RECENT experience with the preperitoneal approach in the treatment of incarcerated and strangulated groin hernias, or where concurrent abdominal surgery is indicated, has led us to the opinion that this is the operative approach of choice when these indications are present. We are reporting ten cases which conform to these criteria and which illustrate the advantages inherent in this technique.
Materials and Methods
In the 18-month period between November 1965 and May 1967, we have performed preperitoneal hernioplasties on seven patients in whom these criteria were satisfied. An additional three patients underwent "incidental" appendectomy at the time of preperitoneal hernioplasty (Table).All of the incarcerated hernias were considered preoperatively to possibly contain nonviable bowel and this contributed to the choice of the preperitoneal approach. Actually, small bowel resection was required only in patient 2 and this was performed easily through the original right lower quadrant transverse incision. All operations were