Hernia Blogs


Informed Consent is required to avoid legal suits from the Patient before Hernia Surgery with Mesh!!!

Every surgeon and the hospital now should take an informed consent in writing from the patient before his surgery of hernia repair with mesh.The consent should mention that mesh is a foreign body, it is a piece of synthetic cloth and it is associated with possible complications of a foreign body. Otherwise, the doctors and hospitals may have to face legal suits in future filed by the patients for the damages!!!!

Mesh is widely used in hernia surgery all over the world. Many patients are not aware that it is a foreign body and they give general consent for surgery as advised by their doctor because of faith in him. Patient feels that the doctor would not do anything that is harmful to him. This faith is being used by the mesh manufacturing companies to market and sale their product at any cost without bothering much for the harmful consequences patient may face in future due to known foreign body complications. But now patients are becoming more and more aware from the internet that mesh is a foreign body, a simple piece of synthetic cloth naturally associated with many foreign body complications. So it is now necessary as prevention of future legal complications that every surgeon and the hospital should take an informed consent in writing that the mesh is a foreign body prepared of synthetic threads like cloth and may cause harm to him due to well-known foreign body complications. OTHERWISE,patient may file a legal suit against the surgeons or the hospital and may claim for huge damages!!!

      

                                                       Mesh shrinkage                                        Testicular damage                            Infected mesh (Light weight)

 

                                                                                                                   Infected mesh (Heavy weight)

Mesh is a foreign body, a piece of cloth prepared from the synthetic threads. Therefore, its use in inguinal hernia repairs is known to cause all sorts of complications like pain, recurrence, infection etc. “Desarda technique” is a new technique of groin hernia surgery without mesh and it uses your own body muscle for repair and gives virtually complete cure from inguinal hernia problem. An undetached strip of the external oblique aponeurosis is stitched on the weak area between the muscle arch and the inguinal ligament to form a new, strong and physiologically dynamic posterior wall that gives protection and prevents recurrence. Normally patient goes home in a day after surgery and can drive car and go to office in 3-4 days’ time. This "Desarda repair" is now followed in many countries all over the world. This inguinal hernia repair does not use any foreign body like mesh for repair and therefore there are no complications that are seen in mesh repairs. A visit to Topix or other hernia forums show thousands of posts showing sufferings of many patients due to mesh repairs. Laparoscopic surgery is done with mesh only. And that is more hazardous because the mesh is stitched inside your abdomen.

ABOUT US: Invented a new operation technique for inguinal hernia repair that does not need any mesh or foreign body for its treatment. Even sutures used are absorbable leaving no trace of foreign body after hernia surgery. Visit for details http://www.desarda.com   cell number: +91 9373322178 EMAIL: desarda@hotmail.com

"FIRST WORLD HERNIA CONFERENCE HONOURED DR. MOHAN DESARDA BY

 INVITING HIM AS GUEST SPEAKER"


The first world hernia conference was held from 25 to 29 April 2015 at Milan city in Italy. Nearly 5000 surgeons from different countries all over the world attended this conference. Dr. Mohan Desarda received an honour by receiving an invitation from such a prestigious and magnificent conference as an invited faculty and guest speaker. This conference was held specially to discuss issues related with a very common disease ‘abdominal wall hernias’.

Every conference invites international faculties who are expert in that disease subject and have done some innovative work. They demonstrate their work to surgeons from all over the world so that they can carry this knowledge to their country for the benefit of society at large.

Dr. Mohan Desarda a Pune based senior surgeon and hernia expert has done basic invention in the hernia disease. The world conference took a notice of this and invited him as a guest speaker is an honour not only to him but to our nation. He challenged the old concepts that cough or weight lifting causes hernia and established that hernia occurs only because of a defect in the muscle. He also developed a new operation technique of muscle transfer to close this defect now practiced worldwide as ‘Desarda Technique’. This technique is now included in the medical text books of international repute. This is also an honour received by Dr. Desarda and all of us as Indians.


