In the majority of herniorrhaphies, either direct or indirect, the chief complicating factor confronting a firm and secure closure is the necessity of making an adequate provision for the transmission of the structures of the spermatic cord. It is on this account that the closure of an inguinal hernial opening in the female is a simpler and surer procedure.
The Bassini operation, though adequate in a large number of cases, is in reality no more than the removal of the enlargement of a congenital sac and resuture of the structures, plus a floor construction of muscle tissue that is not firm and the conjoined tendon that must be under unsafe tension. It presents the disadvantage of leaving the opening directly through the aponeurosis, which is the fundamental tissue support, ranking next to bone in this respect, thus leaving a postoperative "weak spot" in a vulnerable portion of the aponeurosis.
PETTIT JA. PLASTIC REPAIR OF INGUINAL HERNIA. JAMA. 1930;95(20):1497-1499. doi:10.1001/jama.1930.02720200033009