Sliding Hernia Case Study: 4
   
 

A nick was made in the external oblique aponeurosis above the superficial ring. Sometimes the ilioinguinal nerve can be seen at the ring and the incision made to avoid the nerve. It was not visible in this case. Lidocaine can be injected under the fascia to separate it from the nerve for safety even if the procedure is not being done under local.

  Sliding Hernia Case Study: 5
   
 

A Metzenbaum scissors was inserted in the nick with the points directed up against the underside of the fascia. It was pushed down into the superficial ring and the points opened to sweep the nerve off the fascia.

  Sliding Hernia Case Study: 6
   
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With the points close together and the lower blade up against the fascia, the scissors were pushed toward the ring.

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