Any News On Desarda Inguinal Hernia Repair?

Digestive health
1

I was diagnosed with double inguinal hernia a couple of years ago and have been on 'watchful waiting' ever since.

I studied quite a bit in the early months and got horrified and worried by all the stories of pain and complications after mesh and laparoscopic surgery.

I found Dr Desarda's technique and rather lurid web site and was very impressed in the finish.  His figures seem good. He has this immense benefit of no chance of mesh complications and the possibly equal benefit of not requiring extensive technical training on the part of the surgeon.

But I couldn't find a surgeon in Australia who would do it.

And the whole medical establishment in Australia, within and without the government - i.e. up to and including the Royal College of Surgeons and the Minister for Health - would do nothing, not the smallest thing, to even acquaint themselves with Desarda's technique, much less make it available to me.

Giving me a further reason to rely heavily on watchful waiting and hope for maybe a self healing.

Well no self healing has happened and I've never heard of any regimen that might promote it.

I now wonder what's happening with the world of patients and ex patients.

Anyone had the Desarda technique? Knowledge of it spreading? Is it becoming available?  Or has it gone backwards for some reason, found to be flawed?  Or laparoscopy improved?

Does anyone have any comment, any new information for me on this subject, please?

2

My only 2 cents is if Desarda is so wonderful and works well the healthcare system in Australia would use it.  There may be why his technique doesn't work well.  I don't believe in conspiracy theories and know that most doctors are our for our betterment. 

3

It is a bit of a leap straight to conspiracy theory, Judith. I simply stated the facts.  There could be many explanations. 

I doubt the surgeons of Australia or the Health Bureaucrats would deliberately conspire against the Desarda technique.

But I am sure they will deliberately 'conspire' to preserve the status quo.   This kind of unofficial 'conspiracy' is almost axiomatic in any organisation.

The surgical world of Australia has in recent times been loudly criticised for 'conspiracy' against the females in their ranks.  That is a demonstration of their human weakness and susceptibility to actions less than optimum.

And so on.  The point being to take a serious view of a question instead of leaping to condemnation of the other party as a 'conspiracy theorist' which is the fashion of the moment in many, many fields. 

No one said Desarda was 'so wonderful' - that is another instance of abscribing falsely. 

Desarda is what it is and has the record it has.  In the world it is quite widely used most especially in those places that cannot afford our fancy machines. 

The record and the studies show that it compares more than merely favourably and that's a simple fact.

Hence it deserves a commensurate place in the armoury of tools - a proportionate place - but it has none such.  Instead it is ignored as though it doesn't exist.

My own experience was that group of surgeons claiming to be very good in their field (hernia surgery etc.) claimed to me, face to face, to have no knowledge whatsoever - none, none at all - of the  Desarda technique and told me face to face again, that they did not wish to have any!

Did not wish to have any!

Would not look at a web link!  Would not research it!  Would not be enlightened!

And you say you doubt they'd conspire!   That in itself was a conspiracy to willful ignorance.  And I know it to be true.

And it went all the way to the Royal Australian College of Surgeons or whatever they're called because I contacted them and got the same response.

I will not engage in a debate about this. You've just awakened some of the ire I felt back then.  I'll deliver myself of this and then fall silent.

It is a fact.  They demonstrated a conspiracy to preserve the status quo and avoid knowledge.  True. Indisputable.  All the way to the Minister.  I have the records of the communications.

Yes. 

4

Perhaps the words conspiracy theory were too strong. Just remove those words. I have now looked up a little info on Desarda.  Most of the info about him is a few years old when there were mesh recalls. That is all over now and meshes are working better.  My brother had an inguenal hernia surgery with a mesh and recovered in a couple of days. He is fine and hasn't looked back.  I had incesional hernia surgery without a mesh and it failed. 

I have nn knowledge of your medical system but do assume they want the best for you. 

5

I think the failure rate for mesh repairs is around  22%,.  Which means that it works for some patients and not for others.  Prior to surgery as far as I know there is no reliable test to help you to know which camp you will be in post surgery.  Two years ago I had an incisional hernia reparied with mesh, I was in considerable pain for 2 to 3 months after the surgery and found it very difficult to walk.  Mesh is not a perfect solution, hernias can be difficult to repair, but I do think that surgeons should be able to offer different types of repair to their patients, to be cynical the companies selling mesh want to sell their products.  Scotland has withdrawn mesh used for POP and SUI repairs pending an investigation and enquiry, because so many mainly women patients have been injured by mesh.  And the debate goes on in the US, about mesh used for the above conditions.  It is great when it works but can be catastrophic when it doesnt.  

