During repair of a recurrent inguinal hernia associated with a weak inguinal floor and a coexisting femoral defect, the surgeon sutures the conjoint tendon and transversus abdominis to Cooper's (pectineal) ligament behind the inguinal ligament. Which repair has been performed?

• A Bassini repair
• B Halsted repair
• C McVay (Cooper's ligament) repair ✓
• D Girard repair

Explanation

The McVay repair approximates the transversus abdominis and conjoint tendon to Cooper's ligament (the pectineal line of the pubis) from the pubic tubercle laterally to the femoral vein, then continues onto the inguinal ligament. Because the repair covers the femoral canal as well as the inguinal floor, it is the classic tissue repair of choice when a femoral hernia coexists with an inguinal defect. The Bassini repair instead sutures the conjoint tendon to the inguinal ligament itself and does not address the femoral canal.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.