Whatever else may be necessary as a part of the operative procedure for the cure of hernia, complete removal of the sac followed by high ligation or suture of the peritoneum is essential. All surgeons recognize this as the most important part of the procedure and many believe that in small-sized indirect hernias in children and young persons success is apt to follow regardless of the method employed for closing the canal. For hernias of large size, for direct hernia with imperfect development or absence of the conjoined tendon and for postoperative rupture, it is necessary to suture together certain fascial structures, such as the conjoined tendon and the shelf of Poupart's ligament. In many cases the use of fascial strips as recommended by Gallie is extremely important.
The numerous modifications of the original operations of Bassini and of Halsted have been directed largely, if not solely, to methods of