Herniorrhaphy of any type has been found in all clinics to be an inadequate procedure for the treatment of some inguinal hernias. Recognition of this fact has led the most recent workers on this particular problem to seek some method that will effect a larger percentage of cures. Resulting methods in almost every instance comprise the use of fascia either as a suture material or for plication in the abdominal structures or in the form of a transplant.
In a search for reasons for recurrent or postoperative inguinal hernia, it is well to recall some anatomic conditions of the inguinal region. An indirect inguinal hernia has its exit from the abdominal cavity through the internal ring—an opening in the transversalis fascia. A direct inguinal hernia protrudes through the floor of the canal or else bulges this structure. It then becomes the first covering of such a hernia. All inguinal hernias,
FLEMING BL. INGUINAL HERNIOPLASTY WITH FASCIA TRANSPLANT. Arch Surg. 1938;36(4):698-704. doi:10.1001/archsurg.1938.01190220140009