In traditional operations done today, surgeons stitch a mesh by open or laparoscopic surgery. Mesh being a foreign body has many inherent disadvantages and complications. Desarda repair does not use mesh or endoscopes so it does not have any complications associated with them. This operation is very simple to do and to understand for any surgeon. Dr. Desarda purposefully did not make any patent of this so that any surgeon can use this freely for the benefit of their patients. Patient can bend, squat, climb up the staircase, carry luggage and travel or go to office within couple of days after surgery without any fear of recurrence.

Dr. Desarda calls all surgeons to use this technique for repair of inguinal hernias in their patient and give them benefit of a mesh free surgery. Interested patients or doctors can contact on 7738181022 or email at Desarda@gmail.com or visit our website: www.desarda.com for more information.   


DESARDA TECHNIQUE OF HERNIA OPERATION GOES FROM INDIA TO GERMANY"

Dr. Mohan Desarda, an eminent hernia surgeon from Pune, is invited to Germany to deliver lecture and to demonstrate his invented new groin hernia operation technique in the international conference. “BERLIN HERNIA DAY” is a prestigious hernia conference organized in Berlin, the capital city of Germany. More than 500 surgeons from Europe, UK and USA take part in this conference to listen to speakers and learn more advanced operation techniques. Dr. Desarda is invited as Faculty teacher and speaker for this conference to be held on 25-26 January 2013 in Berlin.

The big problem in today’s hernia operation is that it recurs in spite of surgery again and again. It is great mental torture to face the failures of operation to the patients as well as family members. Almost all groin hernia operations are done to day where a mesh is stitched on the defect through open or laparoscopic surgery. This mesh is not safe in all respects to the body because this mesh is a simple piece of cloth prepared from the synthetic threads like Polypropylene or Polyester. Naturally, patients have to face all possible complications arising from stitching such foreign body inside the abdomen during surgery. Recurrence, pain, infection, migration, perforation, rejection, testicular ischemia are all known complications arising out of this mesh with which patient might have to suffer lifelong also. Strong nearby muscles become weak, atrophic and thin like paper causing permanent damage because mesh gets adherent to all nearby muscles and life of some patients even get ruined facing all these complications. It is very difficult and complicated to re-operate on such patients and still no guarantee of cure.  In spite of this, some doctors advertise to operate with costly or 3D mesh etc. to attract patients for personal gains. Mesh and endoscope manufacturing companies also market use of mesh through doctors to increase their sails and earn more profits.

Because of this, research is going on for decades all over the world about inguinal hernias. Dr. Desarda did original research in this hernia disease and found the reason why groin hernia takes place and challenged all century old theories published in the text books by previous researchers. He also developed a new operation technique based on these new theories. It does not use any mesh during surgery, instead a strong and live strip of a nearby muscle is stitched on the hernia defect. Therefore, it gives complete cure from hernia with fast recovery. Patient can start his normal activities within couple of days without any fear of recurrence. Patients can be operated under L.A. as day procedure.

Inguinal hernia cannot be cured without surgery. Do not believe if somebody says to heal hernia with medicines or exercises or hernia belt or yoga. There is no pain in this disease so some patients neglect it and postpone surgery resulting into increase in size of hernia and its complications. So get hernia operated as early as possible from a good surgeon, Dr. Desarda advised.

Interested doctors and patients may contact: EMAIL: Desarda@hotmail.com  or  visit our web site: http://www.desarda.com

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What is mesh used in hernia surgery?

Hernia is a common disease that can affect any body from his childhood to old age. We need to stitch the shirt if it is torn, like wise we have to do surgery to get relief from this disease. Many times a small piece of cloth is used to repair the torn shirt, like wise this mesh is used to cover the weak spot of hernia or the hernia hole to repair it.

