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November 1981

Can Relaxing Rectus Sheath Incision Predispose to Recurrent Direct Inguinal Hernia?-Reply

Author Affiliations

Little Rock, Ark

Arch Surg. 1981;116(11):1493. doi:10.1001/archsurg.1981.01380230107017

In Reply.–I am delighted that Dr Schwarzbart took the time to write a letter regarding the article by Dr McLeod and me in the April 1981 issue of the Archives. His observations at the operation regarding tension are obviously extended and confirmed, as he says, by our measurements. I believe that his article in 1970, regarding herniation secondary to the relaxing incision, is the original report of this entity. Fortunately, it is a rare happening and, in itself, should not inhibit the use of the rectus sheath relaxing incision that continues to prove itself in the management of inguinal herniation. There have been one or two reports of Spigelian herniation occurring lateral to the rectus muscle when the anterior sheath, after the relaxing incision, retracts laterally and inferiorly so far as to leave the muscle. Normally, an attachment of transversalis fascia to the lateral border of the rectus muscle,

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