Repair of posterior wall

The posterior wall of the inguinal canal must be repaired during herniorrhaphy. There are many methods of doing this that involve either:

• approximation of structures:
  • transversus abdominis aponeurosis is sutured to either:
    • inguinal ligament - Bassini repair
    • iliopubic tract - McVay repair
  • tension may compromise the repair as the aponeurosis is stretched inferiorly; a tension-relieving incision may be necessary above the inguinal region within the anterior part of the rectus sheath

reinforcement of the wall with a:

þþ darn e.g. Moloney's repair

• prosthetic mesh
• a combination of approaches e.g. the Shouldice technique