ZenToks Publication

Chapter 4

The Bassini and Darning repair for inguinal hernia: A Review

Abstract/Preface

Inguinal hernia repair is among the most commonly performed surgical procedures globally. While mesh-based techniques are the standard of care for most adult patients, tissue-based repairs remain significant in specific clinical contexts, such as contaminated surgical fields, resource-limited environments, and patient preference. Among traditional tissue repairs, the Bassini repair and darning repair retain clinical importance. Edoardo Bassini transformed hernia surgery in the late nineteenth century by introducing anatomical reconstruction of the posterior wall of the inguinal canal, which significantly reduced recurrence rates compared to earlier methods. The darning repair, particularly the Moloney darn, was subsequently developed as a tension-reducing tissue repair that uses nonabsorbable sutures to create a mesh-like support between the conjoint tendon and inguinal ligament. This chapter explores the indications, outcomes, advantages, disadvantages, and current role of Bassini and darning repairs in adults with inguinal hernia. Current evidence indicates that while both techniques are effective for selected patients, darning repair generally results in lower postoperative pain and tension, whereas Bassini repair offers robust anatomical reconstruction but may be associated with higher recurrence rates under excessive tension. Despite the prevalence of mesh repairs, both methods remain valuable components of the hernia surgeon’s repertoire.