Surgery MCQ Answer 57

Answer: a, c, d

The Bassini repair is an inguinal hernia repair used world-wide and has been the standard against which other repairs are judged. The repair involves approximation of the transversus abdominis aponeurosis and transversalis fascia and the lateral edge of the rectus sheath to the shelving edge of the inguinal ligament. A femoral hernia cannot be repaired by the Bassini repair because the orifice to the femoral canal lies deep to the inguinal ligament. A Cooper’s ligament repair does approximate the structures to the transversalis fascia of the pectineal (Cooper’s) ligament between the pubic tubercle and the femoral vein and therefore is appropriate for repair of a femoral hernia.

A relaxing incision for repairs of direct and large indirect inguinal hernias prevents excessive tension in the closure. There are an increasing number of proponents for the use of prosthetic material for the routine repair of inguinal hernias. Prosthetic material, such as polypropylene mesh, have been used for years for repair of large or recurrent inguinal and femoral hernias. The prosthetic mesh provides a low-tension repair for such large defects which otherwise could not be closed without excessive tension. In addition, the mesh incites the formation of scar tissue to further increase tensile strength beyond that provided by mesh alone.

Results reported for inguinal hernia repairs using mesh have been excellent, although there is a slight risk of infection of the prosthetic material which must be considered.

Category: Surgery MCQs