Outcome of femoral hernia repair with a pediculated fascial flap

Abstract

Background: This paper presents the results of the operative treatment of patients with femoral hernias using our own method.
Material and methods: Between 3.04.98 and 14.12.2004, 35 patients underwent femoral hernia repair using a transinguinal access. The hernia ring was secured with a pediculated flap taken from the medial crus of the aponeurosis of the external oblique abdominal muscle; the inguinal canal was strengthened by duplication of the transverse fascia and lateral crus of the aponeurosis.
Results: During the postoperative period, neither femoral nor inguinal hernia recurrences were found; the wounds were healed by first intention. In only 3 patients was transient hypoaesthesia within the fossa ovalis skin observed, which subsided spontaneously. No other complications developed.
Conclusions: A transinguinal access provides good conditions for repair of the femoral hernia sac and for intraoperative diagnosis of multiple hernias as it is safe in the preparation of femoral foramen structures. The operative technique proposed strengthens the myopectoneal hiatus without causing tension, effectively preventing recurrences of femoral and inguinal hernias. The use of the patient’s own fascial tissue (pediculated fascial flap) in the vicinity of the femoral vein and deep lymphatic system of the lower limb is safe and creates no risk of thrombosis or lymphorrhagia.