Effectiveness of the modified darn repair method in inguinal hernia repair: 10 years of experience

Ahmet Başkent 1 * , Fatih Feratoğlu 1
More Detail
1 Department of General Surgery, Kartal Dr Lütfi Kırdar City Hospital, Istanbul, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 20, Issue 3, pp. 104-108. https://doi.org/10.23950/jcmk/13361
OPEN ACCESS 870 Views 733 Downloads
Download Full Text (PDF)

ABSTRACT

Aim: We aimed to evaluate the effectiveness of the Modified Darn Repair (MDR) method performed in our clinic for Inguinal Hernia Repair (IHR) and to determine the postoperative complications and recurrence rates of this method.
Material and methods: The records of all patients who underwent IHR with MDR method in our clinic between January 2012 and December 2021 were obtained from the hospital database. Demographic characteristics of the patients, intraoperative findings, hospitalization and return to normal activities, postoperative complications and recurrence rates were retrospectively analyzed.
Results: A total of 892 patients aged between 18 and 85 with a male:female ratio of 14:1 were studied. Of 1011 elective IHRs, 773 were unilateral (right/left: 452/321) and 119 (119 right + 119 left) were bilateral.  Hernia types were 667 (66%) indirect, 273 (27%) direct, 71(7%) pantaloon (combined) hernias. All procedures were performed under spinal anesthesia. The mean duration of surgery was 35 (15-75) minutes, hospital stay was 1.1 (1-3) days, and return to normal activities was 12.8 (10-20) days. The postoperative complications were wound infection in 33 (3.26%) patients, hematoma in 11 (1.09%) patients, and abscess/seroma in 15 (1.48%) patients. In addition, suture material reaction developed in 1 (0,12%) patient. Recurrence was observed in 25 (2.4%) patients and no mortality was observed in any patient.
Conclusion: The goal of every surgeon is to have a non-recurring repair in IHR without leaving a foreign body in the patient. Despite the criticism, we believe that the MDR technique is a safe, effective and viable option.
Keywords: modified darning, inguinal hernia, repair, recurrence rate, postoperative complications

CITATION

Başkent A, Feratoğlu F. Effectiveness of the modified darn repair method in inguinal hernia repair: 10 years of experience. J CLIN MED KAZ. 2023;20(3):104-8. https://doi.org/10.23950/jcmk/13361

