As far as groin hernias are concerned, Prof. Dr. Desarda has raised questions about the theories mentioned in the text books that prevent herniation. Obliquity of inguinal canal or shutter mechanism or high muscle arch or patent processus vaginalis, etc., are not the real factors that prevent hernia formation in the normal individuals. Similarly, chronic cough, weight lifting, constipation or straining at mictuirition or any other factor that increases intr-abdominal pressure are said to be the factors that result into the groin hernia formation. But then every patient with bronchial asthma or enlarged prostate or constipation do not develop hernia. Real factor that prevents hernia formation in the normal individual is presence of aponeurotic extensions from the transversus abdominis aponurotic arch in first place and strong musculo-aponeurotic structures around the inguinal canal in the second place. REF: Desarda MP. Surgical physiology of inguinal hernia repair. BMC Surgery 2003, 2;3 or visit website http://herniasurgery.tripod.com