When the hand of the Potter shakes as the inguinal region is fashioned, one result may be poor or deficient fibromuscular tissue leaving an inadequate barrier so that abdominal pressures may produce a hernia at any time from fetal life to old age. Such weak tissue may tear when a patent sac is suddenly filled, or may stretch gradually when the sac is slowly fashioned. Removal of the sac does nothing to reinforce the weak fascia which allowed the sac to fill or form, nor does the muscular edge of the combined transversalis and internal oblique muscles act as a "shutter" against future pressures, for those very muscles which may be excellent in texture and volume are quite incapable of holding back, on straining, the reduced contents of a hernia, even in a strong young man with a preformed sac, and if the sac is removed but no reinforcement made
Moloney GE. Darning Inguinal Hernias. Arch Surg. 1972;104(2):129–130. doi:10.1001/archsurg.1972.04180020009001
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