Metternich F U, Claeys L G, Koebke J
Department of Head and Neck Surgery, Academic Teaching Hospital, University of Cologne.
Acta Chir Belg. 1997 Jan-Feb;97(1):19-22.
Anatomical examinations of the inguinal canal exist in many forms. The preperitoneal tissue, the structure directly adjacent to the transverse fascia, was examined in 62 cadavers. The left side of the inguinal abdominal wall was studied with special interest in the transverse fascia and the adjacent preperitoneal tissue. In 75% of the cases the transverse fascia and preperitoneal tissue built a continuous layer. A differentiation was difficult in cadavers with cachexia or an average nutritive state. The tissues could be differentiated without difficulty in individuals with adipositas. In these cases no connection between the two layers was detected. In the medial part of the inguinal abdominal wall the tissue thickness was larger than in the lateral part. However in 32% of the cases the tissue thickness was reverse. As a consequence, the isolated suture of the transverse fascia in inguinal hernia repair is anatomically virtually impossible, if both tissues build one continuous layer.
腹股沟管的解剖学检查形式多样。在62具尸体中对腹膜前组织（直接毗邻腹横筋膜的结构）进行了检查。对腹股沟腹壁左侧进行了研究，特别关注腹横筋膜和相邻的腹膜前组织。在75%的病例中，腹横筋膜和腹膜前组织形成一个连续层。在恶病质或营养状态一般的尸体中很难区分这两层组织。在肥胖个体中，组织很容易区分。在这些病例中，未检测到两层之间的连接。在腹股沟腹壁内侧部分，组织厚度大于外侧部分。然而，在32%的病例中，组织厚度情况相反。因此，如果这两层组织形成一个连续层，在腹股沟疝修补术中单独缝合腹横筋膜在解剖学上几乎是不可能的。
