**Question:** Not true about Herniotomy

A. Herniotomy is a surgical procedure to repair an abdominal hernia without reducing the hernia sac contents back into the abdominal cavity.
B. Herniotomy involves cutting and resecting the hernia sac to prevent future recurrence.
C. Herniotomy is performed in cases of irreducible or strangulated hernias, where the contents of the hernia sac cannot be reduced back into the abdominal cavity.
D. Herniotomy is a minimally invasive procedure that is performed laparoscopically.

**Correct Answer:** D. Herniotomy is a minimally invasive procedure that is performed laparoscopically.

**Core Concept:** Herniotomy is an open surgical procedure specifically designed to repair a hernia, without reducing the hernia sac contents back into the abdominal cavity. The aim is to prevent future recurrence by cutting and resecting the hernia sac and surrounding tissue, known as the sac wall and surrounding fascia.

**Why the Correct Answer is Right:** Herniotomy is a specific type of surgical repair for an abdominal hernia where the surgeon cuts and removes the hernia sac and surrounding tissue to prevent future recurrence of the hernia. This procedure ensures that the hernia contents are not reduced back into the abdominal cavity, as reducing the contents can lead to complications and potential damage to the incarcerated or strangulated organs.

**Why Each Wrong Option is Incorrect:**

A. Herniotomy is not about reducing the hernia sac contents into the abdominal cavity, but rather removing the sac and surrounding tissue to prevent recurrence.
B. Herniotomy is not about resecting the hernia sac and surrounding tissue, but rather cutting the sac and surrounding tissue to prevent recurrence.
C. Herniotomy is performed in cases of irreducible or strangulated hernias, not in all cases, especially those where the hernia contents can be reduced back into the abdominal cavity.
Eliminating hernia sac and surrounding tissue does not prevent recurrence in reducible hernias.

**Clinical Pearl:** Herniotomy is a crucial procedure for certain types of abdominal hernias, particularly irreducible or strangulated hernias. In these cases, reducing the hernia contents can lead to severe complications like bowel necrosis or incarceration. Herniotomy ensures that the hernia contents are permanently removed, preventing future hernia recurrences. In reducible hernias, other surgical techniques like tension-free repair or Lichtenstein tension-free repair should be considered.