Open Surgery for Femoral Hernias: a Single Approach with Double Window for All

Abstract

Femoral hernias are relatively less frequent than inguinal hernias but most often strangulated, which carries significant mortality. The multiple approaches are described to deal femoral hernias including three classical approaches. Each approach describes a separate skin incision and dissection to access the femoral sac. We propose a single approach with double window for all femoral hernias. Inguinal canal is opened by inguinal skin crease incision which is taken over medial half of inguinal ligament. The sac is identified, released from femoral canal, and traced up to the defect of herniation (window-1) If bowel is gangrenous, a second window is made at McBurney’s point by giving another incision as that of gridiron incision (window-2) made by muscle splitting. The gangrenous bowel is dealt from the second window. This new single approach with double window is useful for all elective and emergency femoral hernias. It is easy to perform without any damage to muscles and nerves and obviates the need of multiple approaches.