Study on the Outcomes of Desarda Repair in Inguinal Hernia Surgery

Abstract

BACKGROUND Inguinal hernias are one of the commonest problems encountered by the treating phsicians. Even though the learning curve for Lichtenstein hernioplasty is less, there is usage of a foreign body which may produce mesh reactions leading to various other surgical complications. Also the cost of the mesh is a little higher which may not be affordable for people belonging to low or very low socioeconomic class especially in developing countries like India. Desarda's repair is a tissue based technique of hernia repair using an undetached strip of external oblique aponeurosis to strengthen the posterior wall of the inguinal canal. METHODS This is a hospital based cross sectional study. All patients admitted to the hospital with the diagnosis of inguinal hernia and fulfilling the inclusion criteria were counselled about the study. After obtaining informed written consent, all the study participants were subjected to a standard questionnaire both pre operatively and post operatively. Patients were followed up for a period of 6 months for assessing chronic postoperative pain, to record the post-op day on which they resumed their regular activity and the recurrence rate. Those participants who were unable to attend the review were contacted through the phone and questionnaire was completed. RESULTS A total of 165 patients was studied between Oct 2017 and May 2019. Mean operating time was found to be 44.63 ± 7.76 mins; the cost for surgery in 99.4% was between Rs. 1000-2000; 2.4% patients had developed seroma and only 1 person developed haematoma; none of the subjects had infection or recurrence; 77.6% had a pain score of 4 on POD 1, 96.4% had a pain score 2 on POD 2; mean duration of hospital stay was 4.9 ± 0.99 days; mean duration of resuming duty was 18.58 ± 3.43 days. CONCLUSIONS Desarda's technique is cost effective and therefore can be done in patients of all socioeconomic classes. Our results in this study after Desarda repair are good and similar to the results of Liechtenstein or Shouldice techniques. Hence, Desarda method seems to be an attractive alternative. It is safe, fast, simple and easy to learn and perform with minimal complications or recurrence.