Lobello R, Abate S, Ferulano G P
Arch Sci Med (Torino). 1979 Jan-Mar;136(1):25-30.
In the light of recent publications where common hernia repair techniques are defined as unanatomical and unphysiological, a study of the anatomy of the inguinal region has been undertaken layer by layer on cadavers. The first note analyses the most superficial layer of the inguinal region, namely the external oblique muscle. Having described the dissection technique, the most significant data regarding this formation are examined. Although the correctness of the data given in anatomy textbooks is confirmed in the majority of cases, study of necroptic findings highlights a number of factors which are misunderstood or have been insufficiently analysed. Findings included vibices of the external oblique aponeurosis, to which no pathogenetic importance is attributed with respect to inguinal hernia, as well as the presence of an internal tunic of Lauth's ligament which was not easy to strip away from the posterior surface of the external oblique muscle and, finally, localization variations of the external inguinal ring. The secondary involvement of the aponeurosis of the external oblique muscle in the genesis of inguinal hernia is confirmed along with its importance as a reinforcement in hernia repair operations, the containment function proper being performed by the posterior wall. A subsequent note will deal with this.
鉴于最近有文献将常见的疝修补技术定义为不符合解剖学和生理学原理,我们在尸体上逐层开展了腹股沟区的解剖学研究。第一篇笔记分析了腹股沟区最表层,即腹外斜肌。在描述了解剖技术后,我们研究了有关该结构的最重要数据。尽管解剖学教科书中给出的数据在大多数情况下得到了证实,但对坏死结果的研究突出了一些被误解或未得到充分分析的因素。研究结果包括腹外斜肌腱膜的擦痕,就腹股沟疝而言,其没有致病重要性,还有Lauth韧带内被膜的存在,其不易从腹外斜肌后表面剥离,最后是腹股沟外环的定位变异。腹外斜肌腱膜在腹股沟疝发生过程中的继发性参与得到了证实,同时也证实了其在疝修补手术中作为加强结构的重要性,而后壁则起到真正的容纳功能。后续笔记将对此进行讨论。