6

Thanks for that. Interesting.  You can't quote the study perhaps?

After Judith's second post I decided to go back to researching the matter as I did back two or three years ago. Get some up to date information.

But that's a slow process and I don't have much free time - or rather I choose to spend it in other directions.. 

But it is very apparent to me as a layman taking a cursory look at the field is littered with over simplifications. 

Every patient is different and disregard the minor differences you're still left with enough significant differences:  age, weight, musculature, genealogy.

And every doctor, every hospital.  Many different kinds of mesh.  Many different kinds of post-operative lifestyles.

This makes comparing like with like very hard.  We can see that without being medical experts and before we get anywhere near the studies.

Then we find nearly every study is different.  From casual gathering of anecdotal evidence to rigorous double blind studies.

It looks to me like the whole thing boils down to individual cases really, there being no overall 'better' or 'best'.

But some aspects seem generally true.  Like if we argued about which was the best rope to hang over a cliff from we might argue endlessly about the merits of this fibre or that, natural or artificial, about  cable lays and such but all such debates would be very secondary to consideration of the height of the cliff, wouldn't they?

The higher the cliff the more critical the reliability of the rope for failure means death.

Well I think something similar pertains to this discussion.  There's a 'cliff' called mesh complications which can be quite horrifying.

 I find that very offputting.

Situation gets confused by overshadowing facts such as the 'cliff' that exists whatever you do as regards infection - daily getting to be a more and more dangerous thing as the efficacy of our antibiotics diminishes because of the farmer's desire to maximise profits by feeding unnecessary human antibiotics into his stock as a prophylactic measure - and by hospitals commensurately becoming daily more dangerous as they harbour more and more pathogens.

But this overshadowing I think should be separated out and not allowed to confuse.  It is a bit like telling the cliff hanger not to worry about what rope he uses for he's liable to get attacked by a sea bird or develop a case of the cramps or something.

Don't worry about this risk because there are other risks.

But I've started on the path of discussing the whole thing... not what I meant to do.  I simply meant to say I will research it again

Sorry for all the words.     (Can't bear to delete them though)

7

I was diagnosed today with left inguinal hernia, it hurts badly if I walked for more than approx an hour, or standing!

I have been reading your "rather interesting several discussions with others"

Do you really think self- healing is possible 🙆?

8

I feel it may be possible but I've got no evidence of any sort.  The one person I've found claiming to have done so I view with much suspicion.

But I have this great belief in the body.

But I can't understand what's going on really to get some idea of how/where the self healing might work.

Like apparently there's a lot of slack develops in that part of the membrane.  Why it suddenly gets weak I don't know. But I believe it is a given that cells respond to stress and strain by toughening up. You'd expect this area to toughen up at the least and ideally to fight back and contract down, get smaller, get rid of all the slack.

Doesn't seem to happen. 

And it is uncertain how we might help.  It is not a muscle. The membrane gives way and the contents beneath push up between the muscles.  A kind of structural weak spot in the design of the human beings.

Trying to cure it by strengthening muscles seems to be aiming in the wrong direction. 

The membrane is one large organ. One continuous thing.  Why would it weaken in just this place?  They never discuss that. I don't think they know.  Or care.

Collagen is important but taking extra collagen isn't really going to do any good, I think - because the whole body uses collagen. It is the most ubiquitous and plentiful molecule.

So the only things I can think of to do are diminish the weight - I am overweight for sure - and diminish the eating, which is part of the above.

Less abdominal weight might help.

And less eating - longer time between meals - allows the intestine to empty somewhat and then, perhaps ( if only !) the membrane will begin to shrink down.

And stretching.  Ah. What about stretching?  Very amazing thing  Have you ever stretched much?  Felt strange things?  A good stretch can be felt in quite surprising places in the body.  I fantasize (or theorise would be a nicer way to put it) that a stretch actually stresses the membranes and may help to cause them to respond by looking alive and shortening, squashing  up, getting thicker, tougher, who knows what but maybe something good...

And the right kind of exercise. Difficult to see what that might be but I have opted for bicycle riding.  It exercises all the muscles in that area without seeming to cause the stress that a sneeze, for instance, or even forceable micturition can cause.

And try and be happy.

