Femoral hernias protrude through the femoral canal. The femoral canal originates just deep to the inguinal canal, courses below the inguinal ligament and opens up into the femoral triangle. In other words they occur just below where inguinal hernias occur.
Femoral hernias are very frequently misdiagnosed as an inguinal hernia. They are more common in women but women more commonly have inguinal hernias. Because femoral hernias have a narrow and rigid neck they have a tendency to incarcerate and strangulate and require emergency surgery.
A femoral hernia is best repaired using the McVay procedure. This is an open non-mesh procedure that is also a very good repair for an inguinal hernia.
"Milan—Chronic groin pain after hernia surgery is now considered the most important issue facing inguinal hernia surgeons and their patients. Yet, there is still much uncertainty surrounding what causes the pain and how to prevent it." - Victoria Stern, General Surgery News