The posterior inguinal wall is reinforced by the transversalis fascia. In the Stoppa (giant prosthetic reinforcement of the visceral sac, GPRVS) procedure for bilateral or recurrent inguinal hernia, the prosthetic mesh is placed:

• A In the preperitoneal space behind the transversalis fascia, covering the entire myopectineal orifice bilaterally ✓
• B Anterior to the external oblique aponeurosis (onlay)
• C In the inguinal canal between the external and internal oblique muscles (sublay within canal)
• D Intra-abdominally with a dual-layer mesh fixed to the peritoneum (IPOM)

Explanation

The Stoppa (GPRVS) procedure places a large prosthetic mesh (typically 16 × 24 cm or larger) in the preperitoneal space via a low midline incision, covering the entire myopectineal orifice of Fruchaud bilaterally (inguinal, femoral, and obturator regions). The mesh is held in place by intra-abdominal pressure and does not require fixation sutures. It is particularly suited for bilateral primary hernias, recurrent hernias, and sliding hernias.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.