Mesh-Free Hernia Repair
By Fred Amir
Prof. Dr. Mohan Desarda
While doing more research on mesh-free repair, I came across the work of Prof. Dr. Mohan Desarda, of Pune, India. I visited his website and viewed the following video of an interview with Stuart Harris, of Australia. He had traveled to India to have a mesh-free, tension-free repair done. The day after surgery, he was bending, walking freely, and even lifting luggage.
Then there was David Williamson, of Los Angeles, with similar results:
If you have read my book, Rapid Recovery from Back and Neck Pain, you know that I am quite skeptical when it comes to these types of claims but keep an open mind when presented with new information, so I was looking for an independent verification of Prof. Dr. Desarda’s work. That came when I viewed the following video made by Ron Powers, of Rockville, Maryland, about his trip to India and hernia repair by Prof. Dr. Desarda. He, too, had a quick recovery. (Unfortunately, this video is no longer available.)
Now I was very interested. I emailed Ron and learned more about his experience. I even watched a video of how a typical Desarda repair was done, not that I understood much of it!
As a public service, Prof. Dr. Desarda has put all the information about his innovative technique online so that any surgeon anywhere in the world can learn it and benefit their patients. I was impressed by his concern to help others with his medical knowledge—a completely different approach compared to the surgeons I had seen thus far.
Correct Diagnosis Is Half the Cure
Then I began to study in-depth his many papers involving hundreds of case studies published in medical journals worldwide.
Prof. Dr. Desarda put forth a new theory for the cause of inguinal
hernia. He discovered—based on a study, involving 500 body halves, published in 1971 by B.J. Anson—that 53% of people are missing or have a defect in tendons known as aponeurotic extensions from the transversus abdominis aponeurotic arch. This is a thin but strong membranous structure, the fibers of which are directed downward and medially. Individuals who are missing or who have defective aponeurosis extensions are more likely to develop inguinal hernias with age or other risk factors, such as a chronic cough, constipation, heavy lifting, and family history. Those who have this tendon in place are protected from developing inguinal hernia despite age, heavy lifting, constipation, and other risk factors.
There is a saying: “Correct diagnosis is half the cure.” Prof. Dr. Desarda’s repair aims to correct this deficiency, and by correcting it without a mesh, he has managed to achieve great results. I emailed Prof. Dr. Desarda, as well as several of his patients, and doctors who follow his technique. After evaluating all of the responses I received, I decided this was the repair I wanted for my hernia.
By now my hernia had grown as large as half a tennis ball. I could only sit in an upright position for thirty minutes or so before the pain became unbearable. The idea of air travel to India and sitting several hours in an airplane was too painful to consider.
Dr. Zafar Parvez
Around this time, my physician friend from Fresno recommended I contact Dr. Zafar Parvez. Dr. Parvez is a general, thoracic, and weight loss surgeon who has been in practice for more than 20 years. Of course, in addition to my physician friend’s recommendation, which meant a lot to me, I did my own research. I discovered that Dr. Parvez’s patients had given him an overall rating of 4.5 out of 5 stars on healthgrades.com.
Also, his patients described Dr. Parvez as an excellent surgeon who was honest and caring, and who was a good listener. He answered their questions to their satisfaction and treated them with courtesy. All this made me feel comfortable about seeing Dr. Parvez.
My wife and I drove three hours to Fresno for a visit at his office. We found his waiting room full, which I thought was a good sign. Patricia and the rest of his staff were very friendly and helpful. Dr. Parvez checked my hernia and said it was too large for Dr. Muschaweck’s minimal repair technique. I then introduced Dr. Parvez to the Desarda repair by providing him with one of his papers as well as a DVD of his technique.
Dr. Parvez read the paper and watched the DVD and said that this was a very sound approach and that it was easy to learn and easy to perform. We determined that, since the month of Ramadan was starting in three days, we had better schedule the surgery for after Ramadan. My wife and I left his office feeling very comfortable with Dr. Parvez and his staff. In fact, my wife commented that he must be a very confident and competent surgeon to be willing to learn and implement the Desarda repair. I certainly agreed with her assessment.
Fortunately, during Ramadan, Dr. Parvez had four hernia patients who did not want mesh used in their repairs and agreed to the Desarda technique. He was amazed at how little pain they had after the operation and how quickly they recovered. This was, of course, great news for me as well. My surgery was set for three weeks after Ramadan. The entire arrangement for my surgery was handled meticulously and with care by Dr. Parvez’s staff. I was very happy about that.
As I waited for the surgery date, based on Prof. Dr. Desarda’s papers and the communication I had had with his patients, I developed the following reasonable expectations:
duties, or doing normal, preoperative, non-vigorous activities—within 4 to 14 days. As seen in the videos, some even had a faster recovery. Since my hernia was more serious than those of Stuart Harris and Ron Powers, I expected to be back to my daily activities in 7 to 10 days. Prof. Dr. Desarda mentions in his papers that most patients returned to normal activities—like bending, kneeling, stooping, climbing one or more flights of stairs, carrying groceries, attending to office in about one week.
Very slight chance of post-surgical complications. In his papers, Prof. Dr. Desarda mentions the following rare complications: wound edema, mild skin infection, and hematoma. I certainly hoped to be among the majority that did not have any complications at all.
Early ambulation. Again, since these are tension-free repairs, Prof. Dr. Desarda reports that most patients were ambulatory with a few hours after the operation. The patients with whom I communicated all had a similar experience and found it easy to start walking and moving around just a few hours after surgery. I expected the same.
Minimal postoperative pain. Most of his patients experienced little pain after the operation, as these are tension-free repairs. I hoped for minimal pain as well.