ANATOMI HERNIA INGUINALIS PDF
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.
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Most of these nerves pass through the deep surface of the iliopubic tract to innervate the corresponding area of the perineum and thigh Figure However, these abovementioned nerves can suffer major damage or entrapment when performing separation or fixation or when controlling bleeding, which may cause abnormal sensation hernnia the nerve-innervated area, especially chronic neuropathic pain, and may even cause motor disorders in the lower extremity.
Journal List Ann Transl Med v. The peritoneum is in place, and the various cords are shining through. A single-side repair of the myopectineal orifice can simultaneously and completely repair the site of anatomical weakness for inguinal, direct and femoral hernias.
The inguinal ligament divides the myopectineal orifice hernka two regions: Inguinal hernia, laparoscopic repair, anatomy.
Anatomy essentials for laparoscopic inguinal hernia repair
Some researchers have described it as a two-layer structure, while other researchers have described it as a single-layer structure; some researchers have reported that the transverse fascia is thick and dense in structure, while other researchers have reported that it is thin in structure.
From Wikipedia, the free encyclopedia. This approach is also the principle of adult laparoscopic inguinal hernia repair Figure 2. 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.
An indirect inguinal hernia can result from which structure failing to regress after the descent of the testes? You need to be a supporter to access this content.
Muscle quadratus lumborum Iliopsoas psoas major psoas minor iliacus. Iliac fascia Iliopectineal arch. Which two of the following are the attachment sites for the inguinal ligament? Overall, it is a thin aponeurotic membrane that lies between the rectus abdominis, the deep layer of the transverse abdominal muscle, and the peritoneum. Inguinal triangle Inguinal canal Deep inguinal ring Superficial inguinal ring Intercrural fibers Crura of superficial inguinal ring Inguinal ligament Pectineal ligament Lacunar ligament Reflected ligament.
Where these contents exit through the inguinal canal, having passed through the deep inguinal ringthe condition inguinais known as an indirect or oblique inguinal hernia.
The iliopubic tract is a thickened tendinous structure of the transverse abdominal fascia that connects the anterior superior iliac spine and the pubic tubercle and parallels the inguinal ligament Figure The slightly thin inferior epigastric arteries and veins can be seen at the top of the external iliac vessels. Oliver Jones Last Updated: To facilitate this description, the anatomical structures of the lower anterior abdominal wall especially with respect to the transverse fascia are defined as follows Figure 3.
These two terms are mentioned frequently in this article, and are often mistakenly used interchangeably:. Discuss Proposed since August Wikimedia Commons has media related to Inguinal ligament. This article has been cited by other articles in PMC.
Anatomy essentials for laparoscopic inguinal hernia repair
This page was last edited on 27 Novemberat The deep transverse abdominal fascia is tightly attached to the anterior abdominal wall at the site lateral to the inferior epigastric blood vessel. Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair.
Both types of inguinal hernia can present as lumps in the scrotum or labia majora. The deep transverse fascia becomes a funnel-shaped structure that extends downward to cover the spermatic cord structures the vas deferens, the testicular vessels and the hernia sac of the oblique inguinal at the internal inguinal ring and becomes the internal spermatic fascia entering the inguinal canal.
In juveniles and adults with inguinal injury, retraction can be prolonged and potentially lead to overheating-related infertility. Inguinal canal is tube at lower left. Abdominal contents potentially including intestine can be abnormally displaced from the abdominal cavity. 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.
These structures are the landmarks for making a correct diagnosis and performing accurate surgeries Figure 8. Note that the processus vaginalis normally regresses after the descent of the testes.
Evaluation of orthopedic and athletic injuries.
By TeachMeSeries Ltd Open in a separate window. The superficial and anatomii transverse fasciae extend to the inguinal region and cover the blood vessels under the abdominal wall both sides. The processus vaginalis normally degeneratesbut a failure to do so can cause an indirect inguinal hernia, a hydrocele, or interfere with the descent of the testes.
Indirect inguinal hernias are the more common of the two types. Schematic of the principle of adult laparoscopic inguinal hernia repair. Large herniations are possible in which the peritoneal sac and its contents may traverse the entire inguinal canal, emerge through the superficial inguinal ring, and reach the scrotum.
Colles’ ligament is reflex ligament not inguinal ligament. Usually, the preperitoneal retropubic space is considered to be equivalent to the space of Retzius. In other projects Wikimedia Commons. Otherwise, it is easy to accidentally damage the inferior epigastric vessels or pierce the peritoneum, which may cause difficulties while performing laparoscopic surgery or even require conversion to open surgery.
In fact, the structure of the transverse fascia is not important in the TAPP approach or the IPOM repair; therefore, the transverse knguinalis is often neglected.
The mid-inguinal point, halfway between the anterior superior iliac spine and the pubic symphysis, is the landmark for the femoral artery. Retrieved from ” https: