Intertransversalis fascia approach in urologic laparoscopic operations

Area of Science:

• Anatomical studies
• Surgical innovation
• Urologic surgery

Background:

• The transversalis fascia (TF) is a critical anatomical structure in the abdominal wall.
• Understanding TF anatomy is essential for developing new surgical approaches.

Purpose of the Study:

• To elucidate the clinical anatomy of the transversalis fascia (TF).
• To explore and validate the intertransversalis fascia approach for urologic laparoscopic operations (ULOs).

Main Methods:

• Prospective study analyzing data from 1217 urologic laparoscopic/open operations and 10 hernia repairs.
• Inclusion of findings from 3 fresh autopsies.
• Anatomical study involving photography, micrography, and atlas creation of TF cross and sagittal sections.

Main Results:

• The TF is a connective tissue plane between the transversus abdominis and extraperitoneal fat, comprising superficial and deep layers with an intervening space.
• The intertransversalis fascia approach involves dissection between these two layers of the TF.
• Detailed anatomical descriptions and visual aids of the TF were generated.

Conclusions:

• The intertransversalis fascia approach represents a novel technique in urologic laparoscopic operations.
• This approach offers surgeons a clean, clear, and bloodless operative space, potentially improving surgical outcomes.