Surgical anatomy of the inguinal area

Abstract

The anatomy of the inguinal region is enigmatic and confusing. Among the many structures involved in hernial repair are the iliopubic tract, the transversus abdominis aponeurosis and the transversalis fascia, the transversalis crura and sling, and the inguinal canal. There is still much disagreement among surgeons and anatomists about the existence, structure, and function of these anatomic entities.

Microsurgical anatomy of the hypoglossal nerve

“…There are two important triangles described in the anterior neck. 2 The large or 'anterior' triangle is formed by the anterior border of the sternocleidomastoid muscle posteriorly, the mid-line of the neck anteriorly and the border of the mandible and the mastoid process superiorly, and contains the branches of the ansa cervicalis, which innervates the infrahyoid muscles of the neck. From the neurosurgical view, the second or 'submandibular triangle' is the most important area described in the anterior neck.…”

“…From the neurosurgical view, the second or 'submandibular triangle' is the most important area described in the anterior neck. 2 It is formed by the inferior border of the mandible and the anterior and posterior bellies of the digastric muscle.…”

Transversalis Fascia and Preperitoneal Fascia: A Laparoscopic Study of Live Surgical Anatomy during TEPP Hernioplasty – Final Report and Literature Review

“…[61] Confusions and misunderstandings are continued regarding the extraperitoneal fascial tissues among the practicing surgeons and anatomists alike since the time (1804) of Sir Astley Paston Cooper. [22,24,31,32,49,62] Even direct examination of the live surgical anatomy under excellent perspective and high magnification with clear definition of the various fascial planes under the focused bright lighting of the intraperitoneal and preperitoneal laparoscopy did not help much to alleviate the ever prevailing confusions and misunderstandings/ misinterpretations, and little/no agreement exists among the practicing surgeons and anatomists regarding the interparietoperitoneal fascial tissues, especially the transversalis fascia and the preperitoneal fascia. [22,49] In 1997, Maurice Arregui lamented that 'Unlike the anterior anatomy of the inguinal abdominal wall, little in the current English literature exists about the preperitoneal fascia and conflicting information abounds regarding the transversalis fascia.…”

A prospective endoscopic study of retropubic vascular anatomy in 121 patients undergoing endoscopic extraperitoneal inguinal hernioplasty

“…Last [12] stated that the aberrant obturator artery lies laterally or medially to the neck of a femoral hernia in the proportion of 10 to 1. When the artery lies near the free edge of the lacunar ligament, it is liable to injury during the repair of a femoral hernia [16,22,23]. The aberrant obturator artery then descends across Cooper's ligament to the obturator foramen.…”