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Inguinal Incision: Steps of the Surgical Approach

Urologic Indications

In urology, an inguinal incision is used for radical orchiectomy, hernia repair, surgery for cryptorchidism, and varicoceles.

Inguinal incision: skin incision 1 cm above and parallel to the inguinal ligament, from the inner to the outer inguinal ring.

Patient Positioning

Supine position.

Surgical Technique of an Inguinal Incision

• Incise the skin 1 cm above and parallel to the inguinal ligament, from the inner to the outer inguinal ring [fig. inguinal incision].
• Cut through the subcutaneous fat tissue and Camper fascia to expose the aponeurosis of the external oblique muscle of the abdomen.
• Transsect the aponeurosis of the external oblique muscle from the external inguinal ring to the level of the internal inguinal ring. Identify the ileoinguinal nerve to facilitate preservation.
• Mobilize the spermatic cord to the internal inguinal ring by blunt and sharp dissection.

Wound Closure:

Fascial closure with continuous running (monofilament, elastic, slowly absorbable, suture size USP 2-0) or interrupted sutures.

References

J. A. Smith, S. S. Howards, G. M. Preminger, and R. R. Dmochowski, Hinman’s Atlas of Urologic Surgery Revised Reprint. Elsevier, 2019.

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