Clinical Research Directory

Bassini Repair Versus Desarda Technique in Urgent Complicated Inguinal Hernia Repair

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.