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Inguinal hernia, hydrocele, and other hernias of the abdominal wall
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Sophia Abdulhai, Todd A. Ponsky
During laparoscopic repair, the femoral hernia is seen as medial to the femoral vessels and below the inguinal ligament. Multiple variations of laparoscopic and laparoscopic-assisted repairs are described in both pediatric and adult literature, such as a laparoscopic patch-and-plug technique as well as closure of the femoral defect by suturing the iliopubic tract to the lacunar ligament intracorporeally. Some have described using laparoscopy to allow for a smaller incision of an open repair by inserting a laparoscope, identifying a femoral hernia, placing a Maryland dissector tip into the hernia, and then, on the outside, cutting on top of the Maryland tip to allow for a small incision directly on top of the defect.
Applied Surgical Anatomy
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Vishal G Shelat, Andrew Clayton Lee, Julian Wong, Karen Randhawa, CJ Shukla, Choon Sheong Seow, Tjun Tang
How do you define the femoral canal?Anterior – inguinal ligamentPosterior – pectineal ligamentMedial – lacunar ligamentLateral – femoral vein
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
The boundaries of the femoral canal, which is a small gap at the medial aspect of the femoral sheath, can be summarised as: Anterior: Inguinal ligamentPosterior: Pectineal ligamentMedial: Lacunar ligamentLateral: Femoral vein
De Garengeot hernias. Over a century of experience. A systematic review of the literature and presentation of two cases
Published in Acta Chirurgica Belgica, 2022
Michail Chatzikonstantinou, Mohamed Toeima, Tao Ding, Almas Qazi, Niall Aston
The femoral canal is the most medial compartment of the femoral sheath, which is bordered anterosuperiorly by the inguinal ligament, medially by the lacunar ligament, laterally by the femoral vein and posteriorly by the pectineal ligament. It contains fat lymphatics and the lymph node of Cloquet. A large mobile caecum that extends into the pelvis is the usual reason for the appendix to enter the hernia sac into the femoral ring [13–15]. The abnormal low position of the bowel creates a mass effect that pushes the appendix into the femoral canal, while an abnormal embryological rotation of the gut increases the probability of appendiceal herniation. Intraoperative findings of normal non-inflamed appendix favour the theory of herniation of the appendix and subsequent inflammation rather than incarceration of an already inflamed appendix. The tight rigid femoral ring acts as an entrance to an anatomically confined space for strangulation, inflammation and, eventually, vascular congestion, necrosis and perforation of the appendix.
Oncological impact of inflammatory biomarkers in elderly patients treated with radical cystectomy for urothelial bladder cancer
Published in Arab Journal of Urology, 2021
Andrea Mari, Gianluca Muto, Fabrizio Di Maida, Riccardo Tellini, Riccardo Bossa, Claudio Bisegna, Riccardo Campi, Andrea Cocci, Lorenzo Viola, Antonio Grosso, Sabino Scelzi, Alberto Lapini, Marco Carini, Andrea Minervini
Surgery was performed by four experienced surgeons who usually perform individually >30 RCs/year. The procedure was performed according to the traditional open technique, lymphadenectomy (LND) was performed in 80.4% of the patients. Standard LND included the removal of presacral, internal iliac, obturator fossa and external iliac nodes, with the ureter and genitofemoral nerves being respectively the medial and lateral borders. Caudally it was limited by the circumflex iliac vein, the lacunar ligament and the lymph node of Cloquet. As appropriate, if further lymph nodes were found clinically suspicious for tumour involvement, either an extended or super-extended LND was performed as follows: during the extended LND, nodes were removed in the region of the aortic bifurcation, presacral and common iliac vessels medial to the crossing ureter, whereas it extended cranially to the level of the inferior mesenteric artery when super-extended LND was necessary.