In most cases of femoral hernia the diameter of the femoral canal, through which the femoral hernia protrudes, is quite narrow, often measuring less than 1.5 cm. By approaching the hernia from below, it is simple to free the sac, open it, reduce the hernia, and amputate the sac. Following this step, the ring is obliterated by means of 2–4 sutures attaching the inguinal ligament to Cooper’s ligament and the pectineus fascia. An even simpler method has been suggested by Lichtenstein and Shore. They roll up a length of Marlex mesh into the form of a cigarette whose diameter is equal to the diameter of the femoral ring. After inserting this Marlex “cigarette” into the femoral ring, they fix it in place with 1–2 sutures through the inguinal ligament, the Marlex, and the ligament of Cooper. In the low approach, local anesthesia works well and the entire procedure takes only 20–30 minutes. Reducing the stress of the operation and the anesthesia is desirable because most of these operations are performed in elderly patients under emergency conditions.
KeywordsFemoral Hernia Inguinal Ligament Femoral Canal Transversalis Fascia Common Femoral Vein
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