Study of outcome of a new method of darning for repair of large and recurrent hernias

Dibyendu Das, Neelam Yadav, Kamlesh Jhariya, Reena Minz


Background: Incisional hernia is the result of a failure of fascial tissues to heal and close following laparotomy. Laparoscopic Meshplasty is a standard method of repair but not usually done in large incisional and recurrent hernias.  Recurrence after repair is common in incisional hernia and poses a significant challenge for the plastic surgeons. We describe here a technique of anatomical repair of the large incisional, and recurrent hernia by darning without using mesh, which is effective in midline, paramedian as well as transverse incisional hernias. Aims and objectives to study the outcome and efficacy of our technique of Darning in cases of large and recurrent incisional hernias without using mesh.

Methods: It is a prospective non randomized study of 5 year duration in which we have studied 20 cases of either large or recurrent incisional hernia admitted in our hospital. We operated these cases by darning of the rectus sheath without tension by mattress suture by prolene no.1.

Results: 20 patients underwent this repair with few minor complications and there was no recurrence for minimum period of follow of 2 years.  Approximation of inner margin and separately mattress pattern darning of outer rectus sheath by prolene no.1 strengthens the repair, but do not cause complication associated with meshplasty like infection, adhesion and fistula formatioṇ.

Conclusions: Our technique of darning is an extraperitoneal method of hernia repair which do not incorporate mesh and is an effective method of hernioplasty with manageable early postoperative complication. We have not seen any recurrences in follow up period.


Darning repair, Incisional hernia, Meshplasty, Recurrent hernia

Full Text:



Santora TA, Rosalyn JJ. Incisional hernia. Surg Clin North Am. 1993;73:557-70.

Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg. 1985;72:70.

Regnard JF, Hay JM, Rea S. Ventral incisional hernias: incidence, date of recurrence, localization, and risk factors. Ital J Surg Sci. 1988;3:259.

Langer S, Christiansen J Long-term results after incisional hernia repair. Acta Chir Scand. 1985;151:217-9.

Petro CC, O’ Rourke CP, Posielski NM. Designing a ventral hernia staging system. Hernia. 2016;20(1):111-7.

Kanters AE, Krpata DM, Blatnik JA, Novitsky YM, Rosen MJ Modified hernia grading scale to stratify surgical site occurrence after open ventral hernia repairs. J Am Coll Surg. 2012;215:787-93.

Townsend CM. Sabiston Textbook of Surgery, 20 th Edition; Philadelphia; Saunders/Elsevier. 2017;110.

Young D, Repair of epigastric incisional hernia. Br J Surg. 1961;48:514-6.

Dixon CF, Repair of incisional hernia. Surg Gyneco. Obstet 1929;48:700-1.

Hunter RR. Anatomical repair of midline incisional hernia. Br J Surg. 1971;58:888-16.

Loh A, Rajkumar JS, South LM Anatomical repair of large incisional hernias. Ann R Coll Surg Engl. 1992;74:100-5.

Epigastric AJ. Umbilical and ventral hernia. Maingot’s Abdom Surg. 1997;423:430.

Fartman EH. Tension free suture of incisional hernia, der chirurg; Zeitschrift fur alle Gebiete der operative Medizen. 1997;68:310-6.

Liakakos T, Karanikas I, Panagiotidis H, Denderinos S Use of Marlex mesh in the repair of recurrent incisional hernia. Br J Surg. 1994;81:248-9.

David PJ, Brooks DC, Hernias: Maingot’s abdominal operations, 11th ed. 1997;133-8.

D Johnson, Harrison DH. A technique of repairing massive ventral incision hernias without the use of mesh, Br J Plastic Surg. 1999;52:399-403.