TMSS Medical College Journal

Aims: To assess and compare the efficacy of Desarda’s no mesh repair over prosthetic mesh hernia repair (Lichenstein) for the treatment of primary inguinal hernia. Methods and Material: This prospective study was carried out in the Department of Surgery at Shaheed Ziaur Rahman Medical College Hospital, Bogra from January 2014 to December 2016. A total of 100 male patients were randomly assigned. 50 patients were operated by Desarda’s no mesh repair technique (D group) and 50 patients were operated by prosthetic mesh hernia repair (Lichenstein) (L- group). The outcomes in terms of early and late complications were evaluated in each group and compared. Results: In L-group 07 patients were noticed by early and late complications. In D-group two (02) patient was affected by early complication. The outcomes in each group were statistically analyses using Chi-Square test. Conclusions: The efficacy of Desarda’s no mesh repair looks very ggod. It has minimum postoperative complication and no recurrence. This reason Desarda’s no mesh repair based on physiological principle has good potential to become a standard procedure in groin hernia repair. Key-words: Inguinal hernia, Lichtenstein repair, Desarda’s no mesh repair

Inguinal hernias are one of the most common surgical problem in all over the world. The estimated lifetime risk for inguinal hernia is 27% for men and 3% for women." Annual morbidity rates in various countries vary from 100 to 300 per 100,000 citizens.” Inguinal hernia repair is one of the most frequently performed surgical procedures worldwide. Better surgical techniques and good understanding of the anatomy and physiology of the inguinal canal have no doubtly improved the outcomes patients after surgery. The Desarda’s no mesh repair technique presented in 2001, is an original hernia repair method using an undetached strip of External Oblique Apo neurosis (EOA). In the European Hernia Society (EHS) guidelines, prosthetic mesh hernia repair (Lichenstein) is particular one and endoscopic methods are recommended for treatment of symptomatic primary inguinal hernia in adult men. In a departure from this firm opinion presented by the EHS, the Shouldice method has been acknowledged to be acceptable as well. The synthetic prostheses most often used in the inguinal area can create new clinical problems, such as foreign body sensation in the groin, discomfort, and abdominal wall stiffness, which may affect the everyday functioning of the patient. Surgical-site infections, often with clinical symptoms delayed for many years, are more frequent after hernia treatment using mesh.” © Migration of the mesh from the primary site of implantation in the abdominal cavity is one of the most dangerous complications.” Intense chronic inflammatory process typically associated with foreign body reactions around the mesh prosthesis may produce meshoma or plugoma tumors, the treatment of which becomes a new surgical challenge.'""> Additionally, procreation and sexual function are reported seriously affected after surgical hernia treatment with mesh.*'* Thus, we are still far from accomplishing everything in the hernia surgical field, and complications remain the major clinical issue. The observed complication rates and postoperative dysfunction have influenced many investigators to look for new hernia repair techniques or to modify old ones. An example of such efforts is the Desarda method, which was presented in 2001 and became a new surgical option for tissue-based groin hernia repair.'*