Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

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S. Towfigh
Fig. 39.2. Diagram of left open inguinal dissection prior to onlay repair via
Lichtenstein technique. Green circles demonstrate areas of safe suture placement,
i.e., at or medial to the level of the internal ring. Red circles demonstrate
areas of unsafe suture placement, including no sutures at areas of visible nerves
and in muscle, as the ilioinguinal and iliohypogastric nerves may be traveling
within the muscle layers of the internal oblique prior to their emergence onto the
conjoint tendon. In general, it is safest not to place any sutures lateral to the
internal ring (Adapted from Chen and Amid [ 1 ], with kind permission of
Springer Science + Business Media).
Reference
1. Chen DC, Amid PK. Technique: Lichtenstein. In: Jacob BP, Ramshaw B,
editors. The SAGES manual of hernia repair. New York: Springer; 2013.
p. 41–54.