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Wound closure

Before closure, one may place drains in the space of Retzius and anterior internal iliac fossa.

Layered closure then begins with repair of the conjoint tendon to the distal inguinal ligament. A careful fascial repair restores the floor of the inguinal canal.

The external oblique aponeurosis and the rectus sheath are then repaired, followed by secure reattachment of the abdominal wall origin to the iliac crest, in the lateral portion of the incision. A hernia-free repair, and avoidance of entrapment of the spermatic cord should be achieved.

Subcutaneous drains may be inserted.

Finally, perform an appropriate subcutaneous and skin closure.