Desarda versus Lichtenstein technique for primary inguinal hernia treatment: 3-year results of a randomized clinical trial

Jacek Szopinski, Stanislaw Dabrowiecki, Stanislaw Pierscinski, Marek Jackowski, Maciej Jaworski, Zbigniew Szuflet, Jacek Szopinski, Stanislaw Dabrowiecki, Stanislaw Pierscinski, Marek Jackowski, Maciej Jaworski, Zbigniew Szuflet

Abstract

Background: The Shouldice method and other tissue-based techniques are still acknowledged to be acceptable for primary inguinal hernia repair according to the European Hernia Society guidelines. Desarda's technique, presented in 2001, is an original hernia repair method using an undetached strip of external oblique aponeurosis. This randomized trial compared outcomes after hernia repair with Desarda (D) and mesh-based Lichtenstein (L) techniques.

Methods: A total of 208 male patients were randomly assigned to the D or L group (105 vs. 103, respectively). The primary outcomes measured were recurrence and chronic pain. Additionally, early and late complications, foreign body sensation, and return to everyday activity were examined in hospital and at 7, 30 days, and 6, 12, 24, and 36 months after surgery.

Results: During the follow-up, two recurrences were observed in each group (p = 1.000). Chronic pain was experienced by 4.8 and 2.9% of patients from groups D and L, respectively (p = 0.464). Foreign body sensation and return to activity were not different between the groups. There was significantly less seroma production in the D group (p = 0.004).

Conclusions: The results of primary inguinal hernia repair with the Desarda and Lichtenstein techniques are comparable at the 3-year follow-up. The technique may potentially increase the number of tissue-based methods available for treating groin hernias.

Figures

Fig. 1
Fig. 1
Trial flow chart
Fig. 2
Fig. 2
Desarda’s method. The undetached aponeurotic strip (3) is created and displaced from the anterior to the posterior wall of the inguinal canal. It was then secured to the abdominal internal oblique muscle (1) with interrupted sutures (2) and to the inguinal ligament

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