Habib Ahmed, Muhammad Tariq Nazir, Fakhar Irfan, Mudassar Murtaza, Ashfaq Nasir Khan
Pakistan Journal of Medical & Health Sciences

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Lichtenstein Versus Desarda Technique for Inguinal Hernia Repair: A Randomized Clinical Trial

Habib Ahmed, Muhammad Tariq Nazir, Fakhar Irfan, Mudassar Murtaza, Ashfaq Nasir Khan




Background: There are different techniques for the repair of inguinal hernia, whichcan be classified broadly intothe techniques usingprosthetic mesh andtissue-based techniques. The recent guidelines recommend the mesh repair as first choice, either by laparo-endoscopic technique or an open procedure.The Desarda’s operation is tissue based repair with comparable results to open mesh repair.

Aim:  To compare the results of Lichtenstein mesh repair (L group) with Desarda’s technique (D group).

Methods: 100 adult male patients with uncomplicated inguinal hernias were included; 50 in each group. Patients with intra operative finding of weak, thin or split fibers external oblique aponeurosis were excluded. The patients were followed in terms of postoperative and chronic pain, time taken to start basic activities and work, recurrence of hernia and other complications.

Results:Operating time was comparable in both groups. 6% patients in L group and 4% in D group had mild to moderate groin pain within 30 days. It resolved in all patients except in one patient in L group, who had chronic mild groin pain. Patients in D group took less time to return to basic activities and work than patients in L group. 4% patients in L group and 2% in D group had surgical site infection. Scrotal edemaoccurred in 6% in L group 4% in D group and it resolved in all patients in both groups within 30 days. 6% in L group and 8% in D group suffered wound hematoma; out of these only 1 patient (2%) in L groupneeded operative drainage. Wound seroma occurred in 6% in L group and 2 % in D group; out of these 1 patient needed aspiration once in L group; others resolved spontaneously. There was no recurrence of hernia in both groups in our study.

Conclusion:Inguinal hernia can be treated successfully without mesh by Desarda repair technique. Its recurrence rates are comparable to the standard Lichtenstein mesh repair with less complications. However, intraoperative finding of weak, thin, or splitfibers of external oblique aponeurosis is the basic hindrance in Desarda technique.

Keywords: Inguinal hernia, Lichtenstein, Desarda

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