1.4.4.1 Medial/direct inguinal hernia

This type of inguinal hernia is always acquired. It accounts for around 30–40 % of all cases of inguinal hernias and affects in particular men of advanced age. The hernial opening is situated in the area of what is known as Hesselbach’s triangle, a muscle-free region of the inguinal fossa. The hernial sac runs medially to the blood vessels of the lower abdominal wall (medial = parallel to the midline of the body). It protrudes vertically, that is through a direct pathway, through a region of the abdominal body with acquired tissue weakness.