Fascia: A Pragmatic Overview for Surgeons

Abstract

The term “fascia” is a very frequently used notion, particularly in an anatomical, surgical, and radiological context. A closer look at the underlying concepts, however, reveals that the denomination is all but a consistent one. It is this use of one and the same term for very different entities that is one of the sources for controversial opinions on fascial structures and their applications in surgical practice. This article summarizes and illustrates examples of structures called fasciae. Considering the impossibility to give a simple, universal definition, we conclude that a precise description and iconographic documentation of the structure under consideration remain mandatory. They should replace the presumably unequivocal, but in fact often nebulous, notion “fascia” in surgical, radiological, and anatomical articles.

Urinary Tract

“…On the other hand, if the tumor is attached to the fascia lata, a muscle plane deep to this layer must be removed to achieve a clean margin. Unfortunately, the true defi nition of a " fascial plane " is lacking in medicine, and specifi c guidelines remain elusive (Fasel et al 2007 ). While to some authors the defi nition of fascia has included adipose tissue, this concept is not universally supported (Fasel et al 2007 ).…”

“…Unfortunately, the true defi nition of a " fascial plane " is lacking in medicine, and specifi c guidelines remain elusive (Fasel et al 2007 ). While to some authors the defi nition of fascia has included adipose tissue, this concept is not universally supported (Fasel et al 2007 ). A current defi nition of fascia is considered " sheaths, sheets, or other dissectible connective tissue aggregations visible to the unaided eye " (Wendell -Smith 1997 ; Fasel et al 2007 ).…”

“…While to some authors the defi nition of fascia has included adipose tissue, this concept is not universally supported (Fasel et al 2007 ). A current defi nition of fascia is considered " sheaths, sheets, or other dissectible connective tissue aggregations visible to the unaided eye " (Wendell -Smith 1997 ; Fasel et al 2007 ). Furthermore, fascia can be " considered as gross structures enveloping and/or supporting other formations " (Fasel et al 2007 ).…”

“…A current defi nition of fascia is considered " sheaths, sheets, or other dissectible connective tissue aggregations visible to the unaided eye " (Wendell -Smith 1997 ; Fasel et al 2007 ). Furthermore, fascia can be " considered as gross structures enveloping and/or supporting other formations " (Fasel et al 2007 ). These defi nitions support the removal of a deep layer of connective tissue (not including adipose tissue) when considering a deep margin.…”

Fascial plane mapping for superficial tumor resection in dogs. Part I: Neck and trunk

“…While the concept of the fascial plane is widely used, fascia is inconsistently defined 14‐16 . Fasel et al 14 advocated that fascia be defined as sheaths, sheets, or other dissectible connective tissue aggregations visible to the unaided eye.…”