@drkang recently provided his long anticipated elaboration of the details of his indirect hernia repair procedure. He wrote:
“However, Kang repair hardly mobilizes the cremaster muscle and therefore operates in its original state, i.e. without lifting it. Ultimately, Kang repair is suturing the conjoined muscles in the medial portion and above the cremaster muscle to the lateral iliopubic tract and inguinal ligament without mobilization of cremaster muscle. The advantage is that the operation time is short because it is simple, and unnecessary trauma is not applied to the cremaster muscle and the inguinal floor. And because the length of the deep inguinal ring canal is made longer, we expect it to be much more robust in terms of recurrence.”
The @drkang repair sutures the conjoined muscles to the iliopubic tract using an open anterior approach. Similarly @drtowfigh has described her robotic adaptation of the Nyhus preperitoneal repair involving suturing the iliopubic tract to the arch of the transversus abdominis aponeurosis. Dr. Cordon has described a similar anterior approach.
It would be helpful if @drkang would give his perspective on how his repair differs from the Nyhus/Cordon/Towfigh approach. It would also be helpful if @drkang would explain how he repairs the peritoneum/hernia sac without opening the cremaster muscle and fascia (he seems to say that he does not damage the cremaster)?
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