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Living Aponeurotic Sutures to Repair Inguinal Hernias

Arch Surg. 1962;85(3):418-424. doi:10.1001/archsurg.1962.01310030066011.
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In 1901, McArthur1 described the use of strips of external oblique aponeurosis as suture material for the repair of inguinal hernias, demonstrating both experimentally and clinically that the transplanted material survives. In 1904, he reported 93 consecutive operations with good immediate results.2 Since then the McArthur technique has been used in many reported series3-7 with results that have varied, as might be expected, since the use of aponeurotic sutures solves only one of a number of problems in this field. In 1947, I described a modification of the McArthur technique with a follow-up study of 201 operations done on 170 patients.8 In the majority of these operations one strip of external oblique aponeurosis was used to reinforce the area medial to the internal inguinal ring, the area most vulnerable to recurrence. Although the end results were good, it was noted that those hernias which recurred did


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