Sir Astley Paston Cooper stated in 1804 that a sound knowledge of proper anatomy of hernia is vital. But even in the succeeding two centuries, the confusion has only multiplied by varied and overly enthusiastic descriptions, some speculative and others real, by different workers. An attempt has been made to highlight the size of the controversies surrounding the anatomical structures forming the inguinal canal and groin. The inguinal and femoral hernias should be viewed collectively as one entity and together be called groin hernias. Therefore, the passage for their superficial emergence through the anterior abdominal wall is redefined and is called pubomyoaponeurotic foramen. It is uniformly accepted that the strong posterior wall of the groin area is the only preventive factor towards the emergence of hernia; it has been renamed as posterior groin plait. Therefore, proper understanding of its structure towards effective repair and reinforcement is the only safe method, whether the procedure is carried out by anterior or posterior route or laparoscopically. Hence, an attempt has been made to elucidate its true structure. In spite of so many descriptions, the exact anatomy of hernia is yet to be resolved.
Biomechanical processes involving exact mechanism of air embolism (AE) or gas embolism (GE) in pneumoperitoneum (PP) in operative laparoscopy (OL) causing morbidity and mortality lie in air lock (AL) or gas lock (GL) in right side of heart resulting in traffic jam (TJ) for blood flow in pulmonary tree (PT). This also leads to poorly understood cascade of immunopathological pulmonary reactions. These issues are critically reviewed and discussed to thresh the grain of mechanism from husk of myth of ghost of AE or GE in OL for its dreaded moribund complications. Physics of gas is defined with analysis that venous GE is not exclusive to ambient air (AA) in OL but occurs with CO2, N2O, O2 and other gases also. It is important since use of AA in OL is useful or ostensibly better than CO2 in situations like pregnancy, camps, cardiopulmonary cripples, cirrhotics, war fields, etc and economic needing no cylinders as AA is ubiquitous. Even when gas used was or is CO2 or O2 but blemish is labelled on air for embolism imprudently needing scientific scrutiny.
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