2). The spermatic cord is left subaponeurotic. Fluoro Sorafenib The aponeurotic suture of the EOM is made with a Prolen 0. The skin is closed with intradermal suture (Nylon 3-0). Fig. 1 Hernia sac identification and resection. Fig. 2 Hernia sac on the previous suture, exceeding the internal ring, around the spermatic cord. The dressing is made with a Micropore on the skin and must be removed in the 14th day when the Nylon stitches of the skin are removed. The patients have been observed for a period of two years (at 14, 30, 60, 90, 180 days, one year and two years) after surgery. Results Three serous secretions from the were observed in the 10th post-operative day (two right inguinal hernias and one bilateral hernia). The seroma was drained at office through an opening of 1 cm in the same skin incision, putting a drain of gauze.

All patients recovered without complications. The time of surgery was 10 to 15 minutes longer than the more common techniques. The cost is limited to one or two Nylon 3-0 to fix the hernia sac. The cost of the mesh is much higher. Until now only 4 (2%) patients show recurrences. Discussion Inguinal hernia shows recurrences in 10% of cases in the best methods of correction. The modern surgery of hernia began in Italy with Bassini making the reinforcement of the wall by pleating the fascia transversalis and joining the conjoint tendon to the inguinal ligament. Bassini��s method was followed by many and changed by many others (4�C13). In the last century the repair with prosthesis, since Shouldice, consists in using the polypropylene mesh in order to avoid recurrences.

The best prosthesis is made of materials that cause minor rejection, extrusion and local infection (9�C13). The casuistic of removed prosthesis is not real since sometimes the patients choose another surgeon when inflammation or rejection occur (14,15). The use of the hernia sac, since Alcino L��zaro da Silva, for the correction of abdominal hernia, opens a
in the surgery of hernia. In the beginning the hernia sac was used only for incisional hernia. This tissue is rich in collagen, fibroblasts, vessels and other structures and can be useful to correct the inguinal hernia. In this study there are only 4 recurrences (2%) in six years of observation compared with the 10% in the worldwide literature (15�C17).

The serous secretion from the wound in Brefeldin_A three patients on the 10th post-operative day doesn��t cause recurrence of hernia. The hernia sac is an autogen tissue from the own patient, doesn��t cause rejection and previous studies have shown a fibrosis occurring on it with transformation in aponeurotic tissue reinforcing the abdominal wall. In many patients it is not possible to use the sac, i.e. in direct small hernias and when it is fine and friable (18�C22). Conclusion The hernia sac, due to its resistance and good adaptation, can be used to repair the inguinal hernia.