Applied anatomy of the genital branch of the genitofemoral nerve in open inguinal herniorrhaphy

Objective: To record the anatomical variations and clinical importance of the genital branch of the genitofemoral nerve in the inguinal canal. Design: Neuropathology study. Setting: General hospital, Taiwan. Subjects: 58 cadavers. Interventions: 116 dissections findings of the genitofemoral nerve in the inguinal canal. Main outcome measures: Anatomical variations. Results: All the genital branches passed through the ventral aspect of the internal ring. Almost all these branches entered the ring and continued within the spermatic cord between the fibres of the cremaster and the internal spermatic fascia. In 59% the nerve was related to the inferior fibres and in 38% it was in relation to the lateral or medial fibres. In only 3% did the genital branch run outside the spermatic cord. Conclusion: To avoid damage to the genital branch of the genitofemoral nerve, suturing should be done over the dorsal aspect of the internal ring. The cremaster should be incised longitudinal rather than transversely and the genital branch of the genitofemoral nerve should be identified before repair of the posterior wall.