The surrounding structures of the hernia ring are simple (31), with the pectineal
ligament located below and the conjoined tendon arch above.
The femoral ring is that portion of the femoral canal bounded laterally by the femoral vein, medially by the lacunar ligament, anteriorly by the inguinal ligament, and posteriorly by the pectineal
Silk sutures then incorporated from arching fibers of internal oblique to pectineal
part of inguinal ligament, finally leaves of external oblique we closed with interrupted sutures.
In low constituted ingunal region there may be high arched myoaponeurotic upper border with wide gap between conjoined tendon and the inguinal ligament or pectineal
ligament which creates tension, tissue necrosis with separation of sutured tissue and repeated recurrence of hernia in conventional repair (Abhramsons).
It is inserted by a long flat tendon attached to iliopectineal eminence, pectineal
line and iliac fascia.