Assuming there has been no strangulation, once the femoral hernial sac has been isolated, opened and its contents reduced back, the next step is closure. This is achieved by twisting the sac and applying a transfixion suture e.g. 3/0 catgut, around the neck. Distal to the suture, the sac is excised with scissors. The residual sac passes back into the abdomen.
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