The inguinal ligament is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may develop. The inguinal canals are the two passages in the anterior abdominal wall which in males convey A hernia that exits the abdominal cavity directly through the deep layers of the abdominal wall, thereby bypassing the inguinal canal, is known. Inguinal Hernia: Anatomy and Management is intended for general surgeons and hernia specialists. The goal of this activity is to define current treatment.
|Published (Last):||8 November 2006|
|PDF File Size:||5.5 Mb|
|ePub File Size:||2.63 Mb|
|Price:||Free* [*Free Regsitration Required]|
During a laparoscopic inguinal hernia repair, the dangerous triangle the triangle of doom refers to a triangular area bound by the vas deferens, the testicular vessels and the peritoneal fold. Separating between the inferior epigastric vessels and the deep transverse abdominal fascia is the only approach to correctly gain access to the space of Bogros Figure This work was supported by the Shenzhen government funding for scientific and technical research and development JCYJ The space of Bogros is located lateral to the space of Retzius and is bound anteriorly by the superficial transverse fascia, medially by the inferior epigastric blood vessels, laterally by the pelvic wall, and posteriorly by the psoas muscle, the external iliac vessels and the femoral nerve.
The superficial transverse fascia tightly covers the inner surface of the anterior abdominal muscles, but it is thin and has no clinical value in a hernia repair. Anatomical terminology [ edit on Wikidata ].
Muscle levator ani iliococcygeus pubococcygeus puborectalis coccygeus rectococcygeus. Most of the inferior epigastric arteries are branches of the external iliac arteries or veins.
Muscle quadratus lumborum Iliopsoas psoas major psoas minor iliacus. The peritoneal sac and potentially loops of bowel enters the inguinal canal via inguihalis deep inguinal ring. Inguinal hernia, laparoscopic repair, anatomy. Support Center Support Center. A first-order approximation is to visualize each canal as a cylinder. Laparoscopic inguinal hernia repair is performed more and more nowadays.
By visiting this site you agree to the foregoing terms and conditions. This approach is also the principle of adult laparoscopic inguinal hernia repair Figure 2. Grant’s Atlas of Anatomy. The lateral femoral cutaneous nerve runs just below the iliac fascia and enters the thigh in the 1- to 4-cm-wide region infero—medial to the anterior superior iliac spine under the iliopubic tract.
In fact, the structure of the transverse fascia is not important in the TAPP approach or the IPOM repair; therefore, the transverse fascia is often neglected. Indirect — where the peritoneal sac enters the inguinal canal through the deep inguinal ring. During separation of the space of Bogros, avoiding piercing the iliac fascia and exposing the nerves is one of the most effective methods to reduce the incidence of postoperative chronic neuropathic pain.
To help define the boundaries, these canals are often further approximated as boxes with six sides. This structure demarcates the superior border of the femoral triangle. According to our clinical observations, the transverse fascia can be divided into two layers in the majority of patients.
Not including the two rings, the remaining four sides are usually called the “anterior wall”, “inferior wall “floor” “, “superior wall “roof” “, and “posterior wall”. The inguinal ligament divides the myopectineal orifice into two regions: The canal serves as a pathway by which structures can pass from the abdominal wall to the external genitalia. The slightly thin inferior epigastric arteries and veins can be seen at the top of the external inguinalix vessels.
Abdominal external oblique Inguinalls abdominal Conjoint tendon Rectus sheath rectus abdominis pyramidalis Arcuate line Tendinous intersection Cremaster Abdominal internal oblique. National Center for Biotechnology InformationU. Which of the following forms the posterior wall of the inguinal canal?
Inguinal canal – Wikipedia
During surgery, after the preperitoneal retropubic inguijalis is separated, care should be taken that the deep transverse abdominal fascia is tightly attached to the anterior abdominal wall at the site lateral to the inferior epigastric blood vessels when separating the space aanatomi Bogros Figure 7. All in One Anatomy Review – Volume 3: Overall, it is a thin aponeurotic membrane that lies between the rectus abdominis, the deep layer of the transverse abdominal muscle, and the peritoneum.
The inguinal ligament Poupart’s ligament or groin ligament is a band running from the pubic tubercle to the anterior superior iliac spine. The inguinal canal is bordered by anterior, posterior, superior roof and inferior floor walls.
In males with strong presentation of the cremasteric reflexthe testes can—during supine sexual activity or manual manipulation—partially or fully retract into the inguinal canal for a short period of time. Thus, the deep transverse fascia should be incised at the attachment site to enter the space of Bogros.
Frontolateral view of the right side of the pelvis. Views Read Edit View history. Schematic of the principle of adult laparoscopic inguinal hernia repair. Inguinal Hernia A hernia is defined as the protrusion of an organ or fascia through the anatimi of a cavity that normally contains it.
On the left side the cavity of the tunica vaginalis has been opened; on the right side only the layers superficial to the Cremaster have been removed. However, the degree of development of the iliopubic tract may vary individually; the iliopubic tract in other areas may not be easy to recognize under the laparoscope. This information is intended for medical education, and does not create any doctor-patient relationship, and should not be used as a substitute for professional diagnosis and treatment.