Post-Operative Outcome of Desarda Repair of Inguinal Hernia in Emergency Case in Bangladesh

Background: Desarda hernia repair has emerged as a recognized operative method for inguinal hernia repair. Objective: The purpose of the present study was to see the outcome of emergency inguinal hernia repair by Desarda technique. Methodology: This was an observational study was carried out in the Department of Surgery at Sher-E-Bangla Medical College Hospital, Barisal, Bangladesh and Private Hospital, Narayanganj, Bangladesh from August 2015 to January 2017. Twenty patient was operated by Desarda technique. Variables includes age, operating time, post-operative complications, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Result: Mean age of patient 50.25±18.9, Mean operating time was 78.4±9.64 mins. Majority 16 patient experienced mild post-operative pain measured in VAS score. Mean with SD of hospital stay was 5.05±2.16 days. Patient had developed different post-operative complications like wound infection in 2(10.0%) cases, scrotal edema in 5(25.0%) cases, seroma formation in 1(5.0%) case and no early recurrence and. Conclusion: In this study, it revealed that Desarda repair was associated with less post-operative complications, less post-operative pain, zero recurrence rate, no chronic groin pain and performed in emergency cases. So it is safe and most reliable technique for complicated (Incarcerated, Obstructed, Strangulated) inguinal hernia. Journal of Current and Advance Medical Research 2020;7(1): 44-48

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Repair of inguinal hernia by Desarda technique in both elective and emergency setting

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v45i3.44649 ◽

2019 ◽

Vol 45 (3) ◽

pp. 180-184

Author(s):

S.M. Iftekhar Uddeen Sagar ◽

Muhammad Syeef Khalid ◽

Abu Sayeed Md. Feroz Mustafa ◽

SM Nazrul Islam

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Inguinal Hernia Repair ◽

Groin Pain ◽

Operating Time ◽

Chronic Groin Pain ◽

Post Operative Pain ◽

Operative Complications ◽

Post Operative Complications

Background: Inguinal hernia is a common problem and its repair is one of the most commonly performed procedures in general surgical practice. Several methods have been developed including Lichtenstein’s repair. Among these Lichtenstein’s repair has been standard technique for last few decades. In recent time a new procedure “no mesh Desarda hernia repair” has emerged as a recognized operative method for inguinal hernia repair. Objectives: This study was conducted to evaluate the outcome of Desarda technique in repairing inguinal hernia. Methods: This was a single centered descriptive study to see the outcome of inguinal hernia repair by Desarda technique in both elective and emergency surgery carried out in the Dept. of Surgery, Sher-E-Bangla Medical College Hospital, Barisal from August, 2015 to July, 2016. Results: A total of 100 patients underwent Desarda repair for inguinal hernia including primary/recurrent and elective/ emergency cases. Variables includes age, type of surgery, operating time, post-operative complications, post-operative pain, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Mean age of patient was 48.9±9.07 years. Mean operating time was 43.72±9.64mins. Majority (54%) of the patient experienced mild post-operative pain on first day, measured in VAS score. Ten percent of patients developed different post-operative complications like wound infection (2%), seroma formation (1%) and scrotaledema (7%). Conclusion: In this study, it is revealed that no mesh Desarda repair for inguinal hernia was associated with less operating time, less post-operative pain, less post-operative complications, short hospital stay, zero recurrence rate, no chronic groin pain and performed in emergency cases also. So, it is safe and most reliable technique for all type of inguinal hernia surgery.

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Status of self-medication among the patients attending outpatient department in selected private hospitals in Dhaka city

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v45i3.44650 ◽

2019 ◽

Vol 45 (3) ◽

pp. 185-190

Author(s):

Md. Riyadh Hasan ◽

Nawzia Yasmin ◽

Nuhad Raisa Seoty ◽

Md. Maniul Hasan ◽

Maj. Gen. (Retd) Dr. M Shahjahan

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Inguinal Hernia Repair ◽

Groin Pain ◽

Operating Time ◽

Chronic Groin Pain ◽

Post Operative Pain ◽

Operative Complications ◽

Post Operative Complications

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Desarda’s versus Lichtenstein technique of inguinal hernia repair

International Surgery Journal ◽

10.18203/2349-2902.isj20175553 ◽

2017 ◽

Vol 5 (1) ◽

pp. 92

Author(s):

