2. Herniation of the intra-abdominal contents
through the femoral canal
Less common than inguinal hernia
More common in females; multipara
20% - bilateral; more common on right side
Easily missed on examination
3. Femoral canal – Extends from femoral ring
above and saphenous opening below
Contents –
Fat
Lymphatics
Lymph node of
Cloquet
4. Boundaries –
Anteriorly – Inguinal ligament
Posteriorly – Iliopectineal ligament of Cooper,
pubic bone and fascia covering the pectineus
muscle
Medially – Lacunar ligament (Gimbernat’s)
Laterally – Thin septum separating from the
femoral vein
7. Hernial sac descends down upto saphenous
opening through the femoral canal
Retort shaped
More prone to obstruction and strangulation
8. Swelling in the groin (below and lateral to the
pubic tubercle)
Impulse on coughing, reducibility and dragging
pain
Obstruction or strangulation –
Painful, tender and inflamed
Irreducible
No cough impulse
Vomiting
12. Lockwood Low operation –
Transverse incision made over the hernia
Sac opened and contents reduced
Sutures placed between inguinal ligament
above and fascia overlying the bone below
No risk of bowel resection
13.
14. Inguinal approach (Lotheissens’s) –
Inguinal canal approach
Transversalis fascia is opened and hernia is
reduced
Neck of hernia is closed with sutures or mesh
15. High approach (McEvedy) –
Risk of bowel strangulation
Incision made over femoral canal extending
vertically above the inguinal ligament
Hernia reduced
Sac exposed for careful inspection of the
bowel
Femoral defect closed with sutures or mesh
16.
17. AK Henry’s approach –
Repair of bilateral femoral hernia through
lower abdominal incision
Laparoscopic approach –
TEP and TAPP approaches used for femoral
hernia and a standard mesh inserted.
Ideal for reducible hernia
