LAPAROSCOPIC ANATOMY OF INGUINAL REGION

1. D R M U H A M M A D I M R A N K H A N
M B B S , F C P S
S E N I O R R E G I S T R A R
S U R G I C A L E WA R D
K H Y B E R T E A C H I N G H O S P I TA L
SURGICAL-ANATOMY
OF ANTERIOR
ABDOMINAL WALL

2. POINTS
• Anatomical landmarks
• Anatomical planes
• Dermatomes
• Muscles and rectus sheath
• Layers of abdominal wall
• Inguinal canal
• Femoral canal
• Laparoscopic anatomy

3. LANDMARKS
1. Xiphoid process.
2. Costal margin.
3. Tip of the ninth costal
cartilage.
4. Tendinous intersections.
5. Umbilicus.
6. Iliac crest.
7. Anterior superior iliac
spine.
8. Linea semilunaris.
9. Linea alba.
10. Inguinal ligament.
11. Pubic tubercule.
12. Pubic crest.

4. THE ANATOMICAL PLANES
HORIZONTAL PLANES
XIPHISTERNAL
PLANE=T9
SUBCOSTAL
PLANE=L3
SUPRACRISTAL
PLANE= L4
TRANSTUBERCULAR
PLANE=L5
INTERSPINOUS
PLANE
VERTICAL PLANES
Midline
Two Paramedian Planes
(Mid Clavicular Line/ Mammary Line)

5. DERMATOMES

17. THE SPERMATIC CORD
Three fasciae:
External spermatic (from external
oblique fascia)
Cremasteric (from internal oblique
muscle and fascia)
Internal spermatic (from transversalis
fascia)
Three arteries:
Testicular artery
Cremasteric artery
Deferential artery
Three veins:
Pampiniform plexus and testicular vein
Cremasteric vein
Deferential vein
Three nerves:
Genital branch of genitofemoral nerve
Ilioinguinal nerve
Sympathetic nerves (testicular plexus)
Lymphatics

22. THE FEMORAL HERNIA

28. LAPAROSCOPIC ANATOMY

29. LAPAROSCOPIC ANATOMY