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Bassini Repair Versus Desarda Technique in Urgent Complicated Inguinal Hernia Repair
Sponsor: Assiut University
Summary
Inguinal hernias occur when abdominal contents, such as intestine or fat, protrude through a weakness in the lower abdominal wall. While most hernia repairs are scheduled electively, some hernias present as urgent emergencies due to incarceration (the contents become trapped) or strangulation (the blood supply to the trapped tissue is cut off). In emergency operations, synthetic mesh placement may be avoided due to the increased risk of surgical site infections, tissue swelling, or bowel contamination. In such settings, surgeons rely on tissue-based (mesh-free) repairs. The conventional Bassini repair is a standard non-mesh technique, but it can be associated with higher hernia recurrence rates. The Desarda technique is a physiological, mesh-free repair that uses an undetached strip of the patient's own external oblique aponeurosis (tendinous muscle tissue) to reinforce the weakened inguinal floor without tension. The main objective of this study is to compare the surgical outcomes of conventional Bassini repair alone versus Bassini repair combined with the Desarda technique in adult patients undergoing emergency surgery for urgent, complicated inguinal hernias. This prospective randomized controlled trial is conducted at the Department of General Surgery, Assiut University Hospital. A total of 70 eligible participants presenting with acutely complicated inguinal hernias will be randomly assigned to one of two equal groups: * Group A (Bassini Repair): Patients undergo standard open emergency tissue herniorrhaphy alone. * Group B (Desarda Repair): Patients undergo emergency herniorrhaphy combined with the Desarda aponeurotic reinforcement technique. Participants are monitored during their hospital stay and will attend structured outpatient follow-up visits up to 12 months postoperatively. The primary outcome evaluated is the rate of hernia recurrence. Secondary outcomes include surgical site infections, seroma and hematoma formation, postoperative pain scores (using the Visual Analogue Scale), duration of operative procedure, hospital stay length, and time required to resume normal activities and return to work.
Official title: Bassini Repair Versus Desarda Technique in Urgent Complicated Inguinal Hernia Repair: A Prospective Randomized Controlled Study
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
70
Start Date
2026-11
Completion Date
2027-12
Last Updated
2026-11-02
Healthy Volunteers
No
Interventions
Bassini Inguinal Herniorrhaphy
Standard open tissue-based repair performed without prosthetic mesh. Through a transverse groin incision, the hernia sac is dissected, contents reduced (non-viable bowel resected with primary anastomosis), and high transfixion ligation completed at the deep ring with a 2-0 polypropylene suture. Posterior inguinal canal wall reconstruction is achieved by placing interrupted 0-polypropylene sutures approximating the conjoint tendon (inguinal falx) to the shelving edge of the inguinal ligament from the pubic tubercle to the deep ring. The external oblique aponeurosis is then closed over the spermatic cord using 2-0 polyglactin.
Desarda Inguinal Hernia Repair
Open tissue-based repair reinforcing the posterior inguinal canal wall using an autologous aponeurotic strip without prosthetic mesh. Following standard sac dissection, content reduction, and high ligation, a rectangular strip measuring 2-3 cm wide and 7-9 cm long is created from the lower leaf of the external oblique aponeurosis (EOA), remaining attached laterally near the deep ring. The medial free end is sutured to the conjoint tendon at the pubic tubercle, and the inferior border is sutured to the inguinal ligament using interrupted 0-polypropylene sutures. The upper leaf of the EOA is then sutured to the superior margin of the strip with 2-0 polyglactin.