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Indian Journal of Surgery
Medknow Publications on behalf of Association of Surgeons of India
ISSN: 0972-2068
Vol. 68, Num. 5, 2006, pp. 288-288

Indian Journal of Surgery, Vol. 68, No. 5, September-October, 2006, pp. 288

Letter To Editor

Open repair of inguinal hernia without mesh

Poona Hospital and Research Centre, Pune, Maharashatra
Correspondence Address:18, Vishwalaxmi Housing Society, Kothrud, Pune - 411 029 Email: desarda@gmail.com

Code Number: is06086

Related Article: is06057

Sir,

I congratulate the author for giving an excellent and unbiased review on the "Surgical options in inguinal hernia: Which is the best.[1]

The last section "New method of repair by Dr. Desarda, Pune, India" in this review article needs more clarification regarding hospital stay of two-three days mentioned therein. It was clarified by the author[2] of the article that the hospital stay of two-three days was to observe the postoperative results and complications more carefully and not for any surgical or other reason.

I have already published the results of a larger series of 860 patients having 920 hernias.[3] In this, 838 (97.4%) patients were ambulatory with limited movements in six hours and free movements in 18-24 hours. Seven hundred and ninety-two (92%) patients had a hospital stay of one night and 840 (97.6%) patients returned to normal activities within one-two weeks. Hematoma formation requiring drainage was observed in one patient, while seven patients had wound edema during the postoperative period which subsided on its own. Follow-up was completed in 623 patients (72.5%) by clinical examination or questionnaire. The median follow-up period was 7.8 years (range, 1-12 years). There was no recurrence of the hernia or postoperative neuralgia. "Recurrence-free inguinal hernia repair with absorbable continuous sutures-A dream or reality? (New concepts of the physiology of inguinal hernia in context with new method of repair)" was my latest paper read at the "Asia Pacific Hernia Conference held at New Delhi on 6-8th October 2006. Early results of 177 patients with 200 inguinal hernias operated with absorbable PDSII no.1 (Ethicon) continuous sutures were comparable to the author′s other series using nonabsorbable sutures. Continuous sutures requires only one packet of sutures instead of two for inner sutures, saving cost of operation further, over and above the cost of mesh and saves time also. The dream of every surgeon to give recurrence-free inguinal hernia repair without leaving any foreign body inside the patient may become a reality in future.

References

1.Bhattacharjee PK. Surgical options in inguinal hernia: Which is the best. Indian J Surg 2006;68:191-200.  Back to cited text no. 1    
2.Desarda MP. New method of inguinal hernia repair: A new solution. ANZ J Surg 2001;71:241-4.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Desarda MP. Physiological repair of inguinal hernia: A new technique (study of 860 patients). Hernia 2006;10:143-6.  Back to cited text no. 3  [PUBMED]  

Copyright 2006 - Indian Journal of Surgery

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