title: Preperitoneal femoral hernioplasty: an "umbrella" technique.
abstract: BACKGROUND
  Tension-free inguinal mesh-plug hernioplasty is well established. However, femoral hernia repair remains challenging and controversial. We aimed to evaluate a preperitoneal approach of tension-free hernioplasty for femoral hernia upon the anatomy rationality.
  
  
  METHODS
  A prospective study of 62 patients between October 1999 and June 2011 received femoral hernioplasty in our hospital. This repair method involved a preperitoneal approach accomplished under regional or local anesthesia with mesh and plug; the emphasis was put on fulfilling the abdominal defect, i.e., the myopectineal orifice, with the plug flattened like an "umbrella", above the femoral ring but not to fill the femoral ring.
  
  
  RESULTS
  All cases receiving preperitoneal tension-free hernioplasty had a smooth recovery. There were no severe complications, and no recurrences were detected within a 0.5- to 4-year follow-up. No specific restrictions with regard to activity were placed on the patients after surgery. All cases were able to return to normal life, including work, within 2 weeks.
  
  
  CONCLUSIONS
  The preperitoneal tension-free hernioplasty may be a more effective method of femoral hernia repair; meanwhile, we must re-understand the anatomy of femoral hernia correctly so as to restore the anatomic and physiologic functions at this region optimally.
authors.affiliation: Department of Surgery, The 88th Hospital, Taian, 271000, Shandong, China. junshengkang@163.com.
authors.forename: J S
authors.initials: JS
authors.lastname: Kang
authors.affiliation: Department of Surgery, The 88th Hospital, Taian, 271000, Shandong, China.
authors.forename: F
authors.initials: F
authors.lastname: Qiao
authors.affiliation: Department of Surgery, The 88th Hospital, Taian, 271000, Shandong, China.
authors.forename: L
authors.initials: L
authors.lastname: Nie
authors.affiliation: Department of Surgery, The 88th Hospital, Taian, 271000, Shandong, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Surgery, The 88th Hospital, Taian, 271000, Shandong, China.
authors.forename: S W
authors.initials: SW
authors.lastname: He
authors.affiliation: Department of Surgery, The 88th Hospital, Taian, 271000, Shandong, China.
authors.forename: B
authors.initials: B
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006550:Hernia, Femoral / Q000473:pathology / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome
keywords: Femoral hernia; Mesh-plug repair; Myopectineal orifice; Preperitoneal repair