Although a Cooper ligament repair is a more extensive operation than most hernia repairs, it can be done safely with minimal morbidity and a very low recurrence rate. A generous relaxing incision and careful technique around the femoral vessels are required. Many surgeons would choose a Cooper ligament repair for direct, large indirect, and femoral hernias only. I have used it for all groin hernias in adults, primary or recurrent, regardless of the presenting defect. I believe it is the best hernia repair done today.