Shouldice vs Desarda

[Chuck]

A good study comparing the techniques. Desarda comes out on top in terms of operating time and recovery time. Long term recurrance rate is uncertain. There are a dearth of good surgeons using the Desarda. Tomas has many reports of unprofessional conduct anecdotally, Yunis is new to the repair. I called Desardas clinic and the guy that replaced him had done only 150 desarda repairs. I found this to be surprising. Why didnt desarda train somone one up…Covid was used as excuse for lack of volume…That leaves Lorenz who does them but seems to prefer the shouldice repair. So who do you go to? Also lots of reports of they usual with tissue repairs —i can still feel the repair when i lift groceries…my dog pulls etc…Still waiting for those great studies showing superiority of tissue repairs in terms of chronic pain…will pay pal the winner $200 . here is the study https://pubmed.ncbi.nlm.nih.gov/30639473/

[William Bryant]

I think most people who choose tissue repair do so also because if anything should go wrong, there is no mesh to remove.

It seems there are no conclusive or exhaustive studies on chronic pain sadly, Chuck, just as I don’t think there is a registry to establish the best performing, most reliable, less prone to chronic pain meshes.

[Chuck]

Thx Bryant. Do you have any feeling for which tissue repair is better. Some say shouldice is too invasive, tight prone to chronic pain. Desarda seems less invasive. Less prone to chronic pain. But also maybe less durable. Desarda leaves less junk inside too. Some say shouldice suturing is as much volume as a piece of mesh.

[William Bryant]

I’m leaning more towards Desarda and Dr Kangs repair also as Shouldice seems a bit overkill but there must be a reason the tissue surgeons choose it when suffering a hernia. I haven’t read of any that have had Desarda

[Chuck]

Thx Bryant. Just off the phone with a guy who had shouldice. He has pain and tightness. He had a mesh repair open on the other side and that went bad too. There are simply zero good options. Just live like bubble boy. If you ever want to chat over what’s app. Would love to compare notes

[Chuck]

Bryant I should tell you that teo docs I talked to recently agreed with Dr T that tissue repair rates are way higher than these tissue docs are telling us. Maybe on the order of 20 percent lifetime. If tissue fails particularly at our age mesh will be the only option. So makes me wonder whether open mesh is the best option. Of course that was my rationale the first time around.

[William Bryant]

This is why I’m tempted to watch and wait a little longer however as Watchful pointed out once there are likely to be fewer surgeons capable of a tissue repair as time goes by.

I still think that although, and even if, chronic pain is same across all types of repair, at least with tissue there is no mesh that has to be removed.

[Watchful]

William,

I feel the same – if you are a good candidate for tissue repair, I would go with that instead of implanting mesh. It’s not an obvious or easy decision, though. Also, not that easy to tell in advance if your case is a good fit for a particular type of tissue repair or not.

[Author]

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