A surgeon elects to perform a McVay (Cooper's ligament) repair for a symptomatic femoral hernia. During the repair, the conjoined tendon is sutured down to which structure?
- A Cooper's (pectineal) ligament on the superior ramus of the pubis ✓
- B Poupart's (inguinal) ligament laterally to the femoral vein
- C Gimbernat's (lacunar) ligament along its free edge
- D Transversalis fascia at the iliopubic tract
Correct answer: A. Cooper's (pectineal) ligament on the superior ramus of the pubis
Explanation
The McVay repair approximates the transversus aponeurosis and conjoined tendon to Cooper's pectineal ligament, which lies on the pecten pubis, thereby closing both the inguinal and femoral canals. This makes it suitable for femoral hernias and for large direct defects. B relaxing incision in the anterior rectus sheath is usually needed because the repair is under tension. Suturing to the inguinal ligament alone describes Bassini-type repairs and does not obliterate the femoral canal.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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