An endoscopic view of the surgical anatomy of the inguinal region

Abstract

Laparoscopic techniques in general are being increasingly exploited in surgery. One recently introduced procedure is laparoscopic hernia repair, which potentially offers a shorter recovery time, a return to normal activity and a significant reduction in groin discomfort for patients. Unlike other laparoscopic procedures such as laparoscopic cholecystectomy and appendicectomy where the anatomy encountered by the surgeon through the laparoscope is essentially the same as that seen at open surgery, laparoscopic repair of an inguinal hernia requires a different anatomical approach and the development of a different technique for repair. The anatomy of the inguinal region as seen laparoscopically is unfamiliar to most surgeons. Consequently, so that the procedure is completed successfully without causing damage to anatomical structures or the potential for post-operative recurrence, a detailed anatomical knowledge is essential. In this paper, the intra-abdominal anatomy of the inguinal region is revisited with the aid of diagrams and photographs, to aid the surgeon in understanding the laparoscopic anatomy of the region. In addition the critical elements of successful repair are discussed with respect to anatomical landmarks.

Key Words:

• laparoscopy
• hernia repair
• inguinal canal
• inguinal region