OR / Prep · General Surgery · open
You’re scrubbing into
Open inguinal hernia repair (Lichtenstein)
Why are we operating?
Tension-free mesh repair of the commonest surgical lesion, built on knowing the canal better than the hernia does.
Indication: Symptomatic inguinal hernia; urgently when incarcerated, emergently when strangulation is suspected.
The operation in 5 steps
01Opening the canal
02Cord and sac
03Dealing with the sac
04Tension-free mesh
05Closure
Danger zones
Ilioinguinal nerve
It lies on the very cord the operation dissects and beside the mesh the operation places; entrapment by a suture or the mesh is as damaging as division.
Inferior epigastric vessels
The landmark separating direct from indirect, and a bleeding hazard at the triangle's lateral border.
Vas deferens & testicular vessels
Skeletonised with the cord at every repair; injury threatens fertility and the testis.
Watch it done
Lichtenstein repair of inguinal hernias, revisited
The tension-free mesh repair as the society that teaches it describes the steps.
Source: Hernia Society of India · Watch on YouTubeInguinal hernia repair
The overview a patient hears: what a hernia is, and what open and laparoscopic repair do to it.
Source: Cleveland Clinic Abu Dhabi · Watch on YouTube
Conceptual teaching for learners preparing to observe and assist under supervision, not operative instructions. Five minutes from now you should know why this operation exists, what its shape is, and which structures it is designed not to injure.