Inguinal hernia repair surgery without mesh by Dr. Desarda repair technique


“Desarda Repair for inguinal hernia without mesh”

Traditionally done operations today are tension repairs like Bassini, Shouldice or MacVay’s repairs and tension free repairs like repairs done with mesh, plug and mesh or PHS (Prolene Hernia System). All tension repairs have high rate of recurrences and post-operative pain. Sutures are under tension even at rest and gets aggravated during contractions and scar shrinkage in healing process. Therefore, these tension repairs are practically replaced by tension free repairs where mesh prosthesis is used. But then there are many associated complications of a foreign body. Mesh is prepared from PVC material and therefore recurrence, pain, infection, migration, rejection, testicular ischemia or atrophy and perforations are all documented complications. Laparoscopic hernia surgery reduces pain but then there are dangers of general anaesthesia, gas filling under pressure and instrumentations in addition to the mesh stitched in side. Those complications are more risky because mesh is stitched inside the abdomen.

Desarda repair has removed all drawbacks of both types of repairs. There is no tension on suture lines as seen in tension repairs and there is no foreign body used like mesh repairs. This operation is simple without any complicated dissection or does not require costly equipments like laparoscope or any expertise required to handle those laparoscopes or to do complex dissections. There is minimal pain, fast recovery and virtually complete cure from the inguinal hernia.

Repair with your own muscle strip

Repair with your own muscle strip


RESULTS: This operation is very simple without any complex dissection or without any foreign body or does not require complex instruments like laparoscope. It gives fast recovery and complete cure from the inguinal hernias. All patients are admitted in the morning and taken for surgery under local or spinal anesthesia. Operation takes about 30-40 minutes and patients are freely mobile within couple of hours ready to go home same day. There are no restrictions to be followed and patient can drive car and go to office or travel, lift luggage, climb up or down the staircase or take a walk for shopping within 3-4 days without any fear of recurrence or pain.

As of today, there are more than 60 centers all around the globe in many countries where desarda repair is routinely followed in hundreds of patients. There are 7 centers in USA alone. Nearly 80 research articles are published or presented by different surgeons and out of that more than a dozen are comparative studies or randomized controlled trials. Dr. Desarda himself has operated on more than 2000 patients till today without even a single case of recurrence. Web site published by Dr. Desarda is extremely popular and is visited by over a million of visitors till today. You can also visit this web site and get complete knowledge about inguinal hernias including very high quality videos of operation or recovery or presentation of his various lectures delivered as invited faculty during national as well as international conferences.

FOR DETAILS: Mobile: +91 9373322178 WEB SITE: http://www.desarda.com
EMAIL: desarda@hotmail.com

New method of inguinal hernia repair surgery without mesh


DR. DESARDA`S HERNIA OPERATION GOES INTERNATIONAL

DR.MOHAN DESARDA, a famous Pune based senior general surgeon has successfully demonstrated his new technique of inguinal hernia surgery internationally.  After 18 years of  research into the physiology of hernia development, and the introduction of new techniques of surgery for hernia repair, world hernia scientists and research workers have accepted Dr. Desarda’s thesis which has been published in international scientific journals in Australia and Europe.



Dr.Desarda has developed a novel and cost effective technique of surgery for groin hernias. Traditional operations have a much higher failure and recurrence rate, and the reappearance of the hernia often places the patient under further mental, physical and financial stress. The use of mesh in hernia operations is costly, and also leads to a higher incidence of chronic groin pain than is commonly reported, as well as other complications. Mesh is also not available in many parts of the country.

My operation is simple. It does not require any imported expensive material like mesh, and it can be easily be learned by any general surgeon without specialist training. I have operated on more than 1000 hernia patients with a virtually zero hernia recurrence rate.” This operation, now known as ‘Dr. Desarda`s Repair’ is being followed in large and small hospitals in many cities all over India, and in many countries all over the world.”

