MODIFICATION OF THE DESARDA HERNIOPLASTY METHOD WITH THE INTEGRATION OF A MESH FRAGMENT IN PATIENTS WITH INGUINAL HERNIAS
DOI:
https://doi.org/10.11603/2414-4533.2026.1.16061Keywords:
hernioplasty, inguinal hernia, Desarda plastic, mesh implant, Desarda + mesh hernioplasty, Lichtenstein plasticAbstract
The aim of the work: to increase the effectiveness of surgical treatment of inguinal hernias by conceptual modification of the Desarda hernioplasty method with mesh fragment integration, aimed at combining the advantages of autologous tissue plasticity and alloplastic reinforcement in order to reduce the frequency of recurrences, postoperative pain and complications.
Materials and Methods. A prospective comparative cohort study was conducted with three parallel observation groups: group I consisted of 45 patients who underwent Desarda plasticity, group II consisted of 46 people with the hybrid Desarda method and mesh fragment integration, group III consisted of 46 patients with Lichtenstein hernioplasty. The study included patients aged ≥18 years who were scheduled for surgical intervention for inguinal hernia. Inclusion criteria: the presence of primary unilateral inguinal hernia, corresponding to the code K40.9 according to ICD-10. Exclusion criteria: complicated variants of inguinal hernias, recurrent inguinal hernias, as well as the presence of an infectious process in the area of the planned surgical intervention.
Results. Key conceptual emphases of the modified technique: combination of dynamic autotissue reinforcement and static alloplastic stabilization; mesh isolation under the aponeurotic flap; minimal implant fixation; preservation of inguinal canal anatomy. Criteria for choosing the hernioplasty method – Desarda vs Desarda + mesh. The choice of surgical treatment method was made based on preoperative and intraoperative characteristics. The modified technique that we proposed is based on a combination of dynamic autotissue reconstruction with static alloplastic support. The mesh implant is placed deep in the inguinal canal and isolated by an aponeurotic flap, which acts as a protective barrier, reducing the contact of the mesh with nerve structures and subcutaneous tissue. Implant fixation is minimal or limited, which helps reduce the risk of chronic pain and fibrotic complications. At the same time, the natural anatomy and biomechanics of the inguinal canal are preserved.
Conclusions. The proposed modified Desarda + mesh hernioplasty technique expands the capabilities of the classic Desarda tissue plastic surgery in more complex clinical scenarios, providing a balance between biological tissue adaptation and mechanical reliability of reconstruction, which potentially contributes to a decrease in the frequency of complications and an improvement in the long-term results of inguinal hernia treatment.
Received: 16.01.2026 | Revised: 03.02.2026 | Accepted: 19.02.2026
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