Alternate method for bimanual reduction of an inguinal hernia

A) Anatomy of an indirect inguinal hernia. Note the position in the groin of the hernia "neck" extending through the internal and external inguinal rings. B) The fingers of one hand are first used to sweep along the inguinal canal from the anterior iliac crest to the distal scrotum. The same hand is then used to grasp the testicle, hernia mass, or scrotal skin and apply gentle pressure. C) The index finger and thumb of the opposite hand are used to apply "upward" and lateral traction over the hernia neck to help in keeping the internal and external inguinal rings open. D) The fingers of the hand on the scrotum are then used to "walk" the bottom of the hernia sac progressively up toward the inguinal rings until the hernia is reduced.