Essential Anatomy of the Abdominal Wall

  • Vishy Mahadevan


The vast majority of abdominal hernias involve the anterior abdominal wall, and most of these present in the inguinal region.

The design and architecture of the anterior abdominal wall is complex. A thorough knowledge and understanding of the three-dimensional anatomy of the anterior and anterolateral abdominal wall are essential prerequisites to the rational and optimal surgical management of abdominal hernias. A critical appreciation of the various tissue layers and planes that make up the anterior abdominal wall alongside an acute awareness of the location of various neurovascular hazards in the operative field is integral to successful hernia surgery. Such a detailed perspective of the normal regional anatomy is all the more important when employing transperitoneal or extraperitoneal endoscopic techniques for hernia repair or when performing surgery for recurrent hernias where the previous surgery may have resulted in considerable distortion of the anatomy of the region.

Addressing these surgical considerations, this chapter presents a structured, systematic and comprehensive account of the topographical, surgical and functional anatomy of the anterior abdominal wall.

Infrequently, abdominopelvic contents may be extruded through the pelvic floor to present as perineal hernias, through the obturator foramen to present as obturator hernias or through defects (congenital or traumatic) in the diaphragm resulting in diaphragmatic hernias. The anatomy underlying these relatively rare forms of hernias which do not involve the anterior abdominal wall is beyond the scope of this chapter.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.The Royal College of Surgeons of EnglandLondonUK

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