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The Laparoscopic Anatomy of the Inguino-Femoral Region and Pelvis
Gynecology / May 11th, 2013 7:53 am     A+ | a-
 
 
The laparoscopic anatomy of the inguino-femoral region viewed with a telescope by laparoscopic surgeon or robotic surgeon with laparoscope placed in intra-abdominal position differs radically from the anatomy which we observed via an open or anterior approach. The laparoscopic surgeon has to understand the laparoscopic anatomical structure of the region. Poor familiarity with the complex anatomy of the posterior inguinal view by beginers is an important contributor to the steepness of the laparoscopic inguinal herniorrhaphy or ureteric surgery or gynecological surgery learning curve. World Laparoscopy Hospital guidelines to the performance of an secure TAPP laparoscopic inguinal hernia repair, mandate the subsequent structures should be clearly and unequivocally identified by laparoscopic surgeon: 
 
The Cooper's Ligament
The Inferior Epigastric Vessels
The Spermatic Cord or even the Round Ligament 
The Femoral Canal along with the Iliac Vessels
The Median Umbilical Ligament
The Medial Umbilical Ligament
The Lateral Umbilical Ligament
 
In addition, the laparoscopic anatomical distinction direct, indirect inguinal and femoral hernias ought to be well understood. Before a surgeon attempts to carry out a laparoscopic inguinal or femoral hernia repair, he should memorize and be very informed about the following diagrams. 
 
It is also important to recognize the ureter and to learn the anatomy of three dangerous area like.
 
Triangle of Doom
Triangle of Pain
Trapezoid of Disaster
 
As all laparoscopic anatomical landmarks are engrossed in peritoneum, from the TAPP technique the peritoneum needs to be first incised along with a lower flap developed in order to expose the location adequately. In the TEP repair, the anatomical landmarks need to be meticulously exposed with blunt dissection.

The median umbilical ligament is often a remnant in the embryonic urachus. It forms the center divide by arising within the midline from your apex from the bladder toward the umbilicus. Laterally, the paired medial umbilical ligaments, vestiges from the fetal umbilical arteries, arise through the superior vesicle arteries toward the umbilicus. Relating to the median and medial ligaments lie the supravesical fossae, where external supravesical hernias occur. Most lateral would be the paired lateral umbilical ligaments, which contain the inferior epigastric arteries. Together and the medial ligaments lies the medial fossa, which contains the Hesselbach triangle, the zone of direct hernias. Lateral towards the inferior epigastric arteries is the lateral fossa, the site of indirect hernias. Thus, the lateral umbilical ligaments separate the lateral and medial fossae, and delineate between indirect and direct hernias, respectively.
5 COMMENTS
Dr. kaushik Nath
#1
May 21st, 2020 12:31 pm
The way you teach is truly commendable sir!! When you Explain specially Pelvic Anatomy It's really Amazing !! Thanks for sharing this video of Laparoscopic Anatomy of the Inguino-Femoral Region and Pelvis.
Dr. Khushbu
#2
Jun 15th, 2020 10:27 am
Fantastic demonstrates of the Laparoscopic Anatomy of the Inguino-Femoral Region and Pelvis. The content is extremely educative and useful. Dr. Mishra is excellent in conveying the knowledge of this surgery.
Dr. Sandy
#3
Jun 15th, 2020 10:31 am
Thank you very much for such a wonderful lecture on Laparoscopic Anatomy of the Inguino-Femoral Region and Pelvis. The way of your explanation completely unbelievable. really it's very interesting and very informative.
Dr. Badal Chandra Nath
#4
Jun 24th, 2020 6:11 pm
Wow.. This was very informative and easy to understand, Thank you so much for demonstration of laparoscopic anatomy of the Inguino-femoral region and pelvis. Dr. Mishra you have a wonderful memory. You teach with passion and excellent teaching skill. Thanks for sharing on Internet.
Dr. Bappa Das
#5
Jun 25th, 2020 6:01 am
Thank you so so much!. Absolutely Excellent educative video presentation of Laparoscopic anatomy of the inguino-femoral region and pelvis !! He is brilliant.!. Thanks for the super detailed information.
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