Hernia and abdominal wall: Shouldice repair: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hernia and abdominal wall: Shouldice repair

Sample item

Which tissue repair has the lowest recurrence for inguinal hernia when mesh is not used?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Shouldice repair with multilayer continuous suture of the transversalis fascia

Shouldice reconstructs the posterior wall by overlapping continuous sutures of the transversalis fascia in two or more layers, plus conjoint tendon approximation to the inguinal ligament. It has the best results of the tissue repairs, though mesh repair (Lichtenstein) is generally better.

Option by option

  • A. Shouldice repair with multilayer continuous suture of the transversalis fascia (correct)

    Correct. Shouldice has the lowest recurrence of tissue repairs.

  • B. Bassini repair with interrupted sutures

    Bassini has a higher recurrence rate.

  • C. Simple high ligation of the sac

    High ligation alone treats children.

  • D. Darn repair of skin

    Skin is not used for hernia repair.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Shouldice repair with multilayer continuous suture of the transversalis fascia. Shouldice reconstructs the posterior wall by overlapping continuous sutures of the transversalis fascia in two or more layers, plus conjoint tendon approximation to the inguinal ligament.

Why is "Bassini repair with interrupted sutures" not the answer?

Bassini has a higher recurrence rate.

Why is "Simple high ligation of the sac" not the answer?

High ligation alone treats children.

Why is "Darn repair of skin" not the answer?

Skin is not used for hernia repair.

What concept does this question test?

It tests Hernia and abdominal wall: Shouldice repair in General Surgery. It has the best results of the tissue repairs, though mesh repair (Lichtenstein) is generally better.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hernia and abdominal wall: Shouldice repair?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.