The value of combining both Guarnieri and Desarda nonmesh repair of inguinal hernia: A novel technique.

Purpose: To evaluate the feasibility and effectiveness of combining Guarnieri and Desarda techniques as a newmodification of nonmesh repair.Patients and Methods: This prospective cohort study was performed on 50 adult patients, aged more than 18 withnoncomplicated, nonrecurrent inguinal or inguinoscrotal hernia, who presented to the General Surgery Department atKasr Al Ainy Hospital, Cairo, Egypt. All patients were subjected to combined modified Guarnieri and Desarda techniques(nonmesh repair). Operations were carried out under spinal or under general anesthesia in a supine posture.Results: Regarding determining postoperative pain by visual analog scale (VAS), the median early postoperative VAS(within 24 h) was 4, the median 2-week postoperative VAS was 1.5, and the median 1-month postoperative VAS was1. The 2-week and 1-month postoperative VAS were significantly lower compared to early postoperative VAS (within24 h) (P<0.001 and 0.001), and the 1-month postoperative VAS was significantly diminished in contrast to the 2-weekpostoperative VAS (within 24 h) (P=0.003).Conclusion: Combining both Guarnieri and Desarda nonmesh repair of inguinal hernia is an effective technique withsignificantly lower postoperative pain, rapid return to basic daily activity and work activity, and less incidence ofcomplications with no reported foreign body sensation or hernia recurrence.