Comparison of Postoperative Morbidity Between Two Tension-Free Hernioplasty Techniques: With Mesh versus Without Mesh

Adnan Kulo¹ , Diela Kulo², Ramajana Sukic-Karalic¹, Edin Hodzic¹, Sandin Holjan¹, Lana Sarajlic¹, Salem Bajramagic¹

1 Clinic of General and Abdominal Surgery, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
2 Clinic of Pulmonary Diseases and Tuberculosis, Clinical center University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Corresponding Author: Adnan Kulo MD, MSc . Clinic of General and Abdominal Surgery, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina; E-mail: adnankulo@gmail.com; Phone: +387 33 297 179; ORCID ID: https://orcid.org/0009-0005-3788-9362

Cite this article: Kulo A, Kulo D, Sukic-Karalic R, Hodzic E, Holjan S, Sarajlic L, et al. Comparison of Postoperative Morbidity Between Two Tension-Free Hernioplasty Techniques: With Mesh versus Without Mesh. Sar Med J. 2024; 1(1): Online ahead of print. DOI: 10.70119/0003-24

Original submission: 19 March 2024; Revised submission: 16 June 2024; Accepted: 18 July 2024

Abstract

Introduction. Although inguinal hernia surgery is the most common surgical procedure worldwide, the best surgical method is still not universally accepted. The Lichtenstein technique is considered the gold standard, although it also has its limitations. Therefore, there is still a need for new techniques, such as the Desarda technique. The aim of this article is to evaluate and compare the postoperative morbidity of two tension-free techniques for inguinal canal pla-stic surgery with and without the use of mesh.

Methods. This prospective randomized clinical study was conducted at the Clinic for General and Abdominal Surgery of the Clinical Center of the University of Sarajevo from January 2017 to December 2022. The study included 60 patients with primary inguinal hernia who met the predefi ned inclusion and exclusion criteria and were randomly allocated into two equal groups: 30 patients operated on by the Desarda technique and 30 patients operated on by the Lichten-stein technique.

Results: The following parameters showed a statistically signifi cant diff erence in favor of the Desarda operative technique: shorter hospitalization, lower level of postoperative pain, faster achievement of early physical activity, lesser amount of analgesic consumption, earlier return to regular daily and work activities, and absence of chronic inguinal pain. Postoperative morbidity was more frequent in the Lichtenstein group, but likely due to the small sample size, this diff e-rence remained statistically insignifi cant.

Conclusion: Patients operated on by the Desarda method exhibited signifi cantly lower levels and frequencies of postoperative pain, faster postoperative recovery, and return to usual daily and work activities.

Keywords: hernia, inguinal, treatment, prognosis.