IN 1938, Gertrude Herzfeld, Honorary Surgeon of the Royal Edinburgh Hospital for Sick Children, reviewed her experience with 1,000 cases of indirect inguinal herniorrhaphy in infants. 1 In so doing, she detailed certain techniques and methods of management that are worthy of reemphasis today. Herzfeld pointed out that indirect inguinal hernias were simply congenital defects associated with a persistent patency of the processus vaginalis. She also appreciated the difficulties of conservative management with trusses and the inherent danger of incarceration facing a young infant. This realization led her to advocate performance of an elective herniorrhaphy at the time of first appearance of a hernia in all otherwise healthy infants. Herzfeld's operative technique was a simple one, learned as a student of Sir Harold Stiles and his accomplished assistant, Sir John Fraser (written communication, 1966). Exposure through a small transverse incision was followed by opening the coverings of the cord at