Open Repairs
Open repairs can be divided into tissue (sutured/tension) and prosthetic (mesh/tension-free) repairs and are referred to as either a open herniorrhaphy or open hernioplasty. This type of repair requires one large incision and can be done under general, spinal, or local anaesthesia.
Herniorrhaphy involves the repair of the posterior wall of the inguinal canal, behind the spermatic cord and the repair of the aponeurosis of external oblique in front of the spermatic cord using sutures. Hernioplasty involves the repair of the posterior wall of the inguinal canal using a synthetic mesh to reinforce it by inserting it through the defect in the myopectineal orifice.
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Tissue repairs use non-absorbable sutures and the tendinous aponeurotic and ligamentous tissues from the patient such as the muscular aponeurotic arch or 'conjoined' tendon, Cooper's ligament, iliopubic tract and the edge of inguinal ligament where as prosthetic (mesh) repairs commonly use an open-weave polypropylene mesh but others include polyester, or expanded polytetrafluoroethylene.
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