Groin Hernia is a very common disease and can affect people of any age. It first appears as a balloon type swelling in the groin below the skin. Abdominal contents such as intestine or omentum keep sliding in the swollen sac and the swelling increases when the patient stands and usually decreases in size when sleeping or lying down. Sometimes part of the intestine can become obstructed or strangulated in the sac and the disease becomes serious and urgent surgery is needed. There is no medical treatment available, and only surgery can cure the defect.

 Dr. Mohan Desarda has been invited to demonstrate his hernia repair technique in medical institutions and hospitals in India as well as abroad, and has provided video demonstrations and  information to local doctors about the simplicity and success of his new technique.

 “In my operation, this sac is excised and then a strip is separated from a strong muscle known as the external oblique aponeurosis. Hernia takes place because the tissues and muscles behind the hernia become weak. This separated strong strip is sutured on this weak area so that the weak area gets a new support of natural and pure tissue instead of a foreign artificial material like mesh. Moreover, the weakened muscles get more strength from an additional muscle, and therefore the failure rate in my operation has been virtually zero. All operations to date have shown good results and I would strongly recommend this procedure to other surgeons in the interest of better outcomes for their patients. This surgical technique is equally good in any type of groin hernia and in any age group of patients whenever this type of operation is required.”

Dr.Desarda has also established an advanced institute in Pune for further research into hernia diseases called the “Indian Hernia Institute”.

Dr.Desarda demonstrated a brilliant academic and leadership record   right from his earliest days in college. He is a national scholar and has many gold medals and prizes to his credit.

Dr. Desarda is attached as Honorary Consultant General Surgeon to the Poona Hospital & Research Centre, the Kamala Nehru General Hospital and the Bharati Vidyapeeth Medical College as Professor of Surgery. Interested patients and doctors may write to:  18, Vishwalaxmi Housing Society, Kothrud, Pune-411029 or email at: desarda@gmail.com or desarda@hotmail.com

 

Inguinal hernia repair without mesh

Groin hernia operation with a live muscle strip

 

Other Places to go:

http://www.desarda.com

http://desarda.webs.com

http://herniasurgery.tripod.com

TELEPHONE: +91 0 9373322178

BUY A CD FOR $ 20 (Including postage)

(Live operations on direct, indirect & recurrent groin hernia)

EMAIL: desarda@gmail.com or desarda@hotmail.com

“Why hernia re-occurs again and again”-No recurrence in “Desarda Repair”


When some part of our body leaves its original place and enters in to other cavity or comes out on the body surface then we call it as a hernia formation. Operation is the only remedy to get relief from this disease. Patient will not mind to get operated if he is sure that he is going to be hernia free after surgery. But this does not happen in many patients because rate of relapse or reappearance of hernia at the same place is also quite high and unacceptable. Mesh, which is a piece of synthetic cloth, was introduced in the market in 1990 for use in hernia repairs. We stitch a small piece of cloth to repair our torn shirt. Same principle is used in mesh repairs where in this mesh is stitched on the weak spot or hernia hole to give protection and prevent recurrence. Relapse rate or failure rate after groin hernia surgery has come down to 7-8% in USA after every body started doing hernia surgery by using a mesh, but it failed to give complete cure.
Our intestines are kept in a delicate balloon like bag in side the abdomen and protection is given by 3 layers of muscles all around them. When these muscles get damaged at some spot then that becomes a weak spot or hernia hole from where hernia formation takes place. This damage can happen due to surgery or stretching due to pregnancy or ascitis or they get weakened due to aging or some other disease.

