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A D V E R T I S E M E N T
A D V E R T I S E M E N T
The key anatomical structures are shown in this cross-section view of the left mid-inguinal canal (see anterior inguinal hernia repair.)
A D V E R T I S E M E N T
The modified Bassini is a closed (transversalis is not opened) plication of Hesselbach’s triangle, suturing the falx to the iliopubic tract and adjacent inguinal ligament (see hernia technique master class, frame 56) It is useful for small direct defects, Nyhus type II and greater indirect hernias, and for controlling a large direct bulge (see hernia technique master class, frame 58) in preparation for a Lichtenstein tension free mesh repair. Care is taken to keep the caudal bites superficial over the femoral vessels. Continuous 2-0 non-absorbable monofilament is an appropriate suture material.
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A D V E R T I S E M E N T
The first step in a iliopubic tract/Shouldice repair is to open transversalis fascia at the deep ring, leaving a 1cm strip of iliopubic tract attached to the shelving edge of the inguinal ligament. Reflecting the cephalad flap of transversalis exposes the white band of falx at the lower edge of the transversus (see hernia technique master class, frame 43.) Thinned transversalis is excised back to strong tissue.
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This page was last modified on 6/17/2009.
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