The deep inguinal ring, development, function and repair

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Abstract
The deep inguinal ring opening, due to the outgrowth of the processus vaginalis around the gubernaculum, appears at the end of the 2nd month of foetal life. Around this opening the U-shaped ring of transversalis fascia begins to develop about the 5th month. The U-shaped ring is well formed and its valvular design established at the 7th month. Descent of the testis usually takes place during the 7th or 8th month of intra-uterine life, but the processus vaginalis, which should normally close before or soon after birth, may remain open throughout life. The pressure valve of the deep inguinal ring, with its active closure mechanism, is capable of protecting an open processus vaginalis, often for months or years, against the onset of a hernia. The need to join together cut or raw edges to give sound union is emphasized and the indications for ring repair in oblique hernia and major repair in direct hernia are outlined.