If your surgeon tells you that he will use a piece of your shirt or any other synthetic cloth after getting it sterilized for stitching on the hernia hole then you will never agree to his proposal. No body can think of this idea because you are sure and afraid that a piece of cloth can not be stitched inside your body and to do so is inviting lots of problems and trouble for your life time. You are aware that even if you take out the thorn, a small particle of it remaining inside the body forms a big corn, it pains for years and gets infected any time even after years.                                             

            
                                                                              

                                          Mesh stitched on hernia hole                 Mesh does not give protection

 

Then what is mesh that is used routinely by almost all the surgeons during hernia operation? Every body imagines that mesh must be some special material prepared by the companies for hernia surgery and it must be safe in all respects for our body. In reality, it is not so. It is a simple cloth prepared from synthetic threads of polypropylene, polyethylene or prolene or some other such synthetic material. If companies had made it known to all that this is a piece of synthetic cloth then no body would have accepted it for use in hernia surgery. Therefore, it was named with a special name like “Mesh” and sold in the market. A big cloth is prepared from those synthetic threads. Then it is cut into pieces of various sizes and shapes and then it is nicely packed, sterilized and then sold in the market at exorbitant price. It is estimated that companies are selling those meshes worth Rs. 1000 crores every year in India alone.

 

The mesh which is used today was brought in the market somewhere during 1990. But such meshes prepared from Dacron or Teflon were already used in many patients all over the world much before that. A famous surgeon from Pune, late Dr. Sulakhe and the author himself did use such pieces of cloth like Terene, Terylene etc available at that time around 1970-75 after due sterilization in many patients. But such operations were already rejected by the surgical community because of unacceptable rate of infection following its use in hernia surgery. In reality, those old meshes and today’s mesh both are prepared from synthetic threads and technically there is no difference between them. But because of improved sterilization techniques and availability of better and higher antibiotics after 1990 reduced this infection rate to a great extent and therefore its use in hernia surgery became rapidly popular. Another reason for this was the high rate of recurrence following hernia surgeries done with old techniques. But this does not mean that now there is no recurrence of hernia after it is repaired by using this mesh. Recurrence is still there following mesh repair and it is 7-8% in USA as per their studies. Though recurrence rate and infection rate is substantially brought down, another major problem following mesh repair of chronic groin pain still remains and it is 28-42% as per many studies.

 

Your shirt becomes alright as soon as it is stitched but this does not happen when this mesh is stitched on the weak spot or hernia hole. The mesh is a delicate cloth just like a mosquito net and therefore fails to give immediate protection following the surgery. A foreign body reaction starts in and around the mesh and a curtain of tissues is formed within couple of months just like a corn following thorn prick. Then it takes another 2-3 years for developing sufficient strength in this curtain so as to give real protection against reappearance of hernia. It means the patient is not protected for 2-3 years in spite of hernia surgery with mesh. And if he gets an attack of cough or sneezing etc. during this period then the mesh gets torn or displaced or stitches get avulsed resulting in reappearance of hernia. This mesh can also get crimpled or retract to a size that is 20-50% less increasing chances of recurrences. This is seen in many more cases in India because the mesh routinely used in hernia is of low quality to save on the cost. Therefore, the rate of recurrence seen in India is much more than what is seen in USA.

            
       Shrinkage of mesh from palm to finger size

 

These mosquito net like meshes when used for hernia repairs have made lives of many patients miserable. Many patients from USA and other countries have posted on the internet hernia forums their story of miserable life after mesh repairs. Specialists and specialty clinics are established in USA who does the only job of removing the mesh or treating the chronic groin pain syndrome. Recurrence, infection or pain following mesh surgery requires much larger, difficult and commanding operation to take out the mesh again for getting relief.

“Dr. Desarda Repair” is a new invention by Dr Desarda from Pune, which is a groin hernia operation without mesh. A strip of a strong near by muscles is stitched on the weak spot or the hernia hole instead of mesh. Therefore, protection starts on the operation table itself. This operation does not require general anesthesia, it is done under local or spinal anesthesia. Patient is admitted in the morning and taken for surgery immediately after preparation. Time required for surgery is average 30 minutes and patient can be on his foot as soon as anesthesia effect is gone. Normally patient goes to pass urine on his own within 4-5 hours and he is freely mobile in the wards same day night or next day morning ready to get discharged and go home. There are no restrictions on his movements or food intake. He can drive car and go to office, can climb a staircase, can carry luggage and travel, squat and sit down without much pain within 2-3 days. He is asked to carry his normal routine work as soon as possible and as per his tolerance. So, patient gets high level of satisfaction after this new operation technique. Dr. Desarda has operated on more than 2000 patients till today by this new technique and all of them are well and without any recurrence till today. All foreign patients coming to Indian Hernia Institute go back to their country on third day carrying their luggage and a journey of 20-22 hours without any difficulty. The most important quality of this operation is that there is virtually no recurrence or pain. This operation is spreading quite rapidly all around the globe and today it is being followed in many countries.

