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Desarda or Shouldice repair for Inguinoscrotal hernia?
I have a colleague who apparently also has a hernia. He has had it for several years, for 10 years if I recall correctly. But in the last 3 years it has gone down into his scrotum and it’s about 2 inches down. He is considering surgery now, and so he and I had a good talk about different techniques and options. But he asked me if he should go for Shouldice or something like Desarda. What do you guys think? Do you think these techniques are successful in patients that present with a hernia that has gone down into the scrotum?
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8 Replies
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quote UhOh!:Isn’t it premature to discuss repair types without knowing for certain the hernia type (direct vs. indirect)? Based on what Drs. Kang and Brown say about repair types, it sounds as though the majority of non-mesh techniques are best suited to direct hernias. At the same time, I’ve seen multiple sources suggest that the majority of hernias reaching the scrotum are indirect…Certainly! The more you know, the better! I had the opportunity to talk about the Desarda technique with Dr. Koch and he basically confirmed what people here on the forum are saying about Desarda technique in regards to hernia type, that is: it is not a one-size-fits-all technique, and it certainly is not a very good option for indirect hernias. So if you have indirect hernia, then the Desarda technique may not be your best option.
If you ask Dr. Desarda himself, he will tell you that it does work for both types of hernias. It may work for both types of hernias, but you may not have the best possible outcome if you have one or the other type of hernia. You also have to take into consideration many factors. It may be very successful technique for both types of hernias, but only if performed by the hands of its creator, Dr. Desarda himself.
1. Hernias reaching the scrotum, otherwise known as scrotal hernias, are indirect hernias.
2. Desarda technique is best suited for direct hernias.
3. My brother had his indirect (scrotal) hernia repaired without a mesh by Dr. Koch. -
All great options, understanding that there is no one correct answer. The most commonly performed operation with the best longterm outcomes for large scrotal hernias is a mesh repair. That said, non-mesh repairs, especially those with time-proven outcomes, are alternative options, with varyingly higher recurrence rates based on each patient’s risk factors.
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Isn’t it premature to discuss repair types without knowing for certain the hernia type (direct vs. indirect)? Based on what Drs. Kang and Brown say about repair types, it sounds as though the majority of non-mesh techniques are best suited to direct hernias. At the same time, I’ve seen multiple sources suggest that the majority of hernias reaching the scrotum are indirect…
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quote Chaunce1234:Shouldice has a much longer track record of success compared to Desarda repair, which is relatively new. I am not sure if there have been enough long term studies on Desarda repair, but it certainly seems promising. There is always the Bassini and Mcvay repair as no-mesh options as well.Ultimately you have to do what you’re comfortable with, and with a surgeon you trust.
It is increasingly difficult to find no-mesh hernia surgeons in the USA however, so you may need to travel.
I totally agree ..however i would consider Desarda first…with surgeon you can trust.
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Shouldice has a much longer track record of success compared to Desarda repair, which is relatively new. I am not sure if there have been enough long term studies on Desarda repair, but it certainly seems promising. There is always the Bassini and Mcvay repair as no-mesh options as well.
Ultimately you have to do what you’re comfortable with, and with a surgeon you trust.
It is increasingly difficult to find no-mesh hernia surgeons in the USA however, so you may need to travel.
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I found it.
I guess that answers that. It is possible to use Desarda technique even on very large ingunoscrotal hernias. So what about the Shouldice technique then?
In this case, the patient was told by another surgeon that the only way to repair his hernia was by using a mesh.
Here are some more cases of scrotal hernias repaired with the Desarda technique and the hands of Dr. Tomas.
https://ufirstrejuvenation.com/no-mesh-hernia-and-surgery-center/inguinal-hernia-surgery/
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Speaking of scrotal hernia…
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I recall seeing a video of Dr. Robert Tomas from Miami using the Desarda technique on a patient with a large hernia, but I’m not sure if it was scrotal hernia. I will try to find the video.
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