The anteromedial surface of the cord was inspected for an indirect sac. When none was found, the peritoneal reflection at the deep ring was identified to confirm there was no indirect component.
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The bulging inguinal floor was imbricated, suturing the falx to the iliopubic tract using 2-0 polypropylene. The purpose of this maneuver was to control the bulge and allow easier mesh placement. When this maneuver alone is sufficient to repair the defect, it is known as a modified Bassini repair (see iliopubic tract repair). In this case it was not considered sufficient.
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