In all traditionally done hernia surgeries, hernia sac is excised and a mesh is stitched on this weak spot or this hernia hole in an attempt to give protection to the weak spot and prevent relapse or recurrence. But this does not happen immediately after surgery because this mesh is delicate like a mosquito net. Then why it is stitched if it does not give protection? A foreign body reaction sets in and around the mesh and tissue penetrates in it to form a delicate curtain on the weak spot. This takes couple of months and then it takes another 2-3 years to get sufficient strength in it to give protection. It means the patient is not fully protected for 2-3 years in spite of mesh surgery. If patient gets an attack of cough or sneezing or some such other instance during this period then this mesh gets torn or stitches get torn or mesh moves away from the stitched place and relapse of hernia takes place. Another important reason for more relapses or recurrences seen in India is the low quality mesh used to save on the cost. This low quality mesh shrinks by 50-60% in side the body. Naturally there is increased tension on the sutures due to this shrinkage that tend to break beyond certain limits inviting hernia recurrence. Mesh shrinkage or mesh migrations are well documented complications inviting failures after the mesh surgeries. All hernia surgeries are done by hernia experts or consultants in USA, but, paradoxically in India, hernia surgeries are dedicated to the resident doctors who are not expert in hernia surgeries. This is also one of the important reasons for high rate of hernia recurrences in India.
A story of 38 year old Mr. David from USA is worth listening. He had left groin hernia since 2 years. He consulted with 2-3 consultants and hernia experts in Los Angeles, All of them had said that they will repair his hernia with a mesh. As is done by every American, David also did his own thorough search on the internet to get more knowledge about groin hernias. He found that almost 30 out 100 patients operated with mesh had suffered either from recurrence or chronic groin pain or infection or mesh migration in to the abdomen. These patients had undergone either open surgeries or endoscopic surgeries. So he started search to find out whether there is any centre which does hernia surgeries without using mesh. To his amazement, he found only two such centre all over the world. One was Shouldice centre in Canada and another was “Desarda Centre” in Pune from India. During his further search, he found that Shouldice centre use stainless steel wires to sutures and there is 1-2% of recurrence. So he chose Desarda Centre and came here to our Indian Hernia Institute to get his hernia set right. This story did not end with David, but many more patients from USA, France, and Australia etc have visited our centre for their hernia repairs. The main reason why every body now prefers to come to our centre for his hernia repair is that we do not use any foreign body like mesh. Therefore, no complications are seen in our repairs that are associated with mesh. We use a strip of near by strong muscle to cover the weak spot or hernia hole. Therefore, protection starts on the operation table itself. And patient gets almost complete cure without any fear of relapse or recurrence in future.

Dr. Desarda has operated on more than 1500 patients till today by this new technique and all of them are well and without any recurrence till today. This operation does not require general anesthesia, it is done under local or spinal anesthesia. Patient is admitted in the morning and taken for surgery immediately after preparation. Time required for surgery is average 30 minutes and patient can be on his foot as soon as anesthesia effect is gone. Normally patient goes to pass urine on his own within 4-5 hours and he is freely mobile in the wards same day night or next day morning ready to get discharged and go home. There are no restrictions on his movements or food intake. He can drive car and go to office, can climb a staircase, can carry luggage and travel, squat and sit down without much pain within 2-3 days. He is asked to carry his normal routine work as soon as possible and as per his tolerance. So, patient gets high level of satisfaction after this new operation technique. All foreign patients coming to Indian Hernia Institute go back to their country on third day carrying their luggage and a journey of 20-22 hours without any difficulty. The most important quality of this operation is that there is virtually no recurrence or pain. This operation is spreading quite rapidly all around the globe and today it is being followed in many countries.

Interested patients and doctors can contact Dr. Desarda on his mobile no. 09373322178 or log on to his website

http://www.desarda.com

http://desarda.webs.com

http://herniasurgery.tripod.com

“What is inguinal hernia and “Desarda Repair” operation technique?


Hernia disease is now generally known to common people just as appendicitis is known. When a bulge or swelling appears in the groin, every body knows that it is hernia. So bulge or swelling due to any other disease might be mistaken as hernia bulge. Like wise, hernia occurs only in the groin is also a misconception. It can occur any where inside the body as well as visibly out side the body. The hernias which are visible on the surface of the body mainly occur on the abdomen.

When any organ of our body or part of it leaves its original place and enters into other cavity through a defect or hole, it forms a hernia sac. This sac becomes visible on the abdomen when intestines enter in to it on coughing. This bulge seen on the abdomen is called as hernia. It is seen in nearly 1-1.5% of our people but this incidence is higher (2-3%) in the western countries and Africa. Abdominal wall hernias are given different names depending on the area where they arise. Inguinal hernia, umbilical hernia, epigastric hernia, lumbar hernia, spigelion hernia etc. are some of such hernias that are seen on the abdominal wall. Hernias can occur inside the body also that are not visible outside. Diaphragmatic hernia is an example of this.

