Comparative Study of Open Mesh Repair and Desarda's No-Mesh Repair in a District Hospital in India

Background: The first author has described a new technique of pure tissue hernia repair and published his results previously^1,2. This article describes the results of a comparative study of this new technique and the open mesh repair done in a district level general hospital set up in India.
Methods: This is a retrospective study of 269 hernias operated by the author's technique and 225 hernias operated by the mesh repair during a period from April 1998 to December 2003. Data of hospital stay, intra-operative complications, ambulation, pain, and postoperative early and late complications were recorded and compared using SSPS software.
Results: The mean stay in the author's technique was 1.22+/-0.89 days while it was 3.59+/-1.93 days in the mesh group. The mean time to return to work in the author's technique was 8.48+/-2.43 days while it was 12.46+/-2.11 days in the mesh group. There were 5 complications in the author's technique while there were 16 complications in the mesh group. There was no recurrence seen with the author's technique while there were 4 recurrences in the mesh group (1.97%). In addition there were 3 patients in the mesh group who underwent reoperation for chronic debilitating groin pain (1.47%). At the end of 1 year there were 13 /203 patients (6.49%) who had chronic groin pain while there was no incidence of chronic groin pain in the author's technique. 234(92.8%) patients in author's group and 171(84.3%) patients in mesh group were followed up for a median follow up period of 4.1 and 3.9 years respectively (Range 1-5 years).
Conclusions: The results of the new repair described by the author look very promising. This repair has minimal complications and no recurrence. This operation is based on the physiological principle and this concept of physiological repair of inguinal hernia needs to be studied worldwide. This new repair has the potential to become the gold standard of hernia repair in years to come.