Interested patients and doctors can contact Dr. Desarda on his mobile no. 0091 (0)9373322178 or log on to his website  http://www.desarda.com  OR   EMAIL: desarda@hotmail.com 

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Why hernia re-occurs again and again

When some part of our body leaves its original place and enters in to other cavity or comes out on the body surface then we call it as a hernia formation. Operation is the only remedy to get relief from this disease. Patient will not mind to get operated if he is sure that he is going to be hernia free after surgery. But this does not happen in many patients because rate of relapse or reappearance of hernia at the same place is also quite high and unacceptable. Mesh, which is a piece of synthetic cloth, was introduced in the market in 1990 for use in hernia repairs. We stitch a small piece of cloth to repair our torn shirt. Same principle is used in mesh repairs where in this mesh is stitched on the weak spot or hernia hole to give protection and prevent recurrence. Relapse rate or failure rate after groin hernia surgery has come down to 7-8% in USA after every body started doing hernia surgery by using a mesh, but it failed to give complete cure.

                                               

              Mesh                            Mesh is stitched on the weak spot of hernia

 

Majority of the hernias, almost 99%, are external and seen on the body surface and majority of them are seen on the abdominal wall. Amongst them, the groin hernias are seen in almost 75% of patients. But in India, proportion of other abdominal wall hernias like umbilical, epigastric, ventral or incisional hernia is also quite high. Our intestines are kept in a delicate balloon like bag in side the abdomen and protection is given by 3 layers of muscles all around them. When these muscles get damaged at some spot then that becomes a weak spot or hernia hole from where hernia formation takes place. This damage can happen due to surgery or stretching due to pregnancy or ascitis or they get weakened due to aging or some other disease.

 

 In all traditionally done hernia surgeries, hernia sac is excised and a mesh is stitched on this weak spot or this hernia hole in an attempt to give protection to the weak spot and prevent relapse or recurrence. But this does not happen immediately after surgery because this mesh is delicate like a mosquito net. Then why it is stitched if it does not give protection? A foreign body reaction sets in and around the mesh and tissue penetrates in it to form a delicate curtain on the weak spot. This takes couple of months and then it takes another 2-3 years to get sufficient strength in it to give protection. It means the patient is not fully protected for 2-3 years in spite of mesh surgery. If patient gets an attack of cough or sneezing or some such other instance during this period then this mesh gets torn or stitches get torn or mesh moves away from the stitched place and relapse of hernia takes place. Another important reason for more relapses or recurrences seen in India is the low quality mesh used to save on the cost. This low quality mesh shrinks by 50-60% in side the body. Naturally there is increased tension on the sutures due to this shrinkage that tend to break beyond certain limits inviting hernia recurrence. Mesh shrinkage or mesh migrations are well documented complications inviting failures after the mesh surgeries. All hernia surgeries are done by hernia experts or consultants in USA, but, paradoxically in India, hernia surgeries are dedicated to the resident doctors who are not expert in hernia surgeries. This is also one of the important reasons for high rate of hernia recurrences in India.