Why hernia forms? Every body naturally wants to know as to why at all hernia forms in their body or on abdomen. What are the reasons? Weakness of the abdominal wall muscle cover at some place or spot is the main reason. Then if by any reason say like coughing or straining while passing stools or urine, intra-abdominal pressure rises and the result is the hernia formation through the weak spot. Chronic cough as seen in asthmatic patients, job of lifting heavy weights, constipation, obstruction in passing urine due to enlarged prostate are some of the important reasons that precipitates the hernia formation in the groin or at some other place on abdomen. Stretching of muscles as seen in pregnancy or ascitis can also result in hernia formation. These reasons are not seen in children; still they are affected with hernia due to pre formed hernia sac.

What are the symptoms: A soft swelling appearing in the groin that increases in size after coughing and disappears after lying down or during sleep then you can think that it is groin hernia. This groin swelling is small betel nut size in the beginning but later if kept untreated goes on increasing and enters in the scrotum also. Initially, this bulge can be pushed inside the abdomen but later it becomes impossible to push them back because intestines get adherent to the hernia sac. There is no pain in this hernia swelling. That is the main reason why people are not serious about its early treatment. In general, pain in hernia is to be understood as an alarming symptom. It occurs whenever this hernia gets obstructed and you can not push intestines back or when hernia gets strangulated, a serious condition. Blood supply to the intestines gets cut off and they start dying inside the hernia sac during the process of strangulation. Patient does not allow touching the hernia swelling because it becomes painful and tender. Some times, intestines get perforated inside the sac and peritonitis takes place. Patient starts vomiting, there is abdominal distension and general condition of the patient deteriorates fast. This is a life threatening emergency and needs to be operated immediately to save the life of the patient. Therefore, it is advised that hernia should be treated as early as possible and not to wait till it starts paining.

Examination & treatment: Examination of hernia gives an idea about the type of hernia and whether there are any complications developed in it. What type of organ e.g. intestines or omentum has entered the hernia sac is also judged. Then general examination is done to find out whether patient is having any systemic disease like bronchitis, hypertension, heart disease, enlarged prostate etc. Some blood tests, x-ray chest or ECG. is done to find out whether patient is fit to undergo surgery. If there are some serious complications developed in hernia and patient needs urgent surgery to save his life then patient can be taken for surgery without doing these tests also. Just as a torn shirt needs stitching to repair it, similarly this torn shirt of abdominal muscles also need proper stitching to repair the hernia. First of all the hernia sac is separated from other tissues and it is excised. Second part of the operation is to stitch the hernia hole to prevent hernia formation again. This is called as herniorrhaphy or hernioplasty. Therefore, do not believe if some body assures you that hernia can be cured without surgery and with medicines or some other means. Many times patients are advised to do exercises so as to strengthen the muscles and cure the hernia. It is absolutely wrong to do exercises when there is hernia because every exercise increases the intra-abdominal pressure and that tends to increase the size of hernia. Some times advice of using a hernia truss is given to avoid the surgery. This hernia truss or hernia belt is fitted on the hernia hole in an attempt to prevent it from coming outside. This is not cure to the hernia. At the most you can postpone surgery for some time by using it. But now surgeons clearly advise not to use truss in any situation because of its complications. Hernia belt slips from the hernia hole due to movements and the intestines can get obstructed easily giving rise to a dangerous situation of obstruction or strangulation.

Hernia operation is done by stitching a piece of synthetic cloth called as mesh on the hernia hole. Polypropylene, polyethylene, prolene, Dacron, Teflon is such synthetic chemical thread from which mesh is prepared. This mesh is imported and costly also. Therefore, at many places a low quality mesh is used to save on the cost. This increases the chances of hernia reappearing or getting infected. Recurrence, infection, pain, mesh migration are some of the well documented complications associated with this mesh repair because mesh is a synthetic cloth and a foreign body. Re-operation is the only remedy to treat those complications and this re-surgery is very difficult, complicated and commanding even in the hands of expert surgeons because mesh causes extensive damage to the nearby tissues and fibrosis. Techniques older than this are now discarded because they all had unacceptable rate of surgery failures.

