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

Abstract

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.