Efficacy of Desarda's in Comparison to Lichenstien's Techniques for Primary Inguinal Hernia Repair Regarding to Operative and Post-operative Parameters

Abd-El-Aal Ali Saleem; Islam Ahmed Amer; Emad Gomaa

doi:doi:10.11648/j.js.20210903.17

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Efficacy of Desarda's in Comparison to Lichenstien's Techniques for Primary Inguinal Hernia Repair Regarding to Operative and Post-operative Parameters

Abd-El-Aal Ali Saleem, Islam Ahmed Amer, Emad Gomaa

Published in Journal of Surgery (Volume 9, Issue 3)

Received: 20 April 2021 Accepted: 25 May 2021 Published: 31 May 2021

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Abstract

Background: The aim was to assess the efficacy and safety of Desarda’s no-mesh repair in comparison to Lichtenstein’s tension -free mesh repair in treatment of primary inguinal hernia. Methods: a prospective study of 80 patients suffering from unilateral primary inguinal hernia who underwent elective operation for hernia repair. The patients were of both males and females their age ranged from 20 - 60 years. They were divided into two groups (A and B). Group A: 40 patients were subjected to Desarda’s no mesh repair. Group B: 40 patients were subjected to Lichtenstein’s tension free mesh repair. The data were collected within one year including sociodemograghic data, general and local examination, co-morbidities, type and duration of inguinal hernia, type of operation, intra- and post -operative parameters, hospital stay and recurrence. Results: Demographic parameters, general examination, duration, type of hernia and co-morbidities in the two intervention arms were similar and shows insignificant difference. 35.5 minutes was the operative time in Desarda’s group and 46 minutes in Lichtenstein’s group which was highly significant (p<0.0001). Post-operative pain, loss of sensation over groin, chronic inguinal pain (>1 month), hospital stay duration and return to normal activity were significantly decreased in Desarda’s group in comparison to Lichtenstein’s group (P<0.0001& P<0.01 & P<0.01 & P<0.0001, P<0.001, respectively). Foreign body sensation and reaction, abdominal wall stiffness and migration of mesh occurs only in Lichtenstein’s group. Hematoma, seroma, scrotal edema, surgical site infection and fever shows insignificant deference between the studied groups but more prevalent in Lichtenstein’s group than Desarda’s group (P=0.49 & P=0.26 & P=0.21 & P=0.09 and P=0.67, respectively). No recurrences of hernia in both studded groups through 1- year follow-up. Conclusion: This study has shown that Desarda’s repair for primary inguinal hernia gives better results when compared with the Lichtenstein’s repair. It is easy to learn and it is physiologically sound. It is associated with less operative duration and mesh related complications. It can be used in a contaminated surgical field, in young individuals and in cases of financial constraints.

Published in	Journal of Surgery (Volume 9, Issue 3)
DOI	10.11648/j.js.20210903.17
Page(s)	134-144
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Desarda’s Technique, Lichtenstein’s Technique, Primary Inguinal Hernia

