COMPARISON OF DESARDA METHOD VERSUS LICHTENSTEIN METHOD FOR THE MANAGEMENT OF INGUINAL HERNIA: A SHORT-TERM OUTCOME ANALYSIS

ANURAG SARASWAT; FAHAD TAUHEED; PURSHOTAM DASS GUPTA; RAGHAVENDRA VIKRAM SINGH; ASHOK BHATNAGAR

doi:10.22159/ajpcr.2023.v16i3.47365

Authors

ANURAG SARASWAT Department of General Surgery, School of Medical Sciences and Research, Sharda University, Greater Noida.
FAHAD TAUHEED Department of General Surgery, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi.
PURSHOTAM DASS GUPTA Department of General Surgery, School of Medical Sciences and Research, Sharda University, Greater Noida.
RAGHAVENDRA VIKRAM SINGH Department of General Surgery, School of Medical Sciences and Research, Sharda University, Greater Noida.
ASHOK BHATNAGAR Department of General Surgery, School of Medical Sciences and Research, Sharda University, Greater Noida.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i3.47365

Keywords:

Inguinal hernia, Desarda method, Lichtenstein method, Post-operative pain, Complications

Abstract

Objective: Lichtenstein method is a gold standard surgery modality for the management of inguinal hernia but it is associated with post-operative complications such as groin pain, abdominal wall thickness, and surgical site infections. Desarda method is a physiologic non-mesh repair with no anticipated mesh related complications. The present prospective randomized study was conducted to compare short term outcomes of Desarda with Lichtenstein technique for the management of inguinal hernia.

Methods: This was a prospective randomized study conducted on 60 patients undergoing surgery for inguinal hernia. The patients were allocated into two groups as follows, Group A (n=30) patients undergoing Desarda’s repair for inguinal hernia and Group B (n=30) patients undergoing Lichtenstein’s repair. The following outcome was measured, post-operative pain (Day 1, Day 3, Day 5) – visual analog scale, duration of hospital stay and complications. p value <0.05 was considered significant.

Results: The demographics characteristic were similar in both the groups and not significant. The hospital stay duration was lower in Desarda group as compared to Lichtenstein groups and was significant (4.07±0.83 vs. 6.87±1.87 days). The post-operative VAS score at day 1, 3, and 5 were significantly lower in Desarda group as compared to Lichtenstein group. The incidence of complications were lesser in Desarda group as compared to Lichtenstein group but not significant.

Conclusion: The Desarda technique was superior when compared to Lichtenstein method in terms of early recovery, post-operative pain, and complications for the management of inguinal hernia.

Downloads

Download data is not yet available.

References

Sultan B, Qureshi Z, Malik MA. Frequency of external hernias in Ayub Teaching Hospital Abbottabad. J Ayub Med Coll Abbottabad 2009;21:57-8. PMID 20929014

Rao SS, Singh P, Gupta D, Narang R. Clinicoepidemiologic profile of inguinal hernia in rural medical college in central India. J Mahatma Gandhi Inst Med Sci 2016;21:116-21. doi: 10.4103/0971-9903.189543

Kingsnorth A, LeBlanc K. Hernias: Inguinal and incisional. Lancet 2003;362:1561-71. doi: 10.1016/S0140-6736(03)14746-0, PMID 14615114

Abebe MS, Tareke AA, Alem A, Debebe W, Beyene A. Worldwide magnitude of inguinal hernia: Systematic review and meta-analysis of population-based studies. SAGE Open Med 2022;10:1-9. doi: 10.1177/20503121221139150, PMID 36457844

Simons MP, Kleijnen J, van Geldere D, Hoitsma HF, Obertop H. Role of the Shouldice technique in inguinal hernia repair: A systematic review of controlled trials and a meta-analysis. Br J Surg 1996;83:734- 8. doi: 10.1002/bjs.1800830606, PMID 8696728

Amid PK, Shulman AG, Lichtenstein IL. The Lichtenstein open tension-free mesh repair of inguinal Hernias. Surg Today 1995;25:619- 25. PMID 8658283

Agrawal A, Avill R. Mesh migration following repair of inguinal hernia: A case report and review of literature. Hernia 2006;10:79-82. doi: 10.1007/s10029-005-0024-8, PMID 16258705

Aasvang EK, Møhl B, Bay-Nielsen M, Kehlet H. Pain related sexual dysfunction after inguinal herniorrhaphy. Pain 2006;122:258-63. doi: 10.1016/j.pain.2006.01.035, PMID 16545910

Desarda MP. No-mesh inguinal hernia repair with continuous absorbable sutures: A dream or reality? (A study of 229 patients). Saudi J Gastroenterol 2008;14:122-7. doi: 10.4103/1319-3767.41730, PMID 19568520

Desarda MP. New method of inguinal hernia repair: A new solution. ANZ J Surg 2001;71:241-4. doi: 10.1046/j.1440-1622.2001.02092.x, PMID 11355734

Jones P, Jones S, Guarnieri F, Moscatelli F, Smaldone W, Nwamba C, et al. Topic: Inguinal Hernia-mesh vs non mesh. Hernia 2015;19(Suppl 1):S265-6. doi: 10.1007/BF03355369, PMID 26518821

Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009;13:343-403. doi: 10.1007/s10029-009-0529-7, PMID 19636493

Grant A, Go P, Fingerhut A, Kingsnorth A, Merello J, O’Dwyer P. Repair of groin hernia with synthetic mesh: Meta-analysis of randomized controlled trials. Ann Surg 2002;235:322-32. doi: 10.1097/00000658- 200203000-00003, PMID 11882753

Rosenberg J, Bisgaard T, Kehlet H, Wara P, Asmussen T, Juul P, et al. Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults. Dan Med Bull 2011;58:C4243. PMID 21299930

Naveen N, Srinath R. A comparative study between modified Bassini’s repair and Lichtenstein mesh repair (LMR) of inguinal hernias in rural population. J Clin Diagn Res 2014;8:88-91. doi: 10.7860/ JCDR/2014/7431.4016, PMID 24701491

Neogi P, Gupta V, Tripathi N. A comparative study of outcomes of Lichtenstein repair and Desarda tissue repair in patients of inguinal hernia. Int Surg J 2017;4:2693-99. doi: 10.18203/2349-2902. isj20173407

Ramu AH, Kenchetty P, Chidananda AK. Desarda versus Lichenstein repair in treatment of inguinal hernia: Our experience in KVG Medical College and Hospital. Int Surg J 2021;9:111-7. doi: 10.18203/2349- 2902.isj20215141

Arafa A, Saad H, Fayek F. Desarda vs Lichtenstein technique for the treatment of primary inguinal hernia. Egypt J Surg 2020;39:157-65. doi: 10.4103/ejs.ejs_165_19

Gedam BS, Bansod PY, Kale VB, Shah Y, Akhtar M. A comparative study of Desarda’s technique with Lichtenstein mesh repair in treatment of inguinal hernia: A prospective cohort study. Int J Surg 2017;39:150- 5. doi: 10.1016/j.ijsu.2017.01.083, PMID 28131917

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;16:133-44. doi: 10.1007/s10029-011-0883-0, PMID 21983842

Vupputuri H, Kumar R, Subramani P, Venugopal K. A single-blind, randomized controlled study to compare Desarda technique with Lichtenstein technique by evaluating short-and long-term outcomes after 3 years of follow-up in primary inguinal hernias. Int J Abdom Wall Hernia Surg 2019;2:16-22. doi: 10.4103/ijawhs.ijawhs_21_18