The problem of inguinal hernia has resolved itself into the management of the direct variety. This statement is based on the fact that all surgeons agree that in indirect or oblique hernia the results following operation are excellent, provided it is performed properly and according to one of the approved methods. No such claim can be made for the operative results in direct hernia, nor can it be said that we have a standardized operation for this condition. Many surgeons recognize the futility of the usual technic for indirect hernia when applied to the direct type, and various modifications of recognized procedures have been devised in the effort to correct the inherent anatomic defects that give rise to this form of rupture. Up to the present time, however, none of these modifications have proved satisfactory in all cases, and I, for one, have reached the conclusion that a certain number
DOWNES WA. MANAGEMENT OF DIRECT INGUINAL HERNIA. JAMA Surg. 1920;1(1):53–73. doi:10.1001/archsurg.1920.01110010066005
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