What is the surgical treatment for an abdominal sliding hernia?

Updated: Jul 23, 2019
  • Author: Assar A Rather, MBBS, MD, FACS; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

In about 40% of girls with an inguinal hernia, the fallopian tube (or, occasionally, the ovary or uterus) is a sliding component of the hernia that cannot be easily reduced into the abdominal cavity. The sac wall may seem too thick in the medial or lateral quadrants, or the contained viscus (particularly the fallopian tube and ovary) may not be reducible into the peritoneum. The walls must then be inspected for a sliding component.

To repair a sliding hernia, the sac is ligated distal to the fallopian tube and divided. The proximal sac is ligated and then invaginated into the peritoneal cavity. A purse-string suture inside the opened hernia sac may be used to aid in visualization during sac closure. The internal ring is closed with sutures from the transversalis fascia to the iliopubic tract.


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