Reply To: What’s not to like about Desarda?
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Desarda hasn’t been studied extensively. There isn’t a critical mass of interest in tissue repair out there to change that picture. The few surgeons who practice it and are active at hernia conferences don’t consider it a one-size-fits-all (unlike mesh). It’s another tool in the tissue repair arsenal. Depending on tissue quality and the nature of the hernia, sometimes the patient is a good fit for that, sometimes for Shouldice, sometimes for neither. That’s not going to take over the world of hernia repair when mesh is so entrenched and so widely-applicable across patients. Also, even though Desarda is relatively simple for tissue repairs, it still requires training that surgeons can’t get almost anywhere these days.
I always liked the principle of the Desarda repair, and how much simpler and safer it seems when compared to most other techniques, particularly Shouldice. It’s still open surgery, so the disadvantages of that are still there, but the amount of dissection and stitching is so much lower, and the sutures can even be absorbable.