If a direct hernia is present, it can be repaired with an iliopubic tract, McVay or Bassini tissue repair, or a tension-free mesh repair. Bassini is credited with the first true anatomic hernia repair in 1896, and his report included opening the transversalis fascia as in the Shouldice/iliopubic tract repair. A blind imbrication of the inguinal floor from falx to iliopubic tract/inguinal ligament has come to be called a modified Bassini repair. The structures involved are shown.
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A modified Bassini can be used as the definitive repair for a small direct hernia, or an indirect hernia with weakness of the floor, but it has the disadvantage of not suturing the falx under direct vision. More commonly, imbrication of the floor is done to get the bulge of a direct hernia out of the way in preparation for doing a tension-free mesh repair.
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