INGUINAL HERNIA

PROCEDURES
SURPRIZE QUIZ  Name the procedure?
 BASSINI’S REPAIR
• Interrupted non absorbable suture between
conjoint tendon and inguinal ligament.

• Medial most stitch Bassini’s stitch

( to periosteum of pubic tubercle)
 TANNER SLIDE
• Add a relaxing incision over rectus muscle
sheath.
 HALSTED
• External oblique used to reinforce the
posterior wall
• Cord in subcutaneous position
 Mc Vay repair
• For inguinal + femoral hernias

• Transversalis with
• cooper’s ligament towards femoral
sheath to inguinal ligament
 SHOULDICE REPAIR
• LAYER 1: TF lower flap Posterior part of
upper flap of TF (transversalis fascia)
• LAYER 2: Upper flap to base of lower edge+
Inguinal ligament(IL)
• LAYER 3: Conjoint Tendon to IL
• LAYER 4: Anterior rectus sheath medially to
external oblique aponeurosis laterally.
External oblique closed anteriorly.
 DARNING:
• Continous non absorbable suture:
Between CT+ IL
 LYTLE’S REPAIR:
• Internal ring narrowing by
• Inturrupted sutures in TF medially
 DESARDA’S
• Flap of external oblique used to strengthen
the posterior wall
•  stitched to Internal oblique above
•  to inguinal ligament below
 GPRVS/STOPPA’S
• GIANT PROSTHETIC REINFORCEMENT OF
VISCERAL SAC
• Pre- Peritoneal approach.
 RIVES REPAIR
• MESH IN PRE-PERITONEAL SPACE.
PLUG REPAIR
FLAT MESHES
 PHS
• PROLENE HERNIA SYSTEM:
• 1 mesh anterior and 1 posterior.
LICHSTENSTEIN TENSION FREE MESH REPAIR