A new technique- “Dr. Desarda repair”: A search to find out some operation technique that

does not use mesh and gives excellent results was going on through out the world. Desarda repair introduced in the market in year 2001 became immediately popular because it gives what you want and that too without use of any foreign body like mesh. This operation is done by taking a cut on the skin. It is simple and does not require any foreign body like mesh or any complicated instruments like endoscopes. A strip of a nearby muscle is separated and stitched on the weak spot to cover the hernia hole. There is no foreign body like mesh or no endoscopes are required therefore, this operation is free from all complications and risks that are associated with the mesh or laparoscopic repair. There is no tension on the stitches or muscles as seen in Bassini-Shouldice operation. Therefore, there are no complications and risks that are associated with the Bassini- Shouldice operation. Hernia hole is covered by a strong muscle. Therefore, protection starts on the operation table itself. Patient is admitted in the morning and immediately taken for surgery after preparation. Operation is done under local or spinal anaesthesia. No general anaesthesia is required. Operation is completed in 30 minutes and patient is back on his feet as soon as anaesthesia effect is gone. Patient goes to bathroom on his own within couple of hours and moves freely in the wards afterwards and goes home same day night or next day morning. Patients are allowed to drive car and go to office, bend, squat, climb up the staircase or carry luggage and travel. All foreign patients coming to Indian Hernia Institute go back to their country on third day carrying their luggage and a journey of 20-22 hours without any difficulty. The most important quality of this operation is that there is virtually no recurrence or pain. This operation is spreading rapidly around the globe and today it is being followed in many countries.

Interested patients and doctors can contact Dr. Desarda on his mobile no. 09373322178 or log on to his website

http://www.desarda.com

http://desarda.webs.com

http://herniasurgery.tripod.com

“Different types of groin hernia operations”


Hernia is a common disease that can affect any body from his childhood to old age. Operation is the only remedy to get relief from this disease. Patient will not mind to get operated if he is sure that he is going to be hernia free after surgery. But this does not happen in many patients because rate of relapse or reappearance of hernia at the same place is also quite high and unacceptable. Different surgeons recommend different operations to repair the hernia. Therefore, there is confusion in the mind of patients as to which operation they should prefer for their hernia surgery. This article gives details of different types of groin hernia operations done worldwide for knowledge of those patients.

Groin anatomy in hernia patients: All the vessels, lymphatics, vas, nerves along with their covers, together called as spermatic cord pass from abdomen to scrotum through inguinal canal. A protrusion of peritoneum called as hernia sac appears in this canal along with the cord and goes on increasing in size if this hernia sac is kept untreated. This canal and cord is normally protected by cover of two muscles behind and one muscle in front. The reason why hernia sac formation takes place is the weakness in those two muscles behind. This weakened spot in the posterior wall is called as weak spot or hernia hole. All traditionally done operations are designed to repair this hernia hole so that there is no recurrence of hernia after surgery.

There are two parts of hernia operations. First part is to separate the hernia sac and excise it. Second part is to repair this weak spot or hernia hole so as to prevent any recurrence in future.

Bassini Shouldice operation: In this operation patient is kept in the hospital for 2-4 days.

General or spinal anaesthesia is given. Hernia sac is excised. Then for repair of hernia hole, back two muscles are pulled down and sutured to the groin ligament. Surgeon takes several stitches so as to keep these pulled down muscles in place. There is tension on those stitches so patient has to take care for life time to avoid disruption of sutures. Unfortunately, this tension on muscles cause pain in groin area and prolonged rest needs to be taken to get relief and then only he can go to his routine work. There is more than 10% recurrence rate in this operation and increases with time because of contraction of the scar tissue adding more tension on the sutures. This results in more incidences of recurrences and groin pain. Repeat operation for recurrence or pain is difficult and bigger and the results are also far from satisfaction.