References

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[2]	Schwartz's Principles of Surgery:- 10th edition. McGraw Hill Education; 2014; 37.
[3]	Zinner MJ, Ashley SW. Maingot’s Abdominal Operations. 12th ed. Boston, Massachusetts: McGraw Hill Publishers; 2018. 127.
[4]	Courtney M, Townsend JR, Beauchamp RD, Evers BM, Mattox KL, eds: Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 17th ed: Elsevier Inc. 2007.
[5]	Szopinski J, Dabrowiecki S, Pierscinski S, Jackowski M, Jaworski M, Szuflet Z: Desarda versus Lichtenstein technique for primary inguinal hernia treatment: 3-year results of a randomized clinical trial. World J Surg. 2012 May 1; 36 (5): 984-92.
[6]	Rodríguez P, Herrera PP, Gonzalez OL, Alonso JR, Blanco HS: A randomized trial comparing lichtenstein repair and no mesh desarda repair for inguinal hernia: a study of 1382 patients. East Central Af J Surg. 2013; 18 (2): 18-25.
[7]	Amid PK: Lichtenstein tension-free hernioplasty: its inception, evolution, and principles. Hernia. 2004; 8 (1): 1-7.
[8]	Desarda MP: Physiological repair of inguinal hernia: a new technique (study of 860 patients). Hernia. 2006 Apr 1; 10 (2): 143-6.
[9]	Desarda MP: Inguinal herniorrhaphy with an undetached strip of external oblique aponeurosis: a new approach used in 400 patients. Europ J Surg. 2001 Jun 1; 167 (6): 443-8.
[10]	Prakash et al: Comparative study of open mesh repair and Desarda’s no-mesh repair for inguinal hernia, in GMKMCH, Salem, India. Int Surg J. 2018 Sep; 5 (9): 3139-3145.
[11]	Mitura K, Romańczuk M: Comparison between two methods of inguinal hernia surgery – Lichtenstein and Desarda. Pol Merkur Lekarski 2008; 24: 392-5.
[12]	Youssef T, El-Alfy K, Farid M: Randomized clinical trial of Desarda versus Lichtenstein repair for treatment of primary inguinal hernia. Int J Surg. 2015; 20: 28-34.
[13]	Gupta A, Sharma SC, Sharma JP, Singhal P. Comparison of tension free Desarda technique with Lichtenstein for inguinal hernia repair. International Surgery Journal 2019; 6 (5): 1528-33.
[14]	Manyilirah W, Kijjambu S, Upoki A, Kiryabwire J: Comparison of non-mesh (Desarda) and mesh (Lichtenstein) methods for inguinal hernia repair among black African patients: a short-term double- blind RCT. Hernia. 2012; 16 (2): 133-44.
[15]	Szczesny W, Szopinski J, Reslinski A: Early postoperative pain after Lichtenstein and Desarda hernioplasty. Polish Surg. 2010; 12: 67-75.
[16]	Horstmann R, Hellwig M, Classen C et al: 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: 1742–1749.
[17]	Staerkle RF, Buchli C, Villiger P: Patient satisfaction, hernia recurrence rate, and chronic pain 10 years after endoscopic total extraperitoneal inguinal hernia repair. Surg Laparosc Endosc Percutan Tech.; 2009. 19: 405–409.
[18]	Desarda MP: Surgical physiology of inguinal hernia repair-a study of 200 cases. BMC Surg. 2003 Dec; 3 (1): 2.

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APA Style

Abd-El-Aal Ali Saleem, Islam Ahmed Amer, Emad Gomaa. (2021). Efficacy of Desarda's in Comparison to Lichenstien's Techniques for Primary Inguinal Hernia Repair Regarding to Operative and Post-operative Parameters. Journal of Surgery, 9(3), 134-144. https://doi.org/10.11648/j.js.20210903.17

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ACS Style

Abd-El-Aal Ali Saleem; Islam Ahmed Amer; Emad Gomaa. Efficacy of Desarda's in Comparison to Lichenstien's Techniques for Primary Inguinal Hernia Repair Regarding to Operative and Post-operative Parameters. J. Surg. 2021, 9(3), 134-144. doi: 10.11648/j.js.20210903.17

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AMA Style

Abd-El-Aal Ali Saleem, Islam Ahmed Amer, Emad Gomaa. Efficacy of Desarda's in Comparison to Lichenstien's Techniques for Primary Inguinal Hernia Repair Regarding to Operative and Post-operative Parameters. J Surg. 2021;9(3):134-144. doi: 10.11648/j.js.20210903.17