So, yes, I believe it can be possible but I don't know how and don't even have any good leads.

My own way is to eat less, lose weight, exercise on a bike and be happy.  

And keep an eye out for developments from time to time.  Which I'm just about to embark upon again.  Another 'research the web' project.

I wish I had something better to say.....

9

Thank you so much for your inspirational reply, I am now more than ever determine to fight this thing. For sure you are imazing human being and I sincerely wish to you all the best

:-)

10

Hi

I registered solely to make a comment on your above comment. I fully agree. I could not find any surgeon in Australia to do anything but the mesh and then pretended ignorance on the other techniques.I believe its the Mesh companies buying the surgeons and because its an Island make it very hard for patients to do anything else. Our way or the Highway, any surgeon choosing a different.technique may be ostracized. My dozens of telephone calls points to that conclusion. Mesh is more expensive so keep the cost up.

Conclusion: ALL Australians Surgeons not doing the right thing for Inguinal Hernia Patients.

PS:Still have an Inguinal hernia 4 years and seeking a repair. Tried all the natural healing methods with no success. But still haven'i  given up but how long can you wait while your life passes away.

I am very interested in the desarda technique and have spoken to 4 of their surgeons and met 1 face to face.

Fell free to communicate with me directly.

LiammaiL

11

egistered solely to make a comment on your above comment. I fully agree. I could not find any surgeon in Australia to do anything but the mesh and then pretended ignorance on the other techniques.I believe its the Mesh companies buying the surgeons and because its an Island make it very hard for patients to do anything else. Our way or the Highway, any surgeon choosing a different.technique may be ostracized. My dozens of telephone calls points to that conclusion. Mesh is more expensive so keep the cost up.

Conclusion: ALL Australians Surgeons not doing the right thing for Inguinal Hernia Patients.

PS:Still have an Inguinal hernia 4 years and seeking a repair. Tried all the natural healing methods with no success. But still haven'i  given up but how long can you wait while your life passes away.

I am very interested in the desarda technique and have spoken to 4 of their surgeons and met 1 face to face.

Fell free to communicate with me directly.

LiammaiL

12

Hi...

I'm now on the waiting list for a mesh repair in an Adelaide hospital.

Signed up for this because the thing is beginning to get worse, finally - giving different variieties of pains from time to time.

And perhaps getting a little larger.

All the things I've tried to improve it just haven't worked.

This surgeon tell me he has had this operation performed on himself. With mesh.

He says mesh is much improved, etc...  

The biggest single thing he said to persuade me to change my mind was that it is difficult to replicate Desarda's results.

And that seems true alright.

In the years that I have been following this I'd expect the Desarda technique to attract more and more followers and rise to more and more studies, etc. - but in fact there's effectively merely silence, nothing happening...

He claims the same recurrence rate,  the same 'trouble free' rate.

For all that I'm persuaded by his statements - more I'm consoled or mollified or something...   Mainly I'm without other recourse and feel I should get something done now.

My skin is getting very delicate I notice.  If I bump almost anything that even looks like an edge my skin can tear and I'll bleed.

If my inner membranes are like that, too, I shudder to think how on earth a surgeon is going to fasten them together....

If anyone is going to cut and sew me I'm thinking the sooner it is done the better before my aged tissues get even more fragile.

So I'm going to do it, just waiting to hear from him.

In all the time, for instance, this post, this thread, has been here I've never had any private contact with information about Desarda - availability,  encouraging studies,  spread of the use, anything....

And you can all see there's been no postings here.

so that's what's going on with me.... 

13

Good afternoon,

I have a left inguinal hernia. I am scheduled to have surgery using the Desarda technique in about three weeks at the Desarda Hernia Center in the USA in Ft. Myers, Florida. There are a few doctors in the United States that do a no-mesh hernia repair. When the mesh works, it works. But when it doesn't, it's bad news. There are many complications associated with mesh repair: chronic pain, infection, etc, with 20% of patients. 5% of patients have life altering pain with severe complications. 

The reason mesh is claimed to be the gold standard is because that is what is taught in medical schools and that is what the pharmaceutical companies pedal. Reoccurrence is lower with the mesh, but complications are greater and more sever with mesh. Shouldn't the goal be no chronic to life altering problems than reoccurrence?