Some surgeons use another modification of this technique to reduce tension on the stitches. They suture back muscles and fascia in 4 layers. This reduces the tension on the muscles and sutures but for that many more complicated sutures are needed to be taken. Therefore, this operation can be done only by expert and specially trained hernia surgeons. This has brought down the recurrence rate but it has not totally disappeared. This operation is grouped under ‘tension repairs’ because there is tension on the stitches and muscles.

Mesh repair: In this operation no muscles are pulled down to cover the hernia hole. Instead, mesh is sutured on the weak spot to cover the hernia hole. This mesh is a piece of synthetic cloth just like a mosquito net and it is in no way some thing special. There is no tension on the stitches so this operation grouped under ‘tension free repair’. This has reduced the recurrence rate to a great extent (7-8% in USA) but it did not disappear completely. Reduced recurrences and simplicity of operation made it popular immediately all over the world. The mesh per se does not give any protection because it is delicate. But because it is a foreign body stitched inside, foreign body reaction starts and a tissue curtain is formed just like a corn following the thorn prick. This takes 4-6 months to form the curtain. It takes another 2-3 years to gain strength in this curtain. So, practically patient remains without protection for 2-3 years after surgery and if patient gets an attack of cough or sneezing during this period then there are increased chances of recurrence.

Contraction of this scar tissue adds more to the chances of recurrence. Involvement of nerves, vas or other structures in this scar formation results in to groin pain in 28 to 42% of operated patients. Tearing of sutures, disintegration of mesh, infection, migration are all noted complications. The mesh used by many surgeons is of low quality to save on the cost. Such meshes contract more than 50-60% naturally causing more recurrences. All above complications following mesh repair requires repeat surgery and this surgery is quite difficult and commanding even in the hands of hernia expert surgeons and the results are also poor.

Laparoscopic repair: This operation is done by inserting endoscopes inside by making 4 holes on the abdomen. General anaesthesia is given. Co2 gas is pumped in side the abdomen to inflate it. A much larger size of mesh is required to be stitched to cover the hernia hole from inside the abdomen. It is claimed that there is less pain following this surgery and patient can go to his work earlier. This operation can be done by inserting endoscopes to hernia site through abdominal wall instead of entering the abdominal cavity. This operation can be done only by experts in doing such surgery. More recurrences are seen if done by a novice surgeon. There are more risks involved in this surgery like general anaesthesia, pumping Co2, or trauma to intestines etc. Costly equipments, bigger mesh and expertise required to do this risky operation increase the cost of surgery.

Dr. Desarda repair: This operation is done by taking a cut on the skin. It is simple and does not

require any foreign body like mesh or any complicated instruments like endoscopes. A strip of a nearby muscle is separated and stitched on the weak spot to cover the hernia hole. There is no foreign body like mesh or no endoscopes are required therefore, this operation is free from all complications and risks that are associated with the mesh or laparoscopic repair. There is no tension on the stitches or muscles as seen in Bassini-Shouldice operation. Therefore, there are no complications and risks that are associated with the Bassini- Shouldice operation. Hernia hole is covered by a strong muscle. Therefore, protection starts on the operation table itself. Patient is admitted in the morning and immediately taken for surgery after preparation. Operation is done under local or spinal anaesthesia. No general anaesthesia is required. Operation is completed in 30 minutes and patient is back on his feet as soon as anaesthesia effect is gone. Patient goes to bathroom on his own within couple of hours and moves freely in the wards afterwards and is ready to get discharged same day night or next day morning. Patients are allowed to drive car and go to office, bend, squat, climb up the staircase or carry luggage and travel. All foreign patients coming to Indian Hernia Institute go back to their country on third day carrying their luggage and a journey of 20-22 hours without any difficulty. The most important quality of this operation is that there is virtually no recurrence or pain. This operation is spreading quite rapidly all around the globe and today it is being followed in many countries.