Obaid Syed

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Complication Rate ◽

Mesh Repair ◽

Post Operative Pain ◽

Significant Difference ◽

Duration Of Surgery ◽

Operative Complications ◽

The Mean

Background: Ideal method for modern hernia surgery should be simple, cost effective, safe, tension free and permanent. The Lichtenstein operation to a great extent achieves this entire goal. The Lichtenstein mesh repair is associated with complications, postoperative dysfunction and high cost composite meshes. Desarda's technique, became a new surgical option for tissue-based inguinal hernia repair. The present study was designed to evaluate and compare the effectiveness and complications of the Desarda’s repair with Lichtenstein tension-free mesh repair for treatment of inguinal hernia in a developing country.Methods: 200 patients with unilateral, primary, reducible inguinal hernia were selected. Included patients were randomly divided into two groups. Studied parameters were Duration of surgery, intra operative complications, post-operative Pain, Duration of hospital stay, return to normal activities, post-operative complications and recurrences.Results: There were a total of 100 patients each group. There was no statistically significant difference in duration of surgery and complication rate between the two groups. Difference in mean VAS was not statistically significant. The mean hospital stay in Desarda’s technique was 2.5 days while it was 2.6 days in Lichtenstein’s group. The mean time to return to basic physical activity in the Desarda’s technique was 12.6 days while it was 13.3 days in the Lichtenstein’s group. There were no recurrences in either group. Chronic inguinal pain (>1month) was more frequent in Lichtenstein’s group.Conclusions: There is no significant difference in duration of surgery, intra operative complication rate, post-operative pain, complications and recurrence, between Desarda’s technique and Lichtenstein’s technique. However chronic inguinal pain is less in Desarda’s technique. Desarda’s repair must be considered in young patients (<30 years). Its long-term efficacy needs to be studied with larger, prospective double-blind randomized trials, with longer follow-up.

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A comparative study of mesh fixation with polypropylene sutures (prolene) versus polyglactin sutures (vicryl) sutures in assessing inguinodynia in open inguinal hernia repair

International Surgery Journal ◽

10.18203/2349-2902.isj20210925 ◽

2021 ◽

Vol 8 (3) ◽

pp. 904

Author(s):

Ramesh S. Koujalagi ◽

Vinod Karagi ◽

Abhijit S. Gogate ◽

Nikhil M.

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Groin Pain ◽

Mesh Fixation ◽

Chronic Groin Pain ◽

Post Operative Pain ◽

Severity Scores ◽

Group A ◽

Polypropylene Sutures

Background: Inguinal hernia, the most frequently occurring type of hernia globally, Chronic groin pain could be related to nerve mangling while operating. Mesh repair can lead to an inflammatory reaction over a period of time, though it still needs ground work to find out exact cause of pain. So this study aims to compare the effectiveness of polyglactin versus prolene sutures in reducing the post-operative pain in inguinal hernia repair.Methods: A one year hospital prospective study in KLE hospital. A total of 60 adult patients were divided into two groups of 30 each. Mesh fixation with polyglactin sutures was group A (30) and mesh fixation with polypropylene sutures was group B (30) and then post-operative pain, was assessed. Follow-up was for 3 months. Collected data was analyzed using chi–square tests, Mann-Whitney U tests.Results: Our analysis showed that the incidence of postoperative groin pain with mean severity scores of 1.37±0.49 versus 1.43±0.50; 1.40±0.50 versus 1.57±0.73; 1.03±0.61 versus 1.50±0.057; 0.77±0.63 versus 1.30±0.79; at post-operative day 1, 3 in both groups were similar and statistically not significant whereas the 1 week and 3 months follow up in group A and B respectively, were significant (p<0.05).Conclusions: The post-op chronic groin pain is significantly low, hence routine usage of polyglactin sutures to fix a mesh is a safe and effective alternative to polypropylene sutures in Lichtenstein hernia repair.

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Robotic Inguinal Hernias Performed at a Community Hospital: a Case Series of 292 Patients

Surgical Technology Online ◽

10.52198/21.sti.39.hr1510 ◽

2021 ◽

Vol 39 ◽

Author(s):

Matthew McGuirk ◽

◽

Ziad Abouezzi ◽

Zubair Zoha ◽

Abbas Smiley ◽

...

