Preperitoneal | Mesh repair | Flat mesh placed posterior to the transversalis fascia (eg, Nyhus, Rives-Stoppa, Read, Wants, Kugel repairs) | <1% to 4% | Posterior repair recommended for femoral hernias |
Bilayer | Mesh repair | Two-layer meshes placed anterior and posterior to the transversalis fascia | <1% to 3% | A flat mesh in a single plane is the preferred mesh repair |
Desarda | Nonmesh repair | Use a flap of the external oblique muscle aponeurosis to "patch" the defect | 1.4% to 4.2% | Favorable preliminary results but lacking high-quality long-term data |
McVay | Nonmesh repair | Suturing the conjoined tendon to the Cooper's ligament and inguinal ligament, with a relaxing incision of the anterior rectus sheath | 5% to 15% | The only nonmesh repair for femoral hernias |