Mnemonic: FEMORAL
Females (4 times more common)
- Women are always right (more common on right side)
Elderly
McEvedey operation (incision above inguinal ligament – preferred in emergency intervention due to easy access to compromised bowel for any resection if required)
Obstruction/incarceration/strangulation risk is higher (rigid walls of femoral ring)
- 3 months risk of strangulation = 22%
- 21 months risk of strangulation = 45%
Richter’s hernia – most common location
Above inguinal ligament – lump can present above inguinal ligament (confusing with inguinal hernia)
- But neck of hernia is always below and lateral to pubic tubercle
Lotheissen operation (inguinal approach)
Lockwood operation (incision below inguinal ligament)
Laparoscopic approach
Further reading: