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A D V E R T I S E M E N T
A D V E R T I S E M E N T
The relationships of the inferior epigastric vessels, medial umbilical ligament, inguinal and Pectineal ligaments, anterior superior iliac spine and pubic tubercle are shown.
A D V E R T I S E M E N T
The transversalis fascia is the boundary of the abdominal cavity and is key to understanding inguinal anatomy. The neck of transversalis around the spermatic cord structures is the deep inguinal ring. The evagination of transversalis around the cord is the internal spermatic fascia, and the evagination around the femoral vessels is the femoral sheath. An indirect sac lies within the internal spermatic fascia, and a femoral hernia lies within the femoral sheath. The thickening of transversalis adjacent to the inguinal ligament is the iliopubic tract, which is a caudal anchor of an anatomic hernia repair along with the inguinal ligament.
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A D V E R T I S E M E N T
The caudal edge of the transversus muscle is the transversus aponeurotic arch/falx inguinalis. It is adherent to the underlying transversalis fascia and is the cephalad side of an anatomic hernia repair. The medial continuation of the transversus aponeurosis forms the first component of the anterior rectus sheath below the arcuate line. The second component is the internal oblique aponeurosis. It is these fused layers that are incised for a relaxing incision in a Cooper’s ligament/McVay repair. Only transversalis fascia covers Hesselbach’s triangle.
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This page was last modified on 2/10/2009.
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