The Rives Technique: Treatment of Groin Hernias with Mersilene Mesh by an Inguinal Approach

The term groin hernia, as used by Fruchaud, expresses the fact that all hernias of this anatomical region result from a single basic defect, a defect of the transversalis fascia. All groin hernias pass through this “myopectineal orifice.” When the quality of the local structures is adequate, the use of a prosthesis is not indicated, but when the local structures are weak, especially in the case of recurrent hernias, it is mandatory to replace or reinforce the transversalis fascia with a prosthesis placed in the preperitoneal space, as described by Rives et al. as early as 1965. The prosthesis is not simply sutured to the edges of the defect, but placed behind the abdominal wall; the prosthetic material is cut larger than the orifice, and its adherence to the posterior surface of the abdominal wall is guaranteed by intraabdominal pressure.