[Quality control after introduction of a new hernia technique. Barwell transversal fascia-plasty]

From 1987 to 1991 we operated on 320 patients with 360 inguinal hernias with the recently introduced transversalis fascial repair after Barwell. The transversalis fascia is duplicated with an atraumatic looped nylon 0.43 trainees performed 70% of the operations. The follow-up was 30 months (6-62) for 317 (88%) hernias (two examiners). Over all we observed eleven (3.5%) recurrences, in 8 cases after primary operation. Two of this recurrences were initially missed femoral hernias. In the learning phase we found five early recurrences in the first 60 patients and in the following 257 patients with the same follow-up only 6 recurrences. We conclude that with the new technique of transversalis fascial repair after Barwell very good results can be achieved even with a big number of young surgeons in training.