REFERENCES

  • Bay-Nielsen M, Kehlet H, Strand L, Malmstrøm J, Andersen FH, Wara P, et al; Danish Hernia Database Collaboration. Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet. 2001; 358(9288):1124-8. https://doi.org/10.1016/S0140-6736(01)06251-1
  • Rosenberg J, Bisgaard T, Kehlet H, Wara P, Asmussen T, Juul Pet al; Danish Hernia Database. Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults. Dan Med Bull. 2011; 58(2):C4243.
  • Bekker J, Keeman JN, Simons MP, Aufenacker TJ. Een beknopte geschiedenis van de liesbreukoperatie bij volwassenen [A brief history of the inguinal hernia operation in adults]. Ned Tijdschr Geneeskd. 2007; 151(16):924-31.
  • Zsolt B, Csíky M. Bassini mútét recidivája öt év távlatából [Recurrence rate in Bassini operation after five years]. Magy Seb. 2001; 54(5):307-8.
  • Abrahamson J. Hernias. In: Zinner MJ, editor. Maingot’s Abdominal Operations. 10th ed. Conneticut: Appleton and Lange; 1997; 479‑580.
  • Moloney GE. Darning inguinal hernias. Arch Surg. 1972; 104(2):129-30. https://doi.org/10.1001/archsurg.1972.04180020009001
  • Koning GG, Wetterslev J, van Laarhoven CJ, Keus F. The totally extraperitoneal method versus Lichtenstein's technique for inguinal hernia repair: a systematic review with meta-analyses and trial sequential analyses of randomized clinical trials. PLoS One. 2013;8(1):e52599. https://doi.org/10.1371/journal.pone.0052599
  • Farooq O, Batool Z, Bashir-ur-Rehman. Prolene Darn: safe and effective method for primary inguinal hernia repair. J Coll Physicians Surg Pak. 2005; 15(6):358-61.
  • EU Hernia Trialists Collaboration. Laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials. Br J Surg. 2000; 87(7):860-7. https://doi.org/10.1046/j.1365-2168.2000.01540.x
  • Rulli F, Percudani M, Muzi M, Tucci G, Sianesi M (1998) From Bassini to tension-free mesh hernia repair. Review of 1409 consecutive cases. G Chir. 19:285–289
  • Lichtenstein IL, Shulman AG, Amid PK, Montllor MM. The tension-free hernioplasty. Am J Surg. 1989; 157(2):188-93. https://doi.org/10.1016/0002-9610(89)90526-6
  • Bay-Nielsen M, Perkins FM, Kehlet H; Danish Hernia Database. Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg. 2001; 233(1):1-7. https://doi.org/10.1097/00000658-200101000-00001
  • Nienhuijs SW, van Oort I, Keemers-Gels ME, Strobbe LJ, Rosman C. Randomized clinical trial comparing PHS, mesh plug repair and Lichtenstein repair for open inguinal hernia repair. Br J Surg. 2005; 92:33-8. https://doi.org/10.1002/bjs.4702
  • Taylor SG, O'Dwyer PJ. Chronic groin sepsis following tension-free inguinal hernioplasty. Br J Surg. 1999; 86(4):562-565. https://doi.org/10.1046/j.1365-2168.1999.01072.x
  • Uzzo RG, Lemack GE, Morrissey KP, Goldstein M. The effects of mesh bioprosthesis on the spermatic cord structures: a preliminary report in a canine model. J Urol. 1999; 161(4):1344-1349. https://doi.org/10.1016/S0022-5347(01)61681-1
  • The MRC Laparoscopic Groin Hernia Trial Group. Laparoscopic versus open repair of groin hernia: a randomised comparison. Lancet. 1999; 354(9174):185-190. https://doi.org/10.1016/S0140-6736(98)10010-7
  • Lau H, Patil NG, Yuen WK, Lee F. Learning curve for unilateral endoscopic totally extraperitoneal (TEP) inguinal hernioplasty. Surg Endosc. 2002; 16(12):1724-1728. https://doi.org/10.1007/s00464-001-8298-0
  • Welsh DR, Alexander MA. The Shouldice repair. Surg Clin North Am. 1993; 73(3):451-469. https://doi.org/10.1016/s0039-6109(16)46030-5
  • Devlin HB, Gillen PH, Waxman BP, MacNay RA. Short stay surgery for inguinal hernia: experience of the Shouldice operation, 1970-1982. Br J Surg. 1986; 73(2):123-124. https://doi.org/10.1002/bjs.1800730217
  • Danielsson P, Isacson S, Hansen MV. Randomised study of Lichtenstein compared with Shouldice inguinal hernia repair by surgeons in training. Eur J Surg. 1999; 165(1):49-53. https://doi.org/10.1080/110241599750007504
  • Thapar V, Rao P, Deshpande A, Sanghavi B, Supe AN. Shouldice's herniorrhaphy versus Moloney's darn herniorrhaphy in young patients (a prospective randomised study). J Postgrad Med. 2000; 46(1):9-12.
  • Essawy A., Ibrahim M., Thabet E.A.M., Erfan M., Mohammed İ.F.İ. Outcome Of Darnıng Method Of Inguınal Hernıa Repaır. Fayoum University Medical Journal. 2019; 3(1):15-23. https://doi.org/10.21608/fumj.2019.60370
  • Olasehinde OO, Adisa AO, Agbakwuru EA, Etonyeaku AC, Kolawole OA, Mosanya AO. A 5-year Review of Darning Technique of Inguinal Hernia Repair. Niger J Surg. 2015; 21(1):52-55. https://doi.org/10.4103/1117-6806.152722
  • Memon GA, Shah SKA, Habib-Ur-Rehman. An experience with mesh versus darn repair in inguinal hernias. Pak J Med Sci. 2017; 33(3):699-702. https://doi.org/10.12669/pjms.333.13257
  • Manzoor A, Habiba, U., Hussain, A., & Hadi, G. The outcome of Darning method of Inguinal hernia Repair using Polypropylene in A district General hospital. Journal of Postgraduate Medical Institute. 2011; 17.
  • Kamran H, Khan MA, Rafiq MK, Shehzar Khan AG, Waheed A, Amin R. Evaluation Of Darn Repair For Recurrence Rate In The Management Of Indirect Inguinal Hernia. J Ayub Med Coll Abbottabad. 2021; 33(2):198-201.
  • Johansen N, Vyrdal CD, Bisgaard T. Nationwide Results on Chronic Pain After Bilateral Transabdominal Preperitoneal Inguinal Hernia Repair. Scand J Surg. 2020; 109(4):289-294. https://doi.org/10.1177/1457496919874483
  • Desarda MP. No-mesh inguinal hernia repair with continuous absorbable sutures: a dream or reality? (A study of 229 patients). Saudi J Gastroenterol. 2008; 14(3):122-127. https://doi.org/10.4103/1319-3767.41730