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Comparison of Non-Mesh repair tyes (Desarda, Darn, McVay, Bassini)
Hi Everyone,
I am based in Australia, and require an inguinal hernia repair.
For reasons that would be familar to many on this forum, I do not want to go down the mesh path.
However, in Australia there are almost no surgeons who offer non-mesh repairs.However, this is a reputable surgeon in Sydney who uses the Darn technique (or Moloney Darn). I believe this technique was popular until the 60’s. However, it is very uncommon today, with almost no research written about it.
Desarda seems to have good results, but this would require me to travel to NZ or US (which I would be willing to do).
Does Desarda carry any long term risks other than recurrence?McVay and Bassini I have not really researched, I only know them by name. So I would like any feedback on their benefits relative to Desarda if anyone is familiar with them.
Are the Nylon Sutures used in most (non-mesh repairs) cause for concern vs. the absorb-able sutures in the Desarda technique?
Any advice would be appreciated.PS Thank-you to all of the surgeons and medical staff who have taken the time to post their insights into the forum. It is much appreciated.
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8 Replies
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[USER=”2456″]Spoonman[/USER] just wondering how you went? I am in Australia too
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quote SighFigh:[h=1]Laparoscopic, Non-Mesh, Inguinal Hernia Repair (Todd Ponsky)[/h] Hello, I just found this on youtube
This is copy and pasted from the video description.
“Here is a video with both animation and two case demonstrations exhibiting the technique for laparoscopic high ligation of an indirect inguinal hernia in a male. We utilize this technique from infancy to adulthood. I propose that this technique may be an alternative to a mesh repair in an adult with a small indirect inguinal hernia. This technique has almost no post-operative pain, almost no visible scars, low risk to the cord structures, and preliminary data shows a recurrence rate between 1- 3%. This may be ideal for young patients who do not want mesh.”
This is very interesting, I think that is very similar to what is routinely performed on kids with hernias. What would be the downsides to this approach for an adult patient?
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[h=1]Laparoscopic, Non-Mesh, Inguinal Hernia Repair (Todd Ponsky)[/h] Hello, I just found this on youtube
This is copy and pasted from the video description.
“Here is a video with both animation and two case demonstrations exhibiting the technique for laparoscopic high ligation of an indirect inguinal hernia in a male. We utilize this technique from infancy to adulthood. I propose that this technique may be an alternative to a mesh repair in an adult with a small indirect inguinal hernia. This technique has almost no post-operative pain, almost no visible scars, low risk to the cord structures, and preliminary data shows a recurrence rate between 1- 3%. This may be ideal for young patients who do not want mesh.”
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Thanks for your response GI. Your continued input and discussion throughout the forum is appreciated. This may be ignorant, but I am unsure my hernia is direct or indirect (my specialist did not advise at the time)
I’m sure like many users on this forum, it is very easy to get bogged down in uncertainty when it comes to making such an important (effetively life-long) decision like surgery. Easy to overthink – but somehow that is still better than ‘underthinking’ 🙂
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quote Spoonman:Does Desarda carry any long term risks other than recurrence?
McVay and Bassini I have not really researched, I only know them by name. So I would like any feedback on their benefits relative to Desarda if anyone is familiar with them.
You might try contacting surgeons directly that use one of those techniques, and ask them why they chose it. If I recall correctly, for example, Dr. Petersen in Las Vegas, uses a “modified” McVay method after he removes hernia mesh. Desarda’s technique is relatively new, I believe. I would guess that the only person who could compare it to the others is someone who uses it. Dr. Robert Tomas in Florida, does, I think. Not many others. I’m not sure that many surgeons visit this site, and the activity from them seems to be dropping. Maybe too much negativity about mesh, and too many problems reported.
Good luck. You never said what type of hernia you’re concerned with. Direct and indirect are both inguinal but they are not the same.
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Hi – Thanks for your replies.
Yes – I am aware of Dr Garvey. He is well-respected but his preferred method “Darn” is seldom used, and does not appear in many studies etc. This is not to say it is ineffective only that Desarda sounds like it preferred by more surgeons.
In response to Good Intentions – I am 40ish, in reasonable health (slim build).
Dr Kang sounds great (I have been to the Gypsum hospital website) but I do not even know what his method is called?But returning to my original question – I just need some independent guidance on which non-mesh repairs. FYI – Shouldice is out for me.
Thanks
SP -
Yes there is the Shouldice Hospital in Canada that does this pure tissue repair..
on another forum a dr. Garvey I’m Austrailia is frequently mentioned who does non mesh repairs (as well as removed mesh too) -
Hello. I notice that you left out the Shouldice repair method. Also, Dr. Kang and his method, in South Korea.
What type of inguinal hernia do you have? And what type of activities are you hoping to do afterward? Those might be considerations. Good luck.
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