Close relationship between the short round ligament and the ovarian prolapsed inguinal hernia in female infants

Hisako Kuyama1, Sadashige Uemura2, Atsushi Yoshida2

  • 1Department of Pediatric Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. hkuyama@med.kawasaki-m.ac.jp.

Insights

In female infants, a short round ligament is linked to ovarian inguinal hernias. This anatomical finding helps explain why ovaries and fallopian tubes are positioned near the hernia opening, particularly with a patent processus vaginalis.

Area of Science:

  • Pediatric Surgery
  • Anatomy
  • Gynecology

Background:

  • Inguinal hernias are common in female infants.
  • The processus vaginalis (PV) is a potential pathway for herniation.
  • The round ligament's role in ovarian positioning relative to inguinal hernias is not fully understood.

Purpose of the Study:

  • To investigate the relationship between round ligament length and patent processus vaginalis (PV).
  • To test the hypothesis that a short round ligament causes ovarian inguinal hernias in female infants.

Main Methods:

  • Laparoscopic surgery was performed on 132 girls with inguinal hernias.
  • Ovarian prolapse was diagnosed pre-operatively.
  • Internal inguinal ring, PV orifice diameter, and round ligament length were assessed laparoscopically.

Main Results:

  • Ovarian inguinal hernias occurred in 17 infants.
  • In infants, the round ligament was short, positioning the ovary near the hernia orifice.
  • Round ligament length was significantly shorter in cases with an open PV compared to a closed PV, especially in younger girls.

Conclusions:

  • The round ligament, derived from the fetal gubernaculum, is shorter in girls with an open PV.
  • A short round ligament is a contributing factor to ovarian prolapsed hernias in female infants.
Abstract

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