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Surface marking of the deep inguinal ring.
Sreedharan V Koliyadan1, Govindraj Narayan, Premini Balasekran
1Department of Surgery, Kasturba Medical College, Manipal, Karnataka, India.
Clinical Anatomy (New York, N.Y.)
|September 18, 2004
Summary
The deep inguinal ring (DIR) location is not at the mid-inguinal point (MIP) or middle of the inguinal ligament (MIL). Anatomical dissection reveals the DIR is located between these two landmarks in individuals without inguinal hernias.
Area of Science:
- Anatomy
- Surgical Anatomy
Background:
- The surface marking for the deep inguinal ring (DIR) lacks consensus, with descriptions varying between the middle of the inguinal ligament (MIL) and the mid-inguinal point (MIP).
- This ambiguity impacts surgical planning and understanding of inguinal hernia anatomy.
Purpose of the Study:
- To accurately determine the anatomical surface marking of the deep inguinal ring (DIR) in individuals without inguinal hernias.
- To clarify the precise location of the DIR relative to established anatomical landmarks.
Main Methods:
- Dissection of 52 cadavers without inguinal hernias.
- Measurement of the distances from the anterior superior iliac spine (ASIS) to the DIR, MIL, MIP, and femoral artery (FA).
Main Results:
- The mean distance from the ASIS to the DIR was 62 mm.
- The mean distances from the ASIS to the MIL, MIP, and FA were 55 mm, 66 mm, and 65 mm, respectively.
- The DIR was found not to correspond directly to the MIL or MIP, but rather to an area situated between these two landmarks.
Conclusions:
- The surface marking of the deep inguinal ring (DIR) in individuals without inguinal hernias is best described as being in the mid-inguinal region.
- This finding refines anatomical understanding and may improve the accuracy of surgical landmark identification.