Any News On Desarda Inguinal Hernia Repair?

Hi. Check out the Desarda website, there is quite a lot of info and testimonials there.  The repair was a success.  And I was very dubious because there is so much info on the net, your head starts to spin.  Plus I went to India without ever even talking to anyone.  I simply booked it all via email - which was possibly mad, but now with it all going well, in retrospect maybe I wasn't mad ))).  I had the op, stayed in hospital overnight and then went to a hotel nearby to recuperate for a few days. I was mobile within a few days.  One of my initial concerns is whether the whole thing was a scam.  It certainly isn't.  I believe that Dr Desarda has done more than 1500 of these operations without issue.  He is quite a gentlemen too and capable (I reckon he must be late 60's almost 70 but still well in control) and very pragmatic.  I asked him about what I can and can't do after the op - he just said you can do whatever you feel comfortable with. Its up to you.  The surgery technique is such that your activity can't harm the area, unlike mesh repair.  The only provisio is that you don't actually knock the surgery area for a wek or so. The process is not really cheap (and especially not for Indian levels) but if it works then its worth it. I asked Dr Desarda why this method is not used elsewhere.  He firmly believes that one day it will be the only method. He thinks that the mesh companies, teaching places and existing surgeons just push and continue what is already established. Before I left he asked me to do one thing - let people know of my experience with the repair.  So that's what I am doing now.     

Just for interest (as photography is a hobby of mine).  I took some shots of Dr Desarda (the following afternoon after surgery).  I asked him to pose and he was a good sport with it all. Attached

Thank you for your update. I wish you all the best. I have my appointment with the Shouldice Clinic in April. I too believe that one day mesh will be taking a back seat to natural surgery...except where mesh is truly warranted.

Hi SP

See my post above, I had my bilateral inguinal hernias repaired by Dr Robert Tomas in Florida using the Desarda technique 15 months ago and it's been very successful. I flew from Auckland to Florida for the operation. 

IMO, if you are aged in your 20's then you are too young to have mesh implanted unless its to save your life. Life expectancy of males is around 80, expecting mesh to last 60 years without causing an issue is dreaming.

I don't know about Australia, but in New Zealand Gerald Young is the only experienced Desarda surgeon, he's done around 200 now. I've met him, been examined by him, and he'e very good, but at the time he'd only done a handful of Desarda operations so I choose to go to Dr Tomas as he had done around 2,000. With hernia surgery experience is not desirable, its highly critical and the single biggest factor you have control over. Choose the most experienced surgeon you can afford. If you can't afford a great surgeon, then don't have the operation - period. Better to live with a hernia than 24/7 chronic pain. 

When I had my bilateral hernia's done (two hernias) Young quoted me $5,500 NZ, while Robert Tomas quoted me around $6,000 US, so not a massive difference. The financial penalty for the USA operation costs were the air travel and accomodation, especially as you will need a support person with you for the 48 hours after the operation, and help you deal with the airports, planes and baggage for the trip home. Robert Tomas told me not to lift anything more than 5kg for 8 weeks afterwards.

Shouldice is a more complex operation and leaves permanent stitching and/or stainless steel wire inside you forever. It should be done by a Shouldice trained surgeon (most surgeons' here in NZ offering Shouldice have NOT been trained by the Shouldice clinic), with at least 1000 Shouldice operations under his/her belt. I wouldn't have that operation otherwise, its too complex to be done with someone without the proper training. Desarda is a far simpler operation and leaves nothing permanent inside you.

I am not aware of any published studies comparing Shouldice and Desarda, but the reoccurrence figures for an experienced surgeon in each technique are similar. Likewise chronic pain figures are similar for each, however the Shouldice requires more unpicking and reassembling of tissue. In the hands of a less than experienced surgeon that means more risk of chronic pain. Desarda is far simpler. In life, KISS is usually better.

Reabsorable mesh hold a lot of potential promise, but  they still very much untested technology in hernia repair. Naturally long term studies are lacking, but there are several short term studies showing higher reoccurrence rates compared to standard mesh. I was keen on these for a while, but after considerable research on them I choose Desarda because its more natural and means a future operation is considerably simpler.

Hope this helps you.

Regards

John 

Hi John,

Thanks for your detailed reply.

I have actually uncovered 1 more technique for Non-mesh repair, called Moloney Darn, which is the older technique going back to the days from before the dreaded mesh came to be.

Shouldice I gather is a bit of a secret society (just the one clinic in Canada, and detailed study and info is difficult to gather from them, so I am a bit of Shouldice sceptic).

I should have reframed my question to Desarda vs. Darn repair.  , as these are the two leading options for me now.  

Does any one else struggle trying to understand research studies, or even worse, watching you-tube footage of surgery?  I go very weak at the knees around gore and exposed flesh!  But there doesn't appear to be much choice when researching the subject.  There is always a healthy dose of "hernia sac and blood!" 

 

I checked out the Moloney Darn repair and ruled it out. Its a simple and basic stitch repair, IMO Shouldice is superior because it overlaps the tissues. However I remain more than happy with my Desarda decision and even with hindsight would make the same call again tomorrow. The only minus will ALL all tissue repairs is recovery is longer, in my case eight weeks of not lifting more than 5kg.

As to a Desarda surgeon - Robert Tomas in Florida if you can afford the travel costs, Gerald Young in Auckland if you can't. 

Hi John and All,

Yes - I am really bad a making decisions this big.

Feeling undescissive and worried about making the wrong call.

The issue with travelling to NZ is that it adds an extra $6K to my surgery (travel, plus my insurance will not cover surgery outside of Aus

Having said that, if it is the best option.  That is worth paying.

So little is written about Moloney Darn (try googling it!) I wonder if it isn't a 1960's technique?

But I do not understand how Desarda is superior, except to say that there is alot more written about it online and in studies.

You are correct about the sutures (with Darn repairs) there are prolene stiches left inside of you afterwards.  My goal is for zero foreign objects left inside of me, but if they are non-reactive (not sure if prolene is or isnt' then I am fine with that.

John I realise that you went down the Desarda path and were happy, but I am also confident with the skill of Dr. Garvey who is quite a high profile surgeon and very likeable.

Any final advice for me please?

Thanks

 

Hi SM

I can't add much more except that structurally a dynamic muscle repair (Desarda) is a stronger long term solution than relying on stitching tissues together (Moloney). Do you realise the Moloney Darn uses Prolene stitching made from polypropylene - the same stuff hernia mesh is made from? You're right in that the Moloney is an old 1960s technique, it's rarely used nowadays. Regarding the costs. Personally, my health isn't an area to save money but compromise the outcome - I go for the best option, then work out how to pay for it. IMO, if you haven't got good health, you've gone nothing. You get one good shot with a hernia, make it your best shot. 

But it's got to be your call. Good luck.

Cheers

John