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Inguinal Hernia Repair Using the External Oblique Muscle Fascia: Desarda Technique

Received: 28 February 2024    Accepted: 18 March 2024    Published: 2 April 2024
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Abstract

Introduction: An inguinal hernia is a protrusion of abdominal cavity contents or pre-peritoneal fat through a hernial defect in the inguinal region. Desarda's technique is an aponeuroplasty, based on closure of the posterior wall of the inguinal canal by a flap of the external oblique fascia. This technique has the advantage over prosthetic cures in that it is a tension-free cure and does not require an implant. The aim of this study is to demonstrate the feasibility of curing inguinal hernias using the Desarda technique, and to evaluate the initial results in our practice. Material And Method: This is a prospective study over a 2-year period (January 2017 - December 2018), covering 100 cases of uncomplicated inguinal hernia cure in 98 patients operated on by aponeurotic plasty (Desarda technique), in the general surgery department of Ignace DEEN Hospital. Selection criteria were: informed consent, age over 15 years, uncomplicated primary inguinal hernias, normal prostate ultrasound and PSA results for adult males over 50 years of age. Results: The study included 100 cases of uncomplicated inguinal hernia repair in 94 patients operated on by aponeurotic plasty (Desarda technique). The patients were 88 men (94%) and 6 women (6%), with a mean age of 44.7 years and extremes of 19 and 78 years. The majority of patients (37 or 39.36%) were blue-collar workers. The hernia was unilateral in 88 patients and bilateral in 6. One woman had a bilateral hernia. The hernia was located only on the right in 72 cases and only on the left in 20. According to the Nyhus classification, type IIIb 45% was the most frequent. The patients were operated on under spinal anesthesia in 68 cases. On the first postoperative day, nine patients (9.57%) were assessed as having moderate pain. Beyond the third month, pain assessment revealed five cases of chronic pain. Surgical site infection was the most frequent complication. With an average follow-up of 17 months, no cases of recurrence were noted.

Published in Advances in Surgical Sciences (Volume 12, Issue 1)
DOI 10.11648/j.ass.20241201.11
Page(s) 1-5
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Inguinal Hernia, Aponevroplasty, Desarda

References
[1] Berri T; Brahmi K. Inguinal hernias. Algerian medical journal 2021; (36): 62-71.
[2] Huang et al. Lichtenstein inguinal hernia repair with porcine small bowel submucosa: a 5-year follow-up. A prospective randomized controlled study; Regenerative Biomaterials; China-2021; (20) 1-5.
[3] Marre P, Pitre J, Timores A. Inguinal hernia repair in adults using the Lichtenstein procedure. Results at 10 years. EMem Acad Natl Chir 2009; 8(2): 46-7.
[4] Bonnichon Ph, Oberlin O. Evolution of medical thinking in the surgical treatment of male inguinal hernias. E-Mem Acad Natl Chir 2010; 9(4): 30-5.
[5] Johanet H. Laparoscopic groin hernia repair, the transabdomino preperitoneal route (TAPP): technical aspects and results. E-Mem Acad Natl Chir 2009; 8(2): 38-40.
[6] Desarda MP. Physiological repair of inguinal hernia: a new technique (study of 860 patients). Hernia 2006; 10: 143–6.
[7] M Dieng, M Cissé, M Seck, FK Diallo, AO Touré, I Konaté, O Ka, A Dia, CT Touré Adults inguinal hernia repair by plasty using the large oblique muscle aponevrose: Desarda's tech-nique e-mémoires de l'Académie Nationale de Chirurgie, 2012, 11(2): 069-074.
[8] Gainant A, Geballa R, Bouvier S, Cubertafond P, Mathonnet M. Prosthetic treatment of bilateral inguinal hernias by laparoscopy or Stoppa operation. Ann Chir 2000; 125: 560-5.
[9] Manyilirah W, Kijambu S, Upoki A, Kiryabwire J. Comparison of non-mesh (Desarda) and non-mesh (Lichtenstein). Methods for inguinal hernia repair at Mulago hospital. A double-blind randomized controlled trial. Hernia 2012; 16: 133-44.
[10] Bay-Nielsen M, Kehlet H, Strand L. Quality assessment of 26304 herniorraphies in Denmark: à prospective nationwide study. Lancet 2001, 358: 1124-8.
[11] Ananian P, Barrau K, Balandraud P, Le Treut YP. Surgical cure of adult inguinal hernias. Clinical, functional and economic issues of surgical practices. J Chir 2006; 143: 76-83.
[12] Situma SM, Kaggwa S, Masiira NM, et al. Comparison of Desarda versus Modified Bassini inguinal Hernia Repair: A Randomizedcontrolled trial. East and Central African Journal of Surgery 2009; 14: 2.
[13] Aasvang EK, Bay-Nielsen M, Kehlet H. Pain and functional impairment 6 years after inguinal herniorrhaphy. Hernia 2006; 10: 316–21.
[14] Vuilleumier H, Hübner M, Demartines N. Neuropathy after herniorrhaphy: Indication for surgical treatment and outcome. World J Surg 2009; 33: 841-5.
[15] Cunningham J, Temple WJ, Mitchell P, Nixon JA, Preshaw RM, Hagen NA, Cooperative hernia study. Pain in the post-repair patient. Ann Surg 1996; 224: 598 602.
[16] Sakorafas GH, Halikias I, Nissotakis C, Kotsifopoulos N, Stavrou A, et al. Open tension free repair of inguinal hernias; the Lichtenstein technique. BMC Surg 2001; 1: 3.
[17] Phe V, Bitker MO, Misrai V, Richard F. Cure de hernie inguinale selon la technique de Vayre Petit Pazos: Étude rétrospective à propos de 83 patients consécutifs. E-Mem Acad Natl Chir 2008; 7(2): 26-32.
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  • APA Style

