Surg Today (2007) 37:958–960 DOI 10.1007/s00595-007-3543-3 Reprint requests to: A. Guner Received: October 18, 2006 / Accepted: February 28, 2007 Moloney Darn Repair Versus Lichtenstein Mesh Hernioplasty for Open Inguinal Hernia Repair BURAK KAYNAK 1 , FAIK CELIK 1 , ALI GUNER 1 , KADRI GULER 1 , MEHMET A. KAYA 1 , and MELEK CELIK 2 1 Fourth Surgical Department and 2 Department of Anesthesiology and Reanimation, Goztepe Training and Research Hospital, 34722 Kadikoy, Istanbul, Turkey Abstract Purpose. To compare two tension-free techniques of inguinal hernia repair: the Moloney darn repair (MDR) and Lichtenstein mesh hernioplasty (LMH). Methods. The subjects of this study were 651 patients from a total 732 who underwent open inguinal hernior- rhaphy at our clinic between January 2000 and January 2006. We evaluated and compared analgesic require- ment in the first 24 h, operative time, hospital stay, early postoperative complications, time until return to work, and recurrence, between patients who underwent MDR (group A) and patients who underwent LMH (group B). Results. Group B patients required less analgesia in the first 24 h than group A patients. Conversely, the mean operative time and postoperative hospital stay were shorter in group A. Early postoperative complication rates and the time until return to work did not differ significantly between the two groups. During follow-up, recurrences developed in three patients from group A and four from group B. The cost of MDR was signifi- cantly less than that of LMH. Conclusions. Both MDR and LMH resulted in rapid recovery and low recurrence rates; however, the advan- tage of the MDR lies in the fact that it does not require mesh, so it is much less expensive. Key words Inguinal hernia · Moloney technique · Lichtenstein technique · Darn repair · Open inguinal hernia repair Introduction Many different techniques of inguinal hernia repair have been described. Hernia repair can be done via an anterior or posterior approach, using open or laparo- scopic procedures. The darn repair originally described by Moloney et al. 1 is an effective technique for repairing inguinal hernia; however, more recently, polypropylene mesh repair has become popular because of the excel- lent results reported by Lichtenstein et al. 2 Neverthe- less, prospective randomized trials comparing Moloney darn repair (MDR) and Lichtenstein mesh hernioplasty (LMH) have not been conclusive. We conducted the present study to compare these two tension-free tech- niques of repairing inguinal hernia. Methods Between January 2000 and January 2006, 732 patients underwent open repair of an inguinal hernia at the 4 th General Surgery Department, Goztepe Training and Research Hospital in Turkey. The study was approved by the local ethical committee. Signed and informed consent was obtained from all patients. Patients were randomly assigned to one of the two groups in consecu- tive groups of five. Patients with recurrent hernia, those admitted for emergency surgery for an incarcerated or strangulated hernia, those who underwent bilateral repair, and those operated on as outpatients were excluded from the study. Of the remaining 682 patients at the beginning of the study, 31 (4.5%) could not be followed up. Thus, 651 patients were the subjects of this prospective randomized study. The operations were per- formed by one of only six surgeons, all of whom had at least 5 years of surgical experience. Group A consisted of 297 patients who underwent MDR. For MDR, two continuous rows of no. 1 mono- filament nonabsorbable polypropylene sutures were