Interested patients and doctors can contact Dr. Desarda on his mobile no. 09373322178 or log on to his website http://herniasurgery.tripod.com

“Complete cure from hernia is now possible”


The president of “Indian Hernia Institute” and professor of surgery in Poona Hospital & Research Centre did extensive research in groin hernia disease and invented a new operation technique that gives almost complete cure from inguinal hernia disease. This technique is now known all over the world as “Dr. Desarda Repair”. Traditional operation techniques followed every where use mesh for hernia repair. This mesh repair is based on anatomical principle, whereas the new operation technique is based on the physiological principle. After a prolonged study of the anatomy and the physiology of the groin, Dr. Desarda has published in international journals new theories that are responsible for hernia formation. Since this operation corrects the basic pathology of the groin, there is no recurrence after his repair, Dr. Desarda claims.

Can any body give guarantee that there will not be recurrence after hernia surgery? The answer was “no” till today. But now, study did by Dr. Desarda and many other surgeons all over the world have proved that if this new repair is done then there are almost zero% chances of reappearance of groin hernia after surgery. Dr. Desarda uses a strip of a nearby strong muscle, instead of mesh, to repair the weak spot or hole of hernia. Dr. Desarda has already published many research articles about the results of this new operation technique in various international indexed journals. Many surgeons from other countries also did take study trials of this technique and published similar results.

Groin hernia repair was a challenge before the world because of its high failure rates. Uses of mesh for hernia repairs, introduced in market in 1990, have reduced this failure rate to 7-8% as per USA studies, but it is much more than this in India because of low quality mesh used to save the cost. Mesh is a foreign body like any synthetic cloth. So many complications associated with any foreign body like infection, pain or rejection also started revealing after mesh repair surgery. At this time in year 2001, Dr. Desarda put his new theory before the world that if groin hernia repair is done on physiological principle using your own body muscle and not done on anatomical principle, as is done in mesh repairs, then you can give complete cure from the hernia to the patient.

Dr. Desarda has operated on more than 1500 patients till today by this new technique and all of them are well and without any recurrence till today. This operation does not require general anesthesia, it is done under local or spinal anesthesia. Patient is admitted in the morning and taken for surgery immediately after preparation. Time required for surgery is average 30 minutes and patient can be on his foot as soon as anesthesia effect is gone. Normally patient goes to pass urine on his own within 4-5 hours and he is freely mobile in the wards same day night or next day morning ready to get discharged and go home. There are no restrictions on his movements or food intake. He can drive car and go to office, can climb a staircase, can carry luggage and travel, squat and sit down without much pain within 2-3 days. He is asked to carry his normal routine work as soon as possible and as per his tolerance. So, patient gets high level of satisfaction after this new operation technique. All my patients coming from USA or other countries are discharged on 3rd day. They all carry their luggage and travel for 20-22 hours by air to their country without any problem, Dr. Desarda says. The most important quality of this operation is that there is virtually no recurrence or pain. This operation is being followed in many countries all over the world.

Interested patients and doctors can contact Dr. Desarda on his mobile no. 09373322178 or log on to his website http://herniasurgery.tripod.com

“What is mesh used in hernia surgery?”


Hernia is a common disease that can affect any body from his childhood to old age. We need to stitch the shirt if it is torn, like wise we have to do surgery to get relief from this disease. Many times a small piece of cloth is used to repair the torn shirt, like wise this mesh is used to cover the weak spot of hernia or the hernia hole to repair it.

If your surgeon tells you that he will use a piece of your shirt or any other synthetic cloth after getting it sterilized for stitching on the hernia hole then you will never agree to his proposal. No body can think of this idea because you are sure and afraid that a piece of cloth can not be stitched inside your body and to do so is inviting lots of problems and trouble for your life time. You are aware that even if you take out the thorn, a small particle of it remaining inside the body forms a big corn, it pains for years and gets infected any time even after years.   Then what is mesh that is used routinely by almost all the surgeons during hernia operation? Every body imagines that mesh must be some special material prepared by the companies for hernia surgery and it must be safe in all respects for our body. In reality, it is not so. It is a simple cloth prepared from synthetic threads of polypropylene, polyethylene or prolene or some other such synthetic material. If companies had made it known to all that this is a piece of synthetic cloth then no body would have accepted it for use in hernia surgery. Therefore, it was named with a special name like “Mesh” and sold in the market. A big cloth is prepared from those synthetic threads. Then it is cut into pieces of various sizes and shapes and then it is nicely packed, sterilized and then sold in the market at exorbitant price. It is estimated that companies are selling those meshes worth Rs. 1000 crores every year in India alone.