                                      
Mesh itself does not                Shrinkage of mesh from       Desarda Repair with a muscle strip
give protection                          a palm to a finger size                   

         A story of 38 year old Mr. David from USA is worth listening. He had left groin hernia since 2 years. He consulted with 2-3 consultants and hernia experts in Los Angeles, All of them had said that they will repair his hernia with a mesh. As is done by every American, David also did his own thorough search on the internet to get more knowledge about groin hernias. He found that almost 30 out 100 patients operated with mesh had suffered either from recurrence or chronic groin pain or infection or mesh migration in to the abdomen. These patients had undergone either open surgeries or endoscopic surgeries. So he started search to find out whether there is any centre which does hernia surgeries without using mesh. To his amazement, he found only two such centre all over the world. One was Shouldice centre in Canada and another was “Desarda Centre” in Pune from India. During his further search, he found that Shouldice centre use stainless steel wires to sutures and there is 1-2% of recurrence. So he chose Desarda Centre and came here to our Indian Hernia Institute to get his hernia set right. This story did not end with David, but many more patients from USA, France, and Australia etc have visited our centre for their hernia repairs. The main reason why every body now prefers to come to our centre for his hernia repair is that we do not use any foreign body like mesh. Therefore, no complications are seen in our repairs that are associated with mesh. We use a strip of near by strong muscle to cover the weak spot or hernia hole. Therefore, protection starts on the operation table itself. And patient gets almost complete cure without any fear of relapse or recurrence in future.

 

Dr. Desarda has operated on more than 2000 patients till today by this new technique and all of them are well and without any recurrence till today. This operation does not require general anesthesia, it is done under local or spinal anesthesia. Patient is admitted in the morning and taken for surgery immediately after preparation. Time required for surgery is average 30 minutes and patient can be on his foot as soon as anesthesia effect is gone. Normally patient goes to pass urine on his own within 4-5 hours and he is freely mobile in the wards same day night or next day morning ready to get discharged and go home. There are no restrictions on his movements or food intake. He can drive car and go to office, can climb a staircase, can carry luggage and travel, squat and sit down without much pain within 2-3 days. He is asked to carry his normal routine work as soon as possible and as per his tolerance. So, patient gets high level of satisfaction after this new operation technique. All foreign patients coming to Indian Hernia Institute go back to their country on third day carrying their luggage and a journey of 20-22 hours without any difficulty. The most important quality of this operation is that there is virtually no recurrence or pain. This operation is spreading quite rapidly all around the globe and today it is being followed in many countries.

 

Interested patients and doctors can contact Dr. Desarda on his mobile no. 0091 (0)9373322178 or log on to his website    or  http://www.desarda.com

EMAIL: desarda@hotmail.com  

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Complete cure from inguinal hernia is now possible

 (No worry of hernia re-appearing after surgery)


The president of “Indian Hernia Institute” and professor of surgery in Poona Hospital & Research Centre did extensive research in groin hernia disease and invented a new operation technique that gives almost complete cure from inguinal hernia disease. This technique is now known all over the world as “Dr. Desarda Repair”. Traditional operation techniques followed every where use mesh for hernia repair. This mesh repair is based on anatomical principle, whereas the new operation technique is based on the physiological principle. After a prolonged study of the anatomy and the physiology of the groin, Dr. Desarda has published in international journals new theories that are responsible for hernia formation. Since this operation corrects the basic pathology of the groin, there is no recurrence after his repair, Dr. Desarda claims.

Can any body give guarantee that there will not be recurrence after hernia surgery? The answer was “no” till today. But now, study did by Dr. Desarda and many other surgeons all over the world have proved that if this new repair is done then there are almost zero% chances of reappearance of groin hernia after surgery. Dr. Desarda uses a strip of a nearby strong muscle, instead of mesh, to repair the weak spot or hole of hernia. Dr. Desarda has already published many research articles about the results of this new operation technique in various international indexed journals. Many surgeons from other countries also did take study trials of this technique and published similar results.

Groin hernia repair was a challenge before the world because of its high failure rates. Uses of mesh for hernia repairs, introduced in market in 1990, have reduced this failure rate to 7-8% as per USA studies, but it is much more than this in India because of low quality mesh used to save the cost. Mesh is a foreign body like any synthetic cloth. So many complications associated with any foreign body like infection, pain or rejection also started revealing after mesh repair surgery. At this time in year 2001, Dr. Desarda put his new theory before the world that if groin hernia repair is done on physiological principle using your own body muscle and not done on anatomical principle, as is done in mesh repairs, then you can give complete cure from the hernia to the patient.

