Defining the position of deep inguinal ring in patients with indirect inguinal hernias.

Surgical and Radiologic Anatomy : SRA
P SanjayA Woodward

Abstract

A preliminary survey of surgeons of all grades in our hospital revealed confusion about the position of the deep inguinal ring. Standard teaching is that the deep inguinal ring is lateral to the femoral artery. The aim of this study was to define the position of the deep ring in patients undergoing elective inguinal hernia repair. Thirty consecutive male patients undergoing indirect inguinal hernia repair under local anaesthesia were studied. The following landmarks were marked on the patient with a felt pen: anterior superior iliac spine (ASIS), femoral artery (FA), deep inguinal ring (DR), pubic tubercle (PT) and pubic symphysis (PS). The distance of each point from the ASIS was measured in centimetres. The relation of the femoral artery to the deep inguinal ring was confirmed by palpation through the deep ring during surgery. The femoral artery was consistently identified midway between the anterior superior iliac spine and pubic symphysis (mid-inguinal point). The deep inguinal ring was located medial (22/30) or above (8/30) the femoral artery, but never lateral. The mean distances from the anterior superior iliac spine to the deep ring and femoral artery were 8.8 and 7.7 cm, respectively. Contrary to standard teaching, thi...Continue Reading

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Citations

Oct 23, 2010·Surgical and Radiologic Anatomy : SRA·Wei Hwang Wan, Ee Lee Daniel Tan
Jan 9, 2014·Surgical Endoscopy·Wouter G TrompBoudewijn J Dwars
Sep 16, 2008·Journal of Pediatric Urology·Levent ElemenMelih Bulut
Jul 20, 2010·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·P SanjayA Woodward
Sep 11, 2010·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Samuel J M HaleMark D Stringer
Jun 22, 2019·Hernia : the Journal of Hernias and Abdominal Wall Surgery·H KulacogluD Oztuna
Apr 8, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Raquel P CarboneraJanice Luisa Lukrafka

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