Non-mesh repairs for inguinal hernia – best techniques and UK options

Hernia Discussion Forums Hernia Discussion Non-mesh repairs for inguinal hernia – best techniques and UK options

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    • #29281

      Hi everyone,

      I’ve recently joined the forum and not had a chance to search through it fully yet and realise already that this topic has come up numerous times, so please feel free to signpost me to suitable posts.

      I’m UK based and hoping to find a top surgeon who’s very experienced in performing successful non-mesh repairs for inguinal hernias.

      I’m also very keen to know more about the Desarda technique and how effective it is, should any of you be able to shed some light on it for me please? I’ve read a number of studies and meta-studies, mainly from Africa/Asia, which appear to evidence excellent outcomes, though I’ve found some negative posts about it in this forum, which appear to focus on surgeries in the US.

      I’ve found details of surgeons in Germany who practice Desarda and/or a Shouldice type repairs – Dr Ralph Lorenz, Dr Ukrike Muschaweck (who’s operated on many top Premier League footballers), Dr Joachim Conze (who I believe took over from Dr Muschaweck at the Hernia Centre, Munich), Dr Andreas Koch and Dr. Martin Wiese (Biohernia). Dr Muschaweck offers her own Muschaweck repair and ran a UK clinic every month before the pandemic, but isn’t at the moment unfortunately. Her costs seem to be around two and a half to three times more than the others and a bit out of my price range really. I know that some of them offer a tailored approach and choose the type of repair during the operation, which I can see the benefits of doing, but I’d like to know for sure that I’d be receiving a tissue based repair, rather than find out afterwards that they’d decided to use mesh.

      With the pandemic and associated travel issues, plus concerns about follow up appointments, I’m hoping to find a consultant in the UK, though it seems there aren’t many who offer tissue repairs for people over the age of 30, as I’ve only found four so far, despite fairly extensive research. I’ve found some very high profile consultants who’ve operated on numerous elite athletes across a range of sports, but they seem to use mesh for hernia surgeries.

      Of the four I’ve found, from my understanding:
      – Simon Bailly apparently practices the Shouldice technique, though I’ve been unable to find out whether he follows the exact same method/a variation, or any information on recurrence rates. I’m going to try and contact him for more information.

      – Professor Ernest Schilders, apparently offers a laparoscopic tissue repair. I’ve not come across any research on this technique, so haven’t looked into it further.

      – The other two consultants offer Desarda repairs, though both have only done about 10 Desarda procedures each (no recurrences that they’re aware of) and tend to do mesh repairs usually. One of them strongly advocated mesh repairs when I contacted him, though the other said he felt that the Desarda repair was a good equivalent to a mesh repair. I felt that he came across well, so I’m hoping to get a referral to meet him, as he only works through the NHS currently, so a faster private/paid for appointment isn’t an option.

      I’ve seen some of the posts re Dr Kang’a method, including his own and were he not so far away, I’d have been very interested to have a consultation with him, pandemic allowing. Any plans to open a UK clinic Dr Kang, should you happen to read this?

      Does anyone have any experience or knowledge of the consultants I’ve mentioned (including those based in Germany), positive or negative?

      I’d be hugely grateful for any further information that any of you are able to share about all this and particularly re excellent UK consultants offering non-mesh repairs. I really don’t want a mesh repair and I’d like to know that the surgeon I choose has an excellent record of successful long-term outcomes.

      Many thanks in advance for any information you can provide.


    • #29305

      I don’t have first hand experience of the people you’ve mentioned although have seen them when searching. In addition these people/places may do non-mesh or may be people you could look into at least:

      Emin Carapeti (shouldice)
      Greg Sadler – oxford hernia clinic (basini)
      London Hernia (Largely this is mesh though I think Martin Kurzer may do Desarda or at least a different kind of mesh)
      David Nott – Does mesh removal so may do a different kind of repair
      Simon Marsh
      Aali Sheen – Mainly mesh but as he does removal may also be doing different types of repairs

      I think a lot sway towards mesh and also potentially fall outside Bupa/Axa/etc. In the Bupa finder website you can search peoples names and see what procedures they are doing, which gives you an idea of what kind of surgeries they are doing, how often etc. Although this doesn’t really indicate success rate, technique etc. You may find out more about Simon Bailey by also looking for Peter Jones as I believe Simon was his apprentice.

      Interesting that you found people on the NHS that do Desarda repairs, I guess you can’t share names?

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