Inguinal Anatomy

Abstract

The chapter on inguinal anatomy was written with respect to and a heavy leaning upon the many authors who have approached this subject before me. I have attempted to create a thorough, yet concise, treatise which covers the development, relevant anatomy, and structure of the inguinal canal in the “normal” setting so that the pathologic “abnormal” can be better understood. I felt it important to include the traditional eponyms such as Poupart, Gimbernat, Cooper, and Galludet, as they are a part of the rich history of surgical anatomy. The text covers the relevant layers, structures, and contents of the inguinal canal in both the male and female. The inguinal, or “groin” area of the human abdominal wall, is bound by the thigh inferiorly, the pubic tubercle medially, and the anterior superior iliac spine (ASIS) superolaterally. The inguinal canal is an oblique passage connecting the peritoneal surface of the abdomen to the scrotum or, in females, the labia majoris. It is bound by a pair of openings called the deep (or posterior) inguinal ring and the superficial inguinal ring anterior and external to the abdominal cavity. The boundaries of the inguinal canal, discussed later in this text, become important in understanding surgical approaches to hernias formed in this region. The structure central to the anatomy and repair of this region is the inguinal ligament, otherwise known as the Poupart ligament, which is formed from the external oblique aponeurosis as it folds over and inserts from the ASIS to the pubic tubercle.