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@article{10.11648/j.js.20210903.17,
  author = {Abd-El-Aal Ali Saleem and Islam Ahmed Amer and Emad Gomaa},
  title = {Efficacy of Desarda's in Comparison to Lichenstien's Techniques for Primary Inguinal Hernia Repair Regarding to Operative and Post-operative Parameters},
  journal = {Journal of Surgery},
  volume = {9},
  number = {3},
  pages = {134-144},
  doi = {10.11648/j.js.20210903.17},
  url = {https://doi.org/10.11648/j.js.20210903.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210903.17},
  abstract = {Background: The aim was to assess the efficacy and safety of Desarda’s no-mesh repair in comparison to Lichtenstein’s tension -free mesh repair in treatment of primary inguinal hernia. Methods: a prospective study of 80 patients suffering from unilateral primary inguinal hernia who underwent elective operation for hernia repair. The patients were of both males and females their age ranged from 20 - 60 years. They were divided into two groups (A and B). Group A: 40 patients were subjected to Desarda’s no mesh repair. Group B: 40 patients were subjected to Lichtenstein’s tension free mesh repair. The data were collected within one year including sociodemograghic data, general and local examination, co-morbidities, type and duration of inguinal hernia, type of operation, intra- and post -operative parameters, hospital stay and recurrence. Results: Demographic parameters, general examination, duration, type of hernia and co-morbidities in the two intervention arms were similar and shows insignificant difference. 35.5 minutes was the operative time in Desarda’s group and 46 minutes in Lichtenstein’s group which was highly significant (p1 month), hospital stay duration and return to normal activity were significantly decreased in Desarda’s group in comparison to Lichtenstein’s group (P<0.0001& P<0.01 & P<0.01 & P<0.0001, P<0.001, respectively). Foreign body sensation and reaction, abdominal wall stiffness and migration of mesh occurs only in Lichtenstein’s group. Hematoma, seroma, scrotal edema, surgical site infection and fever shows insignificant deference between the studied groups but more prevalent in Lichtenstein’s group than Desarda’s group (P=0.49 & P=0.26 & P=0.21 & P=0.09 and P=0.67, respectively). No recurrences of hernia in both studded groups through 1- year follow-up. Conclusion: This study has shown that Desarda’s repair for primary inguinal hernia gives better results when compared with the Lichtenstein’s repair. It is easy to learn and it is physiologically sound. It is associated with less operative duration and mesh related complications. It can be used in a contaminated surgical field, in young individuals and in cases of financial constraints.},
 year = {2021}
}

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TY - JOUR
T1 - Efficacy of Desarda's in Comparison to Lichenstien's Techniques for Primary Inguinal Hernia Repair Regarding to Operative and Post-operative Parameters
AU - Abd-El-Aal Ali Saleem
AU - Islam Ahmed Amer
AU - Emad Gomaa
Y1 - 2021/05/31
PY - 2021
N1 - https://doi.org/10.11648/j.js.20210903.17
DO - 10.11648/j.js.20210903.17
T2 - Journal of Surgery
JF - Journal of Surgery
JO - Journal of Surgery
SP - 134
EP - 144
PB - Science Publishing Group
SN - 2330-0930
UR - https://doi.org/10.11648/j.js.20210903.17
AB - Background: The aim was to assess the efficacy and safety of Desarda’s no-mesh repair in comparison to Lichtenstein’s tension -free mesh repair in treatment of primary inguinal hernia. Methods: a prospective study of 80 patients suffering from unilateral primary inguinal hernia who underwent elective operation for hernia repair. The patients were of both males and females their age ranged from 20 - 60 years. They were divided into two groups (A and B). Group A: 40 patients were subjected to Desarda’s no mesh repair. Group B: 40 patients were subjected to Lichtenstein’s tension free mesh repair. The data were collected within one year including sociodemograghic data, general and local examination, co-morbidities, type and duration of inguinal hernia, type of operation, intra- and post -operative parameters, hospital stay and recurrence. Results: Demographic parameters, general examination, duration, type of hernia and co-morbidities in the two intervention arms were similar and shows insignificant difference. 35.5 minutes was the operative time in Desarda’s group and 46 minutes in Lichtenstein’s group which was highly significant (p1 month), hospital stay duration and return to normal activity were significantly decreased in Desarda’s group in comparison to Lichtenstein’s group (P<0.0001& P<0.01 & P<0.01 & P<0.0001, P<0.001, respectively). Foreign body sensation and reaction, abdominal wall stiffness and migration of mesh occurs only in Lichtenstein’s group. Hematoma, seroma, scrotal edema, surgical site infection and fever shows insignificant deference between the studied groups but more prevalent in Lichtenstein’s group than Desarda’s group (P=0.49 & P=0.26 & P=0.21 & P=0.09 and P=0.67, respectively). No recurrences of hernia in both studded groups through 1- year follow-up. Conclusion: This study has shown that Desarda’s repair for primary inguinal hernia gives better results when compared with the Lichtenstein’s repair. It is easy to learn and it is physiologically sound. It is associated with less operative duration and mesh related complications. It can be used in a contaminated surgical field, in young individuals and in cases of financial constraints.
VL - 9
IS - 3
ER -

