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Q1: Pubic tubercle rule (2 min)
- Inguinal above/medial; femoral below/lateral — highest yield groin fact
Q2: Hesselbach triangle (2 min)
- Rectus medial, inguinal ligament inferior, inferior epigastric lateral — direct hernia
Q3: Deep vs superficial ring (2 min)
- Deep = midpoint inguinal ligament; superficial above/medial pubic tubercle
- Indirect can enter scrotum; direct rarely
Q4: Lichtenstein principles (3 min)
- Tension-free mesh on floor; protect nerves; day-case; recurrence/chronic pain consent
Q5: Lap repair indications (2 min)
- TEP/TAPP for bilateral and recurrent after anterior repair (HerniaSurge)
Q6: Strangulation algorithm (3 min)
- Irreducible + tender + obstruction/toxicity → emergency; no taxis; resect dead bowel; mesh caution if dirty
Q7: Richter & obturator (2 min)
- Richter: anti-mesenteric rim without complete obstruction
- Obturator: Howship–Romberg; elderly thin women; CT
Q8: Paediatric & prevention (2 min)
- Herniotomy no mesh; small-bites 4:1 laparotomy closure reduces incisional hernia
Q9: Sliding hernia (2 min)
- Viscus (caecum/sigmoid/bladder) forms wall of sac — do not open carelessly; high ligation traps risk
Q10: Mesh infection & chronic pain (2 min)
- Chronic groin pain more common than recurrence in modern series; nerve identification/protection
- Infected mesh may need removal
Q11: Watchful waiting (2 min)
- Minimally symptomatic male inguinal hernia may observe with informed consent; high crossover to surgery over years; femoral never "watch"
Q12: Incisional hernia prevention (2 min)
- Small-bites continuous mass closure, slowly absorbable monofilament, suture:wound ≥4:1; optimise BMI/smoking/infection