Publication:

Reverse darning technique: an effective and innovative method of inguinal hernia repair

Background Laparoscopic mesh repair is the standard of care for inguinal hernias. But, our center being in a rural setup catering mainly poor patients who are daily wagers and laborers, open repairs are commonly done. Lichtenstein’s tension-free mesh repair is the standard technique used worldwide. This study was performed to compare the effectiveness of Reverse darning repair over traditional mesh repair in a rural setup and to reciprocate the changes generally. The outcomes such as postoperative pain, seroma formation, postoperative analgesic use, and the recurrence rate were compared.

Methods Retrospective analysis of patients who had undergone mesh repair and reverse darning procedure between January 2013 and December 2017 was performed in a rural tertiary center.

Results The reverse darning group was found to have significantly lesser mean duration of surgery (15.7±1.7 min. vs. 31.2±2.5 min.; t=37.4, p<0.005), analgesic use (4.4±1.2 doses vs. 7.4±1.3 doses; t=12.2, p<0.005), hospital stay (39.4±8.2 hours vs. 58.1±9.5 hours; t=10.7, p<0.005), and the cost of treatment (Rs. 5188±286 vs. Rs. 7154±1290; t=11.6, p<0.005) compared to the Lichtenstein group. The Reverse daring group was also better than Lichtenstein repair in terms of seroma formation (1 vs. 7; chi-square value=7.9; p=0.005), hematoma (0 vs. 6; chi-square value=9.4, p=0.002), and secondary hydrocele (1 vs. 5; chi-square value=4.9, p=0.03).

Conclusions Reverse darning repair was found to be much better than traditional mesh repair due to its simplicity, lesser duration of surgery, hospital stay, cost of treatment, and postoperative complications.