    Sandaly, D., Lansana, C. F., Togba, S. L., Yaya, D. S., Naby, F., et al. (2024). Inguinal Hernia Repair Using the External Oblique Muscle Fascia: Desarda Technique . Advances in Surgical Sciences, 12(1), 1-5. https://doi.org/10.11648/j.ass.20241201.11

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    ACS Style

    Sandaly, D.; Lansana, C. F.; Togba, S. L.; Yaya, D. S.; Naby, F., et al. Inguinal Hernia Repair Using the External Oblique Muscle Fascia: Desarda Technique . Adv. Surg. Sci. 2024, 12(1), 1-5. doi: 10.11648/j.ass.20241201.11

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    AMA Style

    Sandaly D, Lansana CF, Togba SL, Yaya DS, Naby F, et al. Inguinal Hernia Repair Using the External Oblique Muscle Fascia: Desarda Technique . Adv Surg Sci. 2024;12(1):1-5. doi: 10.11648/j.ass.20241201.11

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  • @article{10.11648/j.ass.20241201.11,
      author = {Diakite Sandaly and Camara Fode Lansana and Soumaoro Labile Togba and Diakite Saikou Yaya and Fofana Naby and Kondano Saa Yawo and Condé Ansoumane and Camara Mariame and Condé Ousmane and Diallo Mamadou Saliou and Ousmane Abakar and Yom Petang Steve Cyrille and Toure Aboubacar},
      title = {Inguinal Hernia Repair Using the External Oblique Muscle Fascia: Desarda Technique
    },
      journal = {Advances in Surgical Sciences},
      volume = {12},
      number = {1},
      pages = {1-5},
      doi = {10.11648/j.ass.20241201.11},
      url = {https://doi.org/10.11648/j.ass.20241201.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20241201.11},
      abstract = {Introduction: An inguinal hernia is a protrusion of abdominal cavity contents or pre-peritoneal fat through a hernial defect in the inguinal region. Desarda's technique is an aponeuroplasty, based on closure of the posterior wall of the inguinal canal by a flap of the external oblique fascia. This technique has the advantage over prosthetic cures in that it is a tension-free cure and does not require an implant. The aim of this study is to demonstrate the feasibility of curing inguinal hernias using the Desarda technique, and to evaluate the initial results in our practice. Material And Method: This is a prospective study over a 2-year period (January 2017 - December 2018), covering 100 cases of uncomplicated inguinal hernia cure in 98 patients operated on by aponeurotic plasty (Desarda technique), in the general surgery department of Ignace DEEN Hospital. Selection criteria were: informed consent, age over 15 years, uncomplicated primary inguinal hernias, normal prostate ultrasound and PSA results for adult males over 50 years of age. Results: The study included 100 cases of uncomplicated inguinal hernia repair in 94 patients operated on by aponeurotic plasty (Desarda technique). The patients were 88 men (94%) and 6 women (6%), with a mean age of 44.7 years and extremes of 19 and 78 years. The majority of patients (37 or 39.36%) were blue-collar workers. The hernia was unilateral in 88 patients and bilateral in 6. One woman had a bilateral hernia. The hernia was located only on the right in 72 cases and only on the left in 20. According to the Nyhus classification, type IIIb 45% was the most frequent. The patients were operated on under spinal anesthesia in 68 cases. On the first postoperative day, nine patients (9.57%) were assessed as having moderate pain. Beyond the third month, pain assessment revealed five cases of chronic pain. Surgical site infection was the most frequent complication. With an average follow-up of 17 months, no cases of recurrence were noted.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Inguinal Hernia Repair Using the External Oblique Muscle Fascia: Desarda Technique
    