The mesh which is used today was brought in the market somewhere during 1990. But such meshes prepared from Dacron or Teflon were already used in many patients all over the world much before that. A famous surgeon from Pune, late Dr. Sulakhe and the author himself did use such pieces of cloth like Terene, Terylene etc available at that time around 1970-75 after due sterilization in many patients. But such operations were already rejected by the surgical community because of unacceptable rate of infection following its use in hernia surgery. In reality, those old meshes and today’s mesh both are prepared from synthetic threads and technically there is no difference between them. But because of improved sterilization techniques and availability of better and higher antibiotics after 1990 reduced this infection rate to a great extent and therefore its use in hernia surgery became rapidly popular. Another reason for this was the high rate of recurrence following hernia surgeries done with old techniques. But this does not mean that now there is no recurrence of hernia after it is repaired by using this mesh. Recurrence is still there following mesh repair and it is 7-8% in USA as per their studies. Though recurrence rate and infection rate is substantially brought down, another major problem following mesh repair of chronic groin pain still remains and it is 28-42% as per many studies.

Your shirt becomes alright as soon as it is stitched but this does not happen when this mesh is stitched on the weak spot or hernia hole. The mesh is a delicate cloth just like a mosquito net and therefore fails to give immediate protection following the surgery. A foreign body reaction starts in and around the mesh and a curtain of tissues is formed within couple of months just like a corn following thorn prick. Then it takes another 2-3 years for developing sufficient strength in this curtain so as to give real protection against reappearance of hernia. It means the patient is not protected for 2-3 years in spite of hernia surgery with mesh. And if he gets an attack of cough or sneezing etc. during this period then the mesh gets torn or displaced or stitches get avulsed resulting in reappearance of hernia. This mesh can also get crimpled or retract to a size that is 20-50% less increasing chances of recurrences. This is seen in many more cases in India because the mesh routinely used in hernia is of low quality to save on the cost. Therefore, the rate of recurrence seen in India is much more than what is seen in USA.

 These mosquito net like meshes when used for hernia repairs have made lives of many patients miserable. Many patients from USA and other countries have posted on the internet hernia forums their story of miserable life after mesh repairs. Specialists and specialty clinics are established in USA who does the only job of removing the mesh or treating the chronic groin pain syndrome. Recurrence, infection or pain following mesh surgery requires much larger, difficult and commanding operation to take out the mesh again for getting relief.

“Dr. Desarda Repair” is a new invention by Dr Desarda from Pune, which is a groin hernia operation without mesh. A strip of a strong near by muscles is stitched on the weak spot or the hernia hole instead of mesh. Therefore, protection starts on the operation table itself. This operation does not require general anesthesia, it is done under local or spinal anesthesia. Patient is admitted in the morning and taken for surgery immediately after preparation. Time required for surgery is average 30 minutes and patient can be on his foot as soon as anesthesia effect is gone. Normally patient goes to pass urine on his own within 4-5 hours and he is freely mobile in the wards same day night or next day morning ready to get discharged and go home. There are no restrictions on his movements or food intake. He can drive car and go to office, can climb a staircase, can carry luggage and travel, squat and sit down without much pain within 2-3 days. He is asked to carry his normal routine work as soon as possible and as per his tolerance. So, patient gets high level of satisfaction after this new operation technique. Dr. Desarda has operated on more than 1500 patients till today by this new technique and all of them are well and without any recurrence till today. All foreign patients coming to Indian Hernia Institute go back to their country on third day carrying their luggage and a journey of 20-22 hours without any difficulty. The most important quality of this operation is that there is virtually no recurrence or pain. This operation is spreading quite rapidly all around the globe and today it is being followed in many countries.

Interested patients and doctors can contact Dr. Desarda on his mobile no. 09373322178 or log on to his website http://herniasurgery.tripod.com