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Arch Surg. 1947;54(4):414-429. doi:10.1001/archsurg.1947.01230070422005.
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EFFECTIVE closure of the inguinal defect in the presence of hernia presents a problem which has taxed the ingenuity of surgeons for many years. It is the purpose of this communication to present a technic for herniorrhaphy which includes, among other important details, a broad approximation of the internal oblique muscle to the inguinal ligament by a combination of nonabsorbable and living fascial sutures, the latter from the external oblique aponeurosis. Approximation may be secured lateral as well as medial to the internal inguinal ring, and it is believed that the broad scar so formed presents a firm and relatively nonstretchable barrier to recurrence. A series of two hundred and one hernias treated by this method is presented, with a recurrence rate of 1.74 per cent.

ANATOMY AND PHYSIOLOGY OF THE INGUINAL REGION  A clear understanding of the anatomy and physiology of the inguinal region is a fundamental requirement for


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