Laparoscopic Inguinal Anatomy Guide
•Download as PPTX, PDF•
72 likes•17,647 views
This document discusses the key anatomical landmarks for laparoscopic inguinal hernia repair. It outlines 9 key landmarks for the trans-abdominal pre-peritoneal (TAPP) approach and 12 landmarks to recognize after the peritoneal reflection for the total extra-peritoneal (TEP) approach. Important structures discussed include the inferior epigastric artery, triangles of Hesselback, Doom and Pain, Cooper's ligament, ilio-pubic tract, and the lateral femoral cutaneous nerve. A thorough understanding of the regional anatomy is essential for accurate surgical treatment of hernias.
Recommended
Recommended
More Related Content
What's hot
What's hot (20)
Similar to Laparoscopic Inguinal Anatomy Guide
Similar to Laparoscopic Inguinal Anatomy Guide (20)
More from Easwar Moorthy
More from Easwar Moorthy (17)
Recently uploaded
Recently uploaded (20)
Laparoscopic Inguinal Anatomy Guide
- 2. Laparoscopic Anatomyof Inguinal Region Dr.S.Easwaramoorthy MS FRCS (Eng) FRCS (Glas) Hon FRCS (Edin) Consultant surgeon, Lotus hospital, Erode, TN EC Member, IAGES South Zone
- 3. “ No disease of the human body, belonging to the Province of the surgeon, requires in its treatment, A better combination of accurate anatomical knowledge With surgical skill than hernia in all its variants” Sir Astley Paston Cooper, 1804
- 5. TAPP Vs TEP
- 7. TAPP: 9 Key Landmarks Median Umbilical ligament Medial Umbilical Ligament Lateral Umbilical ligament Vas Gonadal vessels Deep ring Supravesical fossa Medial inguinal fossa Lateral inguinal fossa
- 8. A: Median Umbilical ligament B: Medial Umbilical ligament C: Lateral Umbilical ligament
- 9. Medial Umbilical Ligament •Obliterated Umbilical artery •Medial end of dissection
- 10. Lateral Umbilical Ligament Inferior Epigastric artery •Direct/Indirect hernia •Hesselback’s triangle •Risk of bleeding C
- 12. Triangle of Doom Vas/round ligament Gonadal vessels
- 13. Deep Ring
- 14. Trapezoid of Disaster (Rt Side) Triangle of Doom Triangle of Pain 4. Vas 5. Deep ring 6. Spermatic vessels 7. Triangle of pain 8.Triangle of Doom
- 15. After Peritoneal Reflection 12 Landmarks to Recognize 3 Vessels •Inferior epigastric artery •Iliac vessels •Corona Mortis 3 Nerves •Genitofemoral N •Lateral femoral cutaneous N •Femoral N 3 Triangles Hesselbeck’s Triangle of Doom Triangle of Pain 3 Ligaments Cooper’s Ligament Lacunar ligament Ilio Pubic tract
- 16. Importance of Inferior Epigastric Artery
- 17. Corona Mortis
- 18. Transversalis Fascia • Deep Ring • Iliopubic tract • Bilaminar membrane – Vascular space – Preperitoneal space • Space of Bogros • Space of Retzius
- 19. Iliopubic tract
- 20. Importance of Ilio Pubic tract
- 22. Triangle of Pain •Lateral Femoral Cutaneous N •Femoral Br of GFN •Femoral N We don’t see Ilio hypogastric N Ilio inguinal N
- 23. Lateral Femoral Cutaneous N Meralgia paraesthetica
- 24. Left Femoral ring and Femoral hernia •Black arrow: Femoral ring •Black line: Ilio pubic tract •Straight arrow: In Epi A •Curved arrow: Deep ring •V: External iliac vein •aa: External iliac artery
- 25. Space of Bogros
- 26. TEP
- 27. Anatomy of Rectus sheath
- 28. Space of Retzius Cooper’s Ligament
- 29. Cooper’s Ligament ‘Light House’ during TEP!
- 30. TEP Direct Hernia: Pseudosac Indirect Hernia
- 31. Pseudo sac of Direct Defect
- 32. Myopectineal Orifice of Fruchand Lateral: Ilio Psoas muscle Medial: Rectus muscle Inferior: Bony margin of Pubis Superior: Arching fibres of In.oblique and transversus
- 33. Suffice to say… “I know more than hundred surgeons whom I would cheerfully allow to remove my gallbladder but only one to whom I should like to expose my inguinal canal.” – Sir Heneage Ogilvie British Surgeon 1887-1991
Editor's Notes
- Swedish anatomist