infection (16.4% ) both immediate and late.
One patient developed a haematoma and another patient developed inguinodynia.

Article: Download PDF    DOI : https://www.doi.org/10.36106/paripex  

Cite This Article:

Abhishek Biswas, Pranab Kumar Mandal, Syamantak Basu, Sushil Kumar Paira, DESARDA‘S NO-MESH NO-TENSION REPAIR OF INGUINAL HERNIA‾IT‘S MERITS AND DEMERITS, PARIPEX‾INDIAN JOURNAL OF RESEARCH : Volume-7 | Issue-8 | August-2018


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