                          
 


Dr. Desarda has operated on more than 2000 patients till today by this new technique and all of them are well and without any recurrence till today. This operation does not require general anesthesia, it is done under local or spinal anesthesia. Patient is admitted in the morning and taken for surgery immediately after preparation. Time required for surgery is average 30 minutes and patient can be on his foot as soon as anesthesia effect is gone. Normally patient goes to pass urine on his own within 4-5 hours and he is freely mobile in the wards same day night or next day morning ready to get discharged and go home. There are no restrictions on his movements or food intake. He can drive car and go to office, can climb a staircase, can carry luggage and travel, squat and sit down without much pain within 2-3 days. He is asked to carry his normal routine work as soon as possible and as per his tolerance. So, patient gets high level of satisfaction after this new operation technique. All my patients coming from USA or other countries are discharged on 3rd day. They all carry their luggage and travel for 20-22 hours by air to their country without any problem, Dr. Desarda says. The most important quality of this operation is that there is virtually no recurrence or pain. This operation is being followed in many countries all over the world.

 

Interested patients and doctors can contact Dr. Desarda on his mobile no. 0091 (0)9373322178 or log on to his website   or  http://www.desarda.com   EMAIL: desarda@hotmail.com 


 Hernia Repair Without Mesh As I see it - by John Appleton


A year ago following an extensive renovation on my house, which involved a lot of lifting heavy weights, I ended up with an inguinal hernia. A hernia is the result of tissue from inside the abdominal cavity pushing through the muscles of the wall of the abdomen. They tend to occur in body areas where there is a potential natural weakness for example the groin and umbilical areas. Up to 75% of all abdominal hernias are inguinal hernias. Men are 90% more likely than women to develop an inguinal hernia. Hernia repair involves surgery and while it is considered to be  a simple procedure there can be complications. There are several methods used to repair hernias and the most common procedure involves laparoscopic surgery which is done under general anaesthetic. Open repairs from the outside can be done under local anaesthetic with sedation. Both procedures usually involve the use of surgical mesh which is sutured into place to cover the area of weakness.

It would be incorrect to say that these techniques are not generally successful but recently the widespread use of mesh is being questioned. Risk of infection, chronic pain, rejection and migration are post-surgery concerns that have been discussed widely in the media. Mesh is not only used to repair hernias, it used in women during hysterectomy surgery and during surgery to rectify bladder weakness also in women. Due to the negative press and accounts from people who have experienced significant problems, I was reluctant to commit to surgery. 

I was thrilled however to discover that "there is a widely acclaimed no mesh hernia repair technique, which was pioneered by Indian surgeon Dr Mohan Desarda" 

 Dr Desarda was invited to speak at the first world hernia conference in Milan in 2015. The conference was attended by 5000 surgeons from around the world.

The Desarda technique for inguinal hernia repair uses live muscle tissue adjacent to the hernia site to repair and reinforce the weakened area. I was excited to learn that there is virtually a zero% recurrence rate with minimal or negligible post-operative early or late complications. The procedure is done under local anaesthetic with sedation and it takes approximately 90 minutes. I was even more surprised to learn that the price is a lot less than what one might pay for standard laparoscopic surgery. Dr Gerald Young at City Med in Auckland has been at the forefront of hernia repair for many years and when he heard about the Desarda technique he wanted to find out more. Dr Young now offers hernia repair using this innovative technique and after seeing how well a friend had done, I was keen to go down this path.  I wasn’t sure what to expect when having surgery without general anaesthesia. The sedation however put me in the twilight zone and I was hardly aware of anything. Immediately following the surgery I stepped off the operating table and was driven home. I took more oral vitamin C and drank a lot of water. When the local anaesthetic wore off 
I was quite sore but I didn’t feel that I needed any pain relief.  I would describe the pain more as discomfort although coughing and sneezing was not a fun experience. Each day following there was noticeable improvement and three weeks later I am back out on my paddleboard and walking at my normal speed. All in all an excellent outcome. I am happy to provide more information for anyone interested.

For more information: John Appleton (09) 489 9362

appletonassoc@xtra.co.nz www.johnappleton.co.nz

John Appleton

THE HEALTHY CHANNEL



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