fig2

Figure 2. Desarda repair of a groin hernia in female patient (with round ligament resection for better visualization). Anterior wall of inguinal canal is opened (A); hernia sac is dissected (B); lower edge of medial/upper flap of external oblique is sutured to inguinal ligament (C, D); creation of external oblique strip with longitudinal incision (E); the strip is sutured to internal oblique (F, G); and the anterior wall of inguinal canal is closed with external oblique (H, I). Inguinal ligament (1); upper/medial flap of external oblique (2); undissected hernia sac [(3a) dissected hernia sac; and (3b) round ligamentum of uterus] (3); suture line between lower edge of upper/medial flap of external oblique and inguinal ligament (4); external oblique aponeurosis (5); upper edge of a created aponeurotic strip (6); lower edge of the upper flap of remaining incised external aponeurosis (7); internal oblique muscle (8); suture line between upper edge of the strip and internal oblique (9); completed and sutured on both edges aponeurotic strip reinforcing inguinal floor (10); lower flap of initially incised external oblique aponeurosis attached to inguinal ligament (11); and suture line of anterior wall of inguinal canal (12).