Figure 1

(a) Suture with prolene started from pubic tubercle. White arrow: first stitch from pubic tubercle Black arrow: weakened bulging transversalis fascia. (b) Transversalis fascia to transversalis fascia suture from pubic tubercle to internal ring. Black arrows: prolene stitches to strengthen the fascia. (c) Strengthened and flat posterior floor and reconstructed internal ring. Black arrow: last stitch to define the border of new internal ring. White arrow: stitches of transversalis fascia. (d) Implantation of mesh with inferior edge slit to accommodate the spermatic cord. Black arrow: slit at the inferior edge of mesh. White arrow: inguinal ligament.