Look at the massive recall of mesh in the United States. Also, did you know the mesh is supposed to be a permanent implant. Ask your surgeon about having the mesh removed if there are complications. They will look at you like you are crazy because many surgeons, not all surgeons, do not know how to remove the mesh with confidence. And most times all of the mesh cannot be removed if there is an infection of the mesh.

If the Desarda repair was so inferior, there would be lots of complaints and the procedure would be banned. If the repair doesn't work, I can always have the mesh later. So, why not try having the repair done naturally first. It's your body. It's your health.

14

Thankyou for all your words. I have a large incisional hernia given to my by an incompetent expensive surgeon performing a laparotomy. I am using elastic belts as now my life savings are gone. This is life and I am so happy I am not young.

15

Funny how this thing works.  I got an email about Jay1796 replying to my comment - came here to see his reply -it's not here!

Perhaps he took it down.

So while I'm here I might report that I'm due to have the laparoscopic operation in a couple of weeks.

I am not convinced at all that it is the best, that the risks are not badly greater than open surgery because of the difficulties of removing mesh - but I've been persuaded that the risks are down at the 5% level either way.

It is a gamble, seems to me.  And Desarda is simply not available to me in Australia.

My surgeon has had an inguinal laparoscopic operation himself, he says. That's persuasive though perhaps logically it shouldn't be.

Gets to the point where you (I) just can't follow logic any more.  The arguments get too similar on either side.  There's too many estimates and unknowns.  There's too much claim of superior knowledge on each side.

It's like the global warming debate in that respect.

But what I thought I might contribute for those who don't know about it, haven't got it, there is a Dr Desarda's Youtube video showing his operation very clearly.

If you can watch this you'll see it is a very understandable and simple operation.  And then if you research just a little further and get an understanding of the 'mechanics' of it you'll be in a much better position to think about it all.

Moderator comment: I have removed the link(s) directing to site(s) unsuitable for inclusion in the forums. If users want this information please use the Private Message service to request the details.

http://patient.uservoice.com/knowledgebase/articles/398331-private-messages

16

Thank you for that message. I agree, i have spoken to Dr, Tomas for over 1 hour on 2 occassions and do understand fully you comments.

Im am planning  to go to Auckland where Dr.Gearld Young has performed 150 Desarda operations in the passed 18 months with no reoccuence according to him.

Whats you view on the Desarda repair with Non absorbable sutures.?

Regards Liammail

17

So your going to go Laparoscopic / mesh,? Getting inguinal hernai repaired is tricky business and its complications much underestimated.I personally would not have a repair done laparoscopically.The quality repair is more important than a cosmetic look or a few extra days in bed with longer or more pain. Open incision i believe is better and the surgeon has more control.

Iv seen a few videos, Which one exactly are you referring too so I can check it out,

It appears that if theres a reoccerence with Desarda its infinitelly more easier to fix it than the mesh.

Cheers LiammaiL 

18

Hi...

yep, I'm surrendering is just about what it amounts to.  Not at all convinced it is the right thing but just about convinced that it is a margin call either way.

That's about the way my surgeon put it - that recurrence rates are about the same - i.e. marginal.

And that mesh complications are not now as they used to be.   Don't know how true that is.

He pointed out - or maintained - that though it appears very simple in the video - only that one tricky bit of getting around that nerve I think it was - there must be more to it because it simply hasn't caught on all around the world.  He claims it is not as easy as it looks.

And has the demerit of using  -  reusing - 'diseased' tissue.

I was referring to the easily accessible youtube video of the Desarda method being used in an actual operation.  It has been up there for about four years I think that I know of.

Did you see the moderator claimed to have removed my link because it was to a site 'unsuitable for inclusion' ?  God knows how they work that out.

Anyway just google desarda repair youtube or similar.  It's almost as though everyone is against this knowledge getting out, isn't it?  I wonder if they'd have the same attitude to 'shouldice repair'  and so on?

 

19

I don't know what Desarda technique is, however, let me assure you that whatever it is, if mesh is used, you will end up in so much pain, you will not likely ever be the same...  whatever you do, find someone who will do it the old fashioned way.

20

It's not the reoccurance that you need to be leary of!  The 5% reported that have life-altering pain is actually quite a bit higher than that.  My sister had it done, pain until removal 1 year ago and, since then has been in even more pain, intolerable pain.  She's up to maximum in narcotic painkiller, has had every test imaginable and still no relief.  The only solution is NOT to let the surgeon use mesh!!  There are surgeons who still, or have learned to, sew rather than use mesh...  Please, seek one out!