Cooper’s Ligament Herniorrhapy (McVay)

  • Jameson L. Chassin


Make a skin incision over the region of the external inguinal ring and continue laterally to a point about 2 cm medial to the anterior superior iliac spine. Open the external oblique aponeurosis with an incision along the line of its fibers from the external inguinal ring laterally for a distance of about 5–7 cm (see Fig. 81–2). Mobilize the spermatic cord. Excise the entire cremaster muscle from the area of the inguinal canal (see Fig. 81–3). Also remove any lipomas of the cord. Explore the cord carefully for the presence of the indirect sac. If a sac is present, dissect it from the cord. Open the sac, explore it, close the sac at its neck with a suture-ligature, amputate the sac, and permit the stump to retract into the abdominal cavity. Identify the external spermatic vessels at the point where they emerge from the transversalis fascia (see Fig. 81–7). Divide and ligate them at this point and remove about 4–5 cm of the vessels and ligate them again at the pubic tubercle (see Fig. 81–8).


Spermatic Cord Anterior Superior Iliac Spine Inguinal Canal Transversalis Fascia Pubic Tubercle 
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  1. McVay CB, Halverson K. Inguinal and femoral hernias. In: Beahrs OH, Beart RW (eds) General surgery. Boston: Houghton Mifflin; 1980.Google Scholar
  2. Rutledge RH. Cooper’s ligament repair for adult groin hernias. Surgery 1980;87:601.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Jameson L. Chassin
    • 1
    • 2
  1. 1.Clinical SurgeryNew York University School of MedicineNew YorkUSA
  2. 2.Department of SurgeryNew York Hospital Medical Center of QueensFlushingUSA

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