Keyword(s):

Inguinal Hernia ◽

Postoperative Complications ◽

Hernia Repair ◽

Learning Curve ◽

Community Hospital ◽

Early Recurrence ◽

Operative Complications ◽

The Mean ◽

Robotic Inguinal Hernia Repair ◽

Post Operative Complications

Background: Robotic inguinal hernia repair has become more common and has replaced the laparoscopic approach in many hospitals in the US. We present a retrospective review of 416 consecutive inguinal hernia repairs using the robotic transabdominal preperitoneal approach in an academic community hospital. Methods: This is a retrospective review of 416 consecutive robotic inguinal hernia repairs in 292 patients performed from October 2015 to March 2021 by two surgeons. The demographics, intra-operative findings, and postoperative outcomes were analyzed. The results for patients during the initial 25 cases (which were considered to be during the learning curve for each surgeon) were compared to their subsequent cases. A multivariable logistic regression analysis was used to determine independent risk factors for postoperative complications. Results: Overall, 292 patients underwent 416 inguinal hernia repairs, of whom 124 (42.5%) had bilateral hernias. The mean age was 61 years and the mean BMI was 26.96 kg/m2. Of the bilateral hernias, 31.5% were unsuspected pre-operatively. Femoral hernias were found in 20.5% of patients, including in 18.4% of men, which were also unsuspected. Post-operatively, 89% of patients were discharged home the same day. The most common post-operative complication was seroma, which occurred in 13%. Three patients required re-intervention: one had deep SSI (infected mesh removal), one had a needle aspiration of a hematoma (SSORI), and one was operated on for small bowel volvulus related to adhesions. On short-term follow-up, there was only one early recurrence (0.2%). When cases during the learning curve period were compared to subsequent surgeries, there were no major differences in post-operative complications or operating time. Patients aged ≥55 years had a 2.456-fold (p=0.023) increased odds of post-operative complications. Conclusions: Robotic inguinal hernia repair can be safely performed at a community hospital with few early post-operative complications and very low early recurrence rates. The robotic approach also allows for the detection of a significant number of unsuspected contralateral inguinal hernias and femoral hernias, especially in male patients. Age ≥55 years was an independent risk factor for postoperative complications.

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A clinical study of inguinal hernia with special reference to laparoscopic trans-abdominal pre peritoneal repair

International Surgery Journal ◽

10.18203/2349-2902.isj20164456 ◽

2016 ◽

Vol 4 (1) ◽

pp. 282

Author(s):

Suraj Singh ◽

Rajkumar Prakash ◽

Vasundhara Singh

Keyword(s):

Inguinal Hernia ◽

Clinical Study ◽

Hernia Repair ◽

Abdominal Cavity ◽

Operating Time ◽

Abdominal Viscus ◽

Conversion To Open Surgery ◽

Early Return ◽

Operative Complications ◽

Post Operative Complications

Background:Hernia may be generally defined as the protrusion of an abdominal viscus outside the abdominal cavity through a natural or acquired defect. Latin meaning of the word “hernia” is tear or rupture. A Clinical study on inguinal hernia is undertaken to assess the incidence of inguinal hernia in relation to age, gender and occupation, the different types and modes of clinical presentation of patients, the management of patients with special consideration to laparoscopic (TAPP) repair, to evaluate the operating time, pre-operative and post-operative complications, duration of hospital stay, time taken for recovery, recurrence rate and limitations with respect to laparoscopic TAPP repair.Methods: This is a prospective study of 54 cases of inguinal hernia admitted and underwent surgery for inguinal hernia in Department of General Surgery in Guwahati Medical College and Hospital during the study period of August 2014 to July 2015.Results:The highest number of cases presenting with inguinal hernia were over 45 years and it was more common in males which constituted 96.3 percent of cases. It is more common on right side and indirect hernia is more common than direct hernia. The major possible risk factors are smoking and strenuous work. The commonest presenting mode was swelling followed by swelling with pain. The mean time taken for TAPP was 91.85±15.85 minutes and the median time was 87.50 minutes. There were no intra operative (neurovascular, visceral) complications in any of the patient and there was no conversion to open surgery. There was no mortality in present study and none of the patient had any testicular complication.Conclusions:Laparoscopic hernia repair is associated with steep learning curve for surgeons and is more costly both to patients and health care system in the present scenario. Laparoscopic TAPP hernia repair is found to have encouraging results which is a safe and viable option for repair of inguinal hernia with less postoperative pain and discomfort, improved cosmesis, less post-operative complications and early return to work.

