J.Jpn. Surg. Soc.. 81(9): 1212-1214, 1980

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Report on the annual meeting

MIZRACHY'S OPERATION FOR INGUINAL HERNIA

This is a study of the overlapping reconstruction of the posterior wall of the inguinal canal performed for inguinal hernia. A total of 773 operations were achieved. Among them 22 or 2.8 per cent of the patients underwent Mizrachy's procedure.
All of 22 patients on whom Mizrachy's operation was carried out have had excellent results and no recurrences occurred.
OPERATION TECHNIQUE
This operation is based on that devised by Shouldice (1945) and documented by Glassow (1978) and modified fascia by Mizrachy in 1973.
The most important part of this procedure is to use the transversalis fascia unlike the commonly used plication technique in which the more attenuated part of the structure is used.
At the inguinal ring, a finger is inserted behind the transversalis fascia and it is opened down into the pubic tubercle. The reconstruction of the posterior wall of the inguinal canal is as follows:The lateral flap of the transversalis fascia is sutured to the undersurface of the medial flap of the arch of the transversus abdominis aponeurosis. A new snug internal ring is formed. The next suture line approximates the free margin of the medial flap of the transversalis fascia to the iliopubic tract including the femoral sheath.
The third and fourth suture lines approximate the internal oblique aponeurosis and anterior rectus sgeath to the inguinal ligament.
The fourth suture line is not always necessary to perform.
It demonstrates the ease and safety with which this procedure can be performed in the ged patient with moderate sized indirect inguinal hernia.

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