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Author Information

Abd-El-Aal Ali Saleem

Department of General Surgery, Faculty of Medicine, Sohag University, Sohag, Egypt
Islam Ahmed Amer

Department of General Surgery, Maxillofacial head and neck unit, Faculty of Medicine, Sohag University, Sohag, Egypt
Emad Gomaa

Department of General Surgery, Faculty of Medicine, Sohag University, Sohag, Egypt

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APA Style

Abd-El-Aal Ali Saleem, Islam Ahmed Amer, Emad Gomaa. (2021). Efficacy of Desarda's in Comparison to Lichenstien's Techniques for Primary Inguinal Hernia Repair Regarding to Operative and Post-operative Parameters. Journal of Surgery, 9(3), 134-144. https://doi.org/10.11648/j.js.20210903.17

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ACS Style

Abd-El-Aal Ali Saleem; Islam Ahmed Amer; Emad Gomaa. Efficacy of Desarda's in Comparison to Lichenstien's Techniques for Primary Inguinal Hernia Repair Regarding to Operative and Post-operative Parameters. J. Surg. 2021, 9(3), 134-144. doi: 10.11648/j.js.20210903.17

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AMA Style

Abd-El-Aal Ali Saleem, Islam Ahmed Amer, Emad Gomaa. Efficacy of Desarda's in Comparison to Lichenstien's Techniques for Primary Inguinal Hernia Repair Regarding to Operative and Post-operative Parameters. J Surg. 2021;9(3):134-144. doi: 10.11648/j.js.20210903.17

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@article{10.11648/j.js.20210903.17,
  author = {Abd-El-Aal Ali Saleem and Islam Ahmed Amer and Emad Gomaa},
  title = {Efficacy of Desarda's in Comparison to Lichenstien's Techniques for Primary Inguinal Hernia Repair Regarding to Operative and Post-operative Parameters},
  journal = {Journal of Surgery},
  volume = {9},
  number = {3},
  pages = {134-144},
  doi = {10.11648/j.js.20210903.17},
  url = {https://doi.org/10.11648/j.js.20210903.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210903.17},
  abstract = {Background: The aim was to assess the efficacy and safety of Desarda’s no-mesh repair in comparison to Lichtenstein’s tension -free mesh repair in treatment of primary inguinal hernia. Methods: a prospective study of 80 patients suffering from unilateral primary inguinal hernia who underwent elective operation for hernia repair. The patients were of both males and females their age ranged from 20 - 60 years. They were divided into two groups (A and B). Group A: 40 patients were subjected to Desarda’s no mesh repair. Group B: 40 patients were subjected to Lichtenstein’s tension free mesh repair. The data were collected within one year including sociodemograghic data, general and local examination, co-morbidities, type and duration of inguinal hernia, type of operation, intra- and post -operative parameters, hospital stay and recurrence. Results: Demographic parameters, general examination, duration, type of hernia and co-morbidities in the two intervention arms were similar and shows insignificant difference. 35.5 minutes was the operative time in Desarda’s group and 46 minutes in Lichtenstein’s group which was highly significant (p1 month), hospital stay duration and return to normal activity were significantly decreased in Desarda’s group in comparison to Lichtenstein’s group (P<0.0001& P<0.01 & P<0.01 & P<0.0001, P<0.001, respectively). Foreign body sensation and reaction, abdominal wall stiffness and migration of mesh occurs only in Lichtenstein’s group. Hematoma, seroma, scrotal edema, surgical site infection and fever shows insignificant deference between the studied groups but more prevalent in Lichtenstein’s group than Desarda’s group (P=0.49 & P=0.26 & P=0.21 & P=0.09 and P=0.67, respectively). No recurrences of hernia in both studded groups through 1- year follow-up. Conclusion: This study has shown that Desarda’s repair for primary inguinal hernia gives better results when compared with the Lichtenstein’s repair. It is easy to learn and it is physiologically sound. It is associated with less operative duration and mesh related complications. It can be used in a contaminated surgical field, in young individuals and in cases of financial constraints.},
 year = {2021}
}

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