A proposed method of dissection of the anterolateral abdominal wall -- applied features

The dissection described allows the segmental nerve supply of the rectus abdominis to be seen in its continuity, namely: intercostal nerves seven to eleven, the subcostal and occasionally the iliohypogastric nerve as shown in Fig. 1. The advantages of transverse or interneural incisions are obvious. The medial retraction of the lower rectus after incision of the anterior part of the rectus sheath, exposing the femoral ring and pectineal ligament is a suitable approach of femoral hernia repair. The posterior part of the dissection shows the relation of subcostal nerve and the ventral ramus of the first lumbar nerve and/or its iliohypogastric and ilioinguinal branches to the superior lumbar triangle, which is of consequence in posterior approaches to the kidney. A lateral cutaneous branch, which normally comes off the iliohypogastric nerve also crosses the field. Brief mention is made concerning the anatomy of local anesthesia for inguinal hernia repair.