Comparative study of open mesh repair and desarda’s no-mesh repair for Inguinal Hernia, in GMKMCH, Salem

Prakash, - (2016) Comparative study of open mesh repair and desarda’s no-mesh repair for Inguinal Hernia, in GMKMCH, Salem. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.


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BACKGROUND AND OBJECTIVES: Inguinal hernia is the most common among the hernias. The best treatment modality of it is primarily surgical. Improvements in surgical techniques of inguinal hernia repair have significantly improved the outcomes for patients. The success rate of hernia surgeries is mostly noted by its permanence, amount of complications, cost effectiveness, and duration to return to normal activity. Though mesh repair has gained popularity among the surgical repair of hernias, it has certain limitations like availability of mesh, cost, learning curve and complications associated with it. Hence this study is being carried out to compare the effectiveness of Desarda’s no mesh repair, a newer cost effective method, with the existing Lichtenstein’s tension free repair, and to decide on a better treatment for inguinal hernia repair based on the results of this study. METHODOLOGY: SOURCE OF DATA : The study was carried out in Government Mohan Kumaramangalam Medical College Hospital, Salem, over a period of 2 years. Study design : prospective study A total of 60 cases diagnosed to have inguinal hernia were included in the study fulfilling the inclusion and exclusion criteria. 30 patients were randomly subjected to Desarda’s technique and 30 patients underwent Lichtenstein’s repair METHODS OF COLLECTION OF DATA: Data for the proposed study was collected in a pretested proforma which included various parameters like type of hernia, duration of symptoms, type of hernia. Detailed history and physical examination were done. After surgical interventions, patients were followed up and noted for complications like Groin pain, Surgical site infections, Duration of hospital stay, Duration to return to normal activity RESULTS: There was no significant differences regarding age, sex, type of hernia, duration of hernia in both the groups. The operation time was 49 minutes in Desarda’s group and 54 minutes in the Lichtenstein group which was considered highly significant (p<0.01). Over a period of two year follow-up there were no recurrences in both the groups. There were no surgical site infections in the Desarda’s group when compared to Lichtenstein’s repair where there were 3 (10%) cases. The occurrences of other complications like Loss of sensation over the groin, Scrotal edema, abdominal wall stiffness were not seen in Desarda’s group, whereas its occurrence was highly significant (p<.01) in Lichtenstein’s group. The mean hospital stay was 4days in Desarda’s group while it was 6days in the Lichtenstein group in those patients who were hospitalized. CONCLUSION: Desarda’s repair is a physiologically sound, easy to learn and simple method when compared to other tissue repair techniques and requires no mesh. It can be performed under local anesthesia when patient is unfit for Regional/General anesthesia and is associated with a less duration of surgery and less mesh associated postoperative complications, with a rapid recovery time. It can be used in contaminated surgical fields in young individuals, and during financial constraints. Hence, Desarda’s no mesh repair is favorably comparable with Lichtenstein’s mesh repair. To conclude, Desarda’s no mesh repair, when compared to Lichtenstein’s mesh repair produces same or better results. Large scale study and long term follow up may be needed to identify recurrences.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Inguinal hernia ; desarda’s no mesh repair ; Lichenstein repair.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 27 Sep 2017 03:26
Last Modified: 27 Sep 2017 03:26

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