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A D V E R T I S E M E N T
A D V E R T I S E M E N T
A femoral hernia passes through the femoral canal and reflects up toward the inguinal ligament. It is often difficult to differentiate a femoral from an inguinal hernia. If the majority of the bulge is below the inguinal ligament (a straight line between anterior superior spine and pubic tubercle) it is likely to be femoral.
A D V E R T I S E M E N T
The hernia is freed from surrounding tissue and reduced if no compromised bowel is present. Reduction is sometimes difficult. The femoral ring can be widened by incising the lacunar ligament medially or the inguinal ligament anteriorly. It is important to isolate only the fascial layer before cutting because of the presence of an aberrant obturator artery immediately above in up to 25% of individuals.
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A D V E R T I S E M E N T
The dilated femoral ring can be narrowed by suturing inguinal ligament to pectineus fascia. In the alternative repair of a femoral hernia from above, the transition stitch of the McVay repair accomplishes the same thing. Some surgeons are now inserting a mesh plug into the canal as well.
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This page was last modified on 3/1/1999.
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