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Desarda’s versus Lichtenstein’s mesh repair for inguinal hernia: A longitudinal study.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.08.4313 ◽

2020 ◽

Vol 27 (08) ◽

pp. 1621-1625

Author(s):

Uzair Ahmad ◽

Asif Anwar ◽

Muhammad Imran ◽

Zahid Aman

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Mesh Repair ◽

Categorical Variables ◽

Lichtenstein Repair ◽

Average Hospital ◽

Operative Complications ◽

Mesh Technique ◽

Post Operative Complications

Objectives: To compare the tissue based Desarda repair with Lichtenstein mesh technique for inguinal hernia in terms of operation time, hospital stay, return to normal activities, cost and post-operative complications such as seroma formation, surgical site infection and recurrence. Study Design: Randomized Controlled trial. Setting: Department of General Surgery Hayatabad Medical Complex, Peshawar, Pakistan. Period: June 2017 to June 2019. Material & Methods: Total of 150 male patients were selected using Non probability consecutive sampling technique. Patients were randomized into two groups using lottery method. 75 patients in group A underwent hernia repair with Desarda no mesh technique and 75 patients in group B underwent hernia repair by performing Lichtenstein mesh technique. Patients were followed up after 2 weeks, 1 month, 3 months, 6 months and 1 year. Data was evaluated using version 22 of SPSS and expressed as a standard deviation, mean. Independent-sample T test was used to compare continuous variables. Categorical variables were compared using Fischer’s exact test. P value of less than 0.05 was considered significant. Results: The mean age of Desarda group was 44.59±10.58 years while it was 44.44±10.30 years in the Lichtenstein group (P=0.932).Mean Operative time was less for Desarda repair (42.08 ± 3.42 min) when compared to Lichtenstein repair (49.01 ± 4.77min) (p=0.000). The average hospital stay after Desarda repair was 2.08±0.27 days and after Lichtenstein repair it was 3.00±0.40 days (p=0.000). After Desarda procedure the average duration to return to work was 11.10±2.32 days while it was 13.92±2.24 days in Lichtenstein procedure (p<0.0001). The total cost of the operation was (Rs 3893±293) in Desarda group and (Rs 7844±175) in the Lichtenstein group (p=0.000). When compared for observed postoperative complications like seroma, wound infection and recurrence in both groups all the p-values were > 0.05 and were non-significant statistically. Conclusion: In comparison to Lichtenstein mesh repair, Desarda technique is cost effective, easy to learn, patients have less hospital stay, less chances of post-operative complications and early return to basic physical activities However Desarda technique is not possible in patients having thin external oblique aponeurosis with divided fibers and here Lichtenstein technique is better option. Further long term randomized control trials are required on large-scale to evaluate this technique further.

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A Comparative evaluation of Non-descent vaginal hysterectomy versus total Abdominal hysterectomy: A hospital based case control study

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v17i1.25310 ◽

2019 ◽

Vol 17 (1) ◽

pp. 20-22

Author(s):

Durga BC ◽

Aseem Sharma ◽

Binod Mahaseth ◽

Nirmala Sharma

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Vaginal Hysterectomy ◽

Operating Time ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Benign Pathology ◽

Operative Complications ◽

Control Study ◽

Post Operative Complications

Background: Hysterectomy is a common surgery performed by gynecologist worldwide. It can be done either by vaginal, abdominal or laparoscopic route. Non decent vaginal hysterectomy (NDVH) is less invasive, less time consuming and scar less surgery. The blood loss during surgery, intra-operative and post-operative complications are less in NDVH compare to TAH (total abdominal hysterectomy). Aim and objective: to compare the clinical outcome between NDVH and TAH. Method: A hospital based prospective study was done at Nepalgunj medical collage Kolhapur between March 2018–March 2019, 60 cases fulfilling selection criteria were selected, 30 cases underwent NDVH next 30 cases underwent TAH. Outcome is measured on the basis of operating time, blood loss during surgery, hospital stay and post-operative complications. Result: The most common indication for hysterectomy was fibroid uterus in both the groups (NDVH and TAH). The operating time, blood loss, hospital stay and post-operative complications were less in NDVH as compare to TAH. Conclusion: NDVH is a choice of surgery over TAH for freely mobile uterus with benign pathology and uterus size less than twelve weeks and without adenexal pathology.

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