Department of General Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, Kent, United Kingdom.
Department of General Surgery, Conquest Hospital, Hastings, United Kingdom.
Clin Anat. 2021 Sep;34(6):842-844. doi: 10.1002/ca.23718. Epub 2021 Jan 19.
The linea alba (LA) is known to be useful to surgeons for making surgical incisions. Laparoscopic entry into the peritoneal cavity using the open technique may involve identification of a point just above or below the umbilicus where the peritoneum is fused to the LA. This anatomical site is found through superficial dissection to expose the junction between the umbilical stalk (US) and the LA, where distinct fibers seem to form a unique ligament-like structure in normal adult anatomy. This point, in fact, is part of a circular fibrous structure that exists almost like a ring around the remnant US. It is formed by the fusion of oblique and transverse fibers of the LA with circular fibers from proliferation of an encircling band of compact mesoderm to close a patent umbilical ring. We describe and name this anatomical landmark as junctio circularis alba or the "circular junction of the LA" as encountered in normal adult human anatomy. We believe this is crucial for describing key surgical procedures at this site to aid effective surgical training and reduce iatrogenic complications from laparoscopic port site entries.
白线(LA)被外科医生用于进行手术切口。使用开放式技术进行腹腔镜进入腹腔时,可能需要确定脐上或脐下的一个点,此处腹膜与 LA 融合。通过浅层解剖可以找到这个解剖部位,以暴露脐索(US)和 LA 之间的交界处,在正常成人解剖中,这里的明显纤维似乎形成了一种独特的韧带样结构。事实上,这个点是一个圆形纤维结构的一部分,它几乎像围绕残余 US 的一个环。它是由 LA 的斜纤维和横纤维与来自环绕致密中胚层带的增殖的圆形纤维融合形成的,以封闭开放的脐环。我们将这个解剖标志描述并命名为 junctio circularis alba 或“LA 的圆形交界处”,在正常成人人体解剖中遇到。我们认为,这对于描述该部位的关键手术程序至关重要,有助于进行有效的手术培训,并减少腹腔镜端口部位进入引起的医源性并发症。