We used these to darn socks mostly, so the mushroom was popped inside the sock then the non-dominant hand held the stalk of the mushroom and sock together on the outside, then the dominant hand performed the darn on the top - first the threads parallel top to bottom then the fill-in threads across them, weaving in and out. The trick is to get the initial threads close enough that the weave will fill in completely. Works on larger items, but tend to be a bit more cumbersome for the 'holding together' hand. Not an invisble darn, but extends the life of the item.
Edit to say: Just read back a bit - the needle is inserted sort of parallel to the mushroom top, rather than stabbing into the fabric and glides across the top of the mushroom... those in the image a really beautiful!
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