Surgical Anatomy of the Abdominal Wall

In this Surgical Open Classroom we will be reviewing the surgical anatomy of the abdominal wall, in-depth knowledge of which is key when performing hernia surgery. 

There are several anatomical structures which must bw taken into account. First, regarding the anatomy of the abdominal wall, the most important structures are: transversus abdominal muscle, internal oblique muscle, external oblique muscle and rectus abdominis muscles. Together they form the wall that protects the structures contained in the abdominal cavity. Their points of origin and insertion as well as the relationship between them and with other structures must be taken into account to have a better understanding of the pathology of the abdominal wall.

Regarding the anatomy of the inguinal canal, it is around 4 cm long and its direction is descendent and oblique. It has two rings and a conduct. The anatomical characteristics of the inguinal canal will be explained in detail. 

Two anatomical areas must be considered in order to perform a safe surgery. First, the triangle of Doom or vascular triangle, which contains major vessels: external iliac artery and vein.  It is limited by the gonadal vessels and vas deferens in men or the round ligament in women. We also have to be careful with the triangle of pain, which contains the lateral femoral cutaneous nerve, the femoral branch of the genitofemoral nerve and the femoral nerve. Its limits are gonadal vessels and the inguinal ligament.