The failure of invagination herniotomy for indirect inguinal hernia.

THE SEARCH for a simple secure method for the repair of indirect hernia continues. In 1899 Kocher (Kocher, 1903) introduced displacement of the invaginated neck of the sac lateral to the inferior epigastric vessels. This method never achieved the popularity of that suggested by Bassini but has been practised by various surgeons; C. J. A. Woodside of Belfast used it throughout his surgical career and claimed, but never published, excellent results. In 1964 Celestin published a modification of the Kocher method which had been used by Grant-Batchelor for at least 10 years. This consists of isolation of the sac up to, but not including, the internal ring, not disturbing the natural adhesions between the fascia transversalis and peritoneum (Fig. 1). The sac is