This article will consider the topography of the femoral canal. Between the pelvic bones and the inguinal ligament, a person has a special space, which is divided into muscle and vascular lacunae through the ileo-scallop ligament. The first is located outside and is the place through which the femoral nerve and the iliopsoas muscle pass to the thigh. Thanks to the ileal fascia, firmly fused with the ligament of the groin and periosteum of the pelvic bones, a common vagina for the nerve and muscle is formed.
Femoral anatomy
A significant barrier is located between the thigh and abdominal cavity. That is why hernias come out through the muscle gap in rare cases. The vascular lacuna is located inside, limited behind by the lateral-iliac-scallop, medial-lacunar and pubic (Cooper) ligaments, in front - the inguinal. An artery and a vein of the thigh, lymphatic vessels, and nerves are laid through it. What is the femoral canal? We will understand further.
A bundle of nerves and blood vessels is located inside the thinnest fascial vagina, originating from the transverse fascia. It is in the vascular lacuna most often formed hernia of the thigh. The weakest section from this point of view is the femoral ring, inside of which there is fatty tissue and a large lymph node, called the Rosenmüller-Pirogov node. In women, the diameter of the ring is 1.8 cm, and in men it is 1.2 cm. Many people are interested in the anatomy of the femoral canal.
About violations
Under normal conditions, the lacunae of muscles and blood vessels do not have free gaps, spaces. Such violations can appear only with certain pathologies. With the formation of a hernia, a femoral canal can arise in this place. The femoral ring becomes its internal opening, and the opening in the wide femoral fascia (oval fossa), where the large saphenous vein is located, becomes the external opening. This hole has a limitation in the form of crescent-shaped legs, it seems to be elongated transversely by a semi-shaft. Ahead, it is covered by a plate-grill, which collapses when a hernia passes here.
In the case of the formation of the latter, the septum of the thigh protrudes, squeezes the lymph node and creates a space that allows the protruding viscera to pass through. They fall between the deep and superficial leaves of the broad femoral fascia. The resulting space between the fascia leaves is just the cavity of the channel, which is a pyramid of three faces. The front wall of the femoral canal is formed by the inguinal ligament and the upper horn of the sickle-shaped