Inguinal anatomy and retropubicvascular hazards of the ilioinguinal approach

Teague, David

doi:10.1016/s1048-6666(97)80057-2

Cited by 3 publications

(8 citation statements)

References 6 publications

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“…19 From his textual and graphical descriptions of this band, it seems to be the very structure identified as the iliopectineal ligament or fascia in earlier Gray's Anatomy editions and Letournel's work, and the iliopectineal arch in the latest Gray's Anatomy edition and Acland's work. 1,8,9,13,14,19 The findings of our cadaveric study align most closely with those of Acland. 8 We confirm the presence of an anterior thickening of the iliopsoas fascia that attaches superolaterally at the medial lip of the anterior iliac crest and inferomedially at the iliopectineal eminence, deemed in this work as the IPF.…”

Section: Discussionmentioning

confidence: 98%

“…16,17 In the post-Letournel orthopaedic literature, Teague has provided one of the more comprehensive descriptions of ilioinguinal anatomy. 19 Like Mayo, he includes in his IPF definition the portion of iliopsoas fascia attaching along the entirety of the posterior pelvic brim; however, it uses a unique term to describe the most anterior thickening of the iliopsoas fascia, the iliopectineal band. 2,19 He states, "The iliopectineal band arches from the anterior superior iliac spine to the iliopectineal eminence."…”

Section: Discussionmentioning

confidence: 99%

“…2,19 He states, "The iliopectineal band arches from the anterior superior iliac spine to the iliopectineal eminence." 19 From his textual and graphical descriptions of this band, it seems to be the very structure identified as the iliopectineal ligament or fascia in earlier Gray's Anatomy editions and Letournel's work, and the iliopectineal arch in the latest Gray's Anatomy edition and Acland's work. 1,8,9,13,14,19 The findings of our cadaveric study align most closely with those of Acland.…”

Section: Discussionmentioning

confidence: 99%

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The Iliopectineal Fascia: A Cadaveric Anatomical Study

Barker

Yang

Matz

et al. 2021

Journal of Orthopaedic Trauma

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Objectives: The iliopectineal fascia (IPF) serves as an important anatomical compass during the ilioinguinal and anterior intrapelvic approaches. The purpose of this investigation is to qualitatively and quantitatively describe the IPF by cadaveric dissection.Methods: Dissections were performed on 7 paired fresh-frozen cadaveric pelvic specimens. Measurements were made with surgical rulers to determine attachments of the IPF relative to surrounding anatomy. Results:The IPF is the thickened anterior portion of the iliopsoas fascia, attached superolaterally at the iliac crest for a mean insertion distance of 2.5 cm (range, 2.0-3.0 cm), immediately posterior to the origin of the inguinal ligament. Inferomedially, the IPF attaches to a bony ridge along the apex of the iliopectineal eminence, between the pelvic brim posteriorly and the anterior wall of the acetabulum anteriorly (mean distance, 4.3 cm; range, 3.1-5.6 cm). The attachment at the iliopectineal eminence is 7.8 cm (range, 6.0-10.0 cm) from the pubic symphysis, measured curvilinearly along the brim. The mean length of the IPF between its superolateral and inferomedial attachments is 9.2 cm (range, 8.0-11.8 cm). Anterolaterally, the IPF is the site of attachment of the internal oblique and transversus abdominis. Posteriorly, the IPF continues as the iliopsoas fascia. Conclusions:The authors have sought clarity and reconciliation of the myriad terms and descriptions of the IPF and its surrounding anatomy. We recommend a thorough understanding of this anatomy to enable safe and effective surgery via the ilioinguinal and anterior intrapelvic approaches to the acetabulum.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Iliopectineal Fascia: A Cadaveric Anatomical Study

Barker

Yang

Matz

et al. 2021

Journal of Orthopaedic Trauma

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“…In this approach, dissection around the femoral vessels in its middle window constitutes a high risk for their iatrogenic injury that necessitates special caution [11]. Knowing that these vessels lie directly in a close relation to the anteromedial surface of the iliopectineal membrane and ligament, a detailed study of its morphological anatomy together with carrying out special tacts during surgical dissection can reduce this risk significantly [1,10]. This Ilioinguinal approach was first mentioned by Letournel in 1961 as an extra-pelvic, extraperitoneal, trans-inguinal canal approach [12,13].…”

Section: Morphological Findingsmentioning

confidence: 99%

“…considered as a continuation of the transversus abdominis fascia. It is thinner anteriorly but progressively becomes thicker medially [1,2]. The iliopectineal membrane is the relatively denser medial part of this iliopsoas fascia on its anteromedial surface run the great femoral vessels.…”

mentioning

confidence: 99%

Iliopectineal Ligament as an Important Landmark in Ilioinguinal Approach of the Anterior Acetabulum: A Cadaveric Morphologic Study

Khanfour¹,

Khanfour²

2019

IJAR

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Background:The iliopectineal ligament is the most stout anterior part of the iliopectineal membrane. It separates "lacuna musculorum" laterally from "lacuna vasorum" medially. This ligament is an important guide in the safe anterior approach to the acetabulum. Aim of the work:To study the detailed anatomy of the iliopectineal ligament demonstrating its importance as a surgical landmark in the anterior approach to the acetabulum. Material and methods:The material of this work included eight adult formalin preserved cadavers. Dissection of the groin was done for each cadaver in supine position with exposure of the inguinal ligament. The iliopectineal ligament and the three surgical windows in the anterior approach to the acetabulum were revealed.Results: Results described the detailed morphological anatomy of the iliopectineal ligament as regard its thickness, attachments and variations in its thickness. The study also revealed important anatomical measurements in relation to the inguinal ligament. The distance between the anterior superior iliac spine (ASIS) to the pubic tubercle ranged from 6.7 to 10.1 cm with a mean value of 8.31±1.3. The distance between the anterior superior iliac spine (ASIS) to the blending point of the iliopectineal ligament to the inguinal ligament ranged from 1.55 to 1.92 cm with a mean value of 1.78±0.15. Conclusion:The iliopectineal ligament detailed morphology and attachments are crucial when planning to do anterior approach of the acetabulum to decrease incidence of iatrogenic injury to the femoral vessels.

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