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Inguinal Direct Hernia Surgical Repair without Cremaster Resection


Reinaldo Silvestre

Surgeon Professor, Santa Cruz del Norte, Cuba, USA

Correspondence to Author: Reinaldo Silvestre


preservation of the cremaster muscle while the direct inguinal hernia is surgically repaired. preserving the cremator's function.The major functions of the cremaster muscle, which surrounds the inguinal cord, are to elevate the testicles and to protect the inguinal cord's components.
Idea: The Hesselbach triangle in the inguinal area is where the direct inguinal hernia is located. The Poupart inguinal ligament is one of the triangle's components. The external border of the rectal muscle and the deep inguinal ring are in close proximity to the epigastric blood veins.
That is the Hesselbach triangule, and the transversalis fascia is the primary wall component there. This makes it the abdominal wall's weakest spot Historical AnalysisOver the years, inguinal hernia repair has advanced significantly. The field of surgery has advanced quickly since Eduardo Bassini's initial treatment was proposed. Analyzing original articles from the sixteenth century reveals that there are two straightforward surgical approaches that form the foundation for all inguinal hernial orifice repair procedures.
principles of repair. The first involves tightening the external inguinal ring and strengthening the anterior wall of the inguinal canal (Stromayr 1559, Purmann 1694, Czerny 1877). The second involves tightening the internal inguinal ring and strengthening the posterior wall of the inguinal canal, either internally (Lucas-Championnire 1881, Bassini 1889, Lotheissen 1898, McVay 1942, Shouldice 1945, Lichtenstein 1987, Stoppa 1989) or externally (Lucas-Championnire 1881, Bassini 1889, Lotheissen 1898, McVay 1942, Shouldice 1945, Lichtenstein 1987, Stoppa 1989) or by laparotomy (Tait 1891) or laparoscopically (Ger 1990, Velez and Klein 1990).
We have made an effort to arrange the various inguinal hernia surgical methods in a methodical manner based on the principles of their repair. We also highlight how they have evolved historically. The patient has an inguinal hernia if there is a palpable, painful mass that gets worse with physical exertion or when performing the Valsalva maneuver. The hernia can be direct if it originates from the Hesselbach triangule or indirect if it arises into the inguinal canal; in either case, surgery is required to fix the problem.
Procedure: The most common procedures to repair the direct hernia are the Zimmerman and Mc Vay, but most of the surgeons actually prefer just to close the posterior wall (fascia transversalis) repairing the Hesselbach triangule.can be manually using non absorbible suture open surgery with a small incision or laparoscopic procedure, how the laparoscopic procedure dont perform disection of the cremaster muscle, we start to perform the open procedure the same way,and this approach was who show,that doing this kind of closing of the posterior wall we can preserve the funtion of the cremaster muscle. Ralph Ger described the first potential laparoscopic inguinal hernia repair in 1982. He describes a metallic clip applying device to close the hernia sac during laparotomy for other operations.


Reinaldo Silvestre. Inguinal Direct Hernia Surgical Repair without Cremaster Resection. World Journal of Clinical Surgery 2023.

Journal Info

  • Journal Name: World Journal of Clinical Surgery
  • Impact Factor: 2.709**
  • ISSN: 2766-6182
  • DOI: 10.52338/wjsurgy
  • Short Name: WJCSR
  • Acceptance rate: 55%
  • Volume: 6 (2024)
  • Submission to acceptance: 25 days
  • Acceptance to publication: 10 days


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