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In every decade there are surgeons who become dissatisfied with the results of operations designed f o r the radical cure. The winter of their discontent does nothing but good, for it is well that the attention of the profession should be focused on these procedures which, lacking the elements of novelty, are too often treated with dangerous complacency (G. GREY TURNER, 1941).No problem of such seeming simplicity has proved so elusive as the certain cure of inguinal hernia, and ascribing its poor results to the incompetence of our surgical colleagues is unlikely to solve it. If we accept the validity of impersonal statistical reviews, in which it must be admitted that the authors have no personal axe to grind, the recurrence rate is claimed to be as high as 15-17 per cent. Furthermore, they indicate that the more elaborate and time-consuming operations give almost as high a rate of recurrence as the Bassini operation.There is little doubt that the Bassini operation, despite almost universal opprobrium, is still the most popular method of repair for inguinal hernia. It has the merit of being time-saving, easy to perform, and is, on the face of it, so logical in its concept. But the Bassini is the prototype of all the posterior repair operations, so that any basic weakness in the Bassini must be inherent in all its more sophisticated modifications. If we analyse the Bassini operation in terms of the inguinal mechanism, two facts emerge: it weakens the defence of the posterior wall, and it fails to protect the internal inguinal ring. Polya (1905) realized that if a recurrence took place, it did so at one of two points: at the lower angle of the canal or at the entrance of the cord to the canal. If we can discover why these two areas of weakness persist we will have come some way towards solving the problem. THE DEFENCE OF THE POSTERIOR WALLNature has adopted an ingenious method of permitting free egress to the spermatic cord through the abdominal wall, at the same time employing the cord as an integral part of the defence mechanism of the posterior wall. Under stress the cord is wedged against the triangular gap which remains between the lower border of the contracted conjoined tendon and the inguinal ligament (Fig. I), and it cushions the transversalis fascia against the outward thrust of intra-abdominal pressure (Fig. t B). When the cord is