    AU  - Diakite Sandaly
    AU  - Camara Fode Lansana
    AU  - Soumaoro Labile Togba
    AU  - Diakite Saikou Yaya
    AU  - Fofana Naby
    AU  - Kondano Saa Yawo
    AU  - Condé Ansoumane
    AU  - Camara Mariame
    AU  - Condé Ousmane
    AU  - Diallo Mamadou Saliou
    AU  - Ousmane Abakar
    AU  - Yom Petang Steve Cyrille
    AU  - Toure Aboubacar
    Y1  - 2024/04/02
    PY  - 2024
    N1  - https://doi.org/10.11648/j.ass.20241201.11
    DO  - 10.11648/j.ass.20241201.11
    T2  - Advances in Surgical Sciences
    JF  - Advances in Surgical Sciences
    JO  - Advances in Surgical Sciences
    SP  - 1
    EP  - 5
    PB  - Science Publishing Group
    SN  - 2376-6182
    UR  - https://doi.org/10.11648/j.ass.20241201.11
    AB  - Introduction: An inguinal hernia is a protrusion of abdominal cavity contents or pre-peritoneal fat through a hernial defect in the inguinal region. Desarda's technique is an aponeuroplasty, based on closure of the posterior wall of the inguinal canal by a flap of the external oblique fascia. This technique has the advantage over prosthetic cures in that it is a tension-free cure and does not require an implant. The aim of this study is to demonstrate the feasibility of curing inguinal hernias using the Desarda technique, and to evaluate the initial results in our practice. Material And Method: This is a prospective study over a 2-year period (January 2017 - December 2018), covering 100 cases of uncomplicated inguinal hernia cure in 98 patients operated on by aponeurotic plasty (Desarda technique), in the general surgery department of Ignace DEEN Hospital. Selection criteria were: informed consent, age over 15 years, uncomplicated primary inguinal hernias, normal prostate ultrasound and PSA results for adult males over 50 years of age. Results: The study included 100 cases of uncomplicated inguinal hernia repair in 94 patients operated on by aponeurotic plasty (Desarda technique). The patients were 88 men (94%) and 6 women (6%), with a mean age of 44.7 years and extremes of 19 and 78 years. The majority of patients (37 or 39.36%) were blue-collar workers. The hernia was unilateral in 88 patients and bilateral in 6. One woman had a bilateral hernia. The hernia was located only on the right in 72 cases and only on the left in 20. According to the Nyhus classification, type IIIb 45% was the most frequent. The patients were operated on under spinal anesthesia in 68 cases. On the first postoperative day, nine patients (9.57%) were assessed as having moderate pain. Beyond the third month, pain assessment revealed five cases of chronic pain. Surgical site infection was the most frequent complication. With an average follow-up of 17 months, no cases of recurrence were noted.
    
    VL  - 12
    IS  - 1
    ER  - 

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Author Information
  • Department of General Surgery, Ignace DEEN National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Department of Visceral Surgery, Donka National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Department of General Surgery, Ignace DEEN National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Department of Visceral Surgery, Donka National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Department of General Surgery, Ignace DEEN National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Department of General Surgery, Ignace DEEN National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Department of General Surgery, Ignace DEEN National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Department of General Surgery, Ignace DEEN National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Department of General Surgery, Ignace DEEN National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Department of General Surgery, Ignace DEEN National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Department of General Surgery, Ignace DEEN National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Department of General Surgery, Ignace DEEN National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

  • Department of General Surgery, Ignace DEEN National Hospital, Gamal Abdel Nasser University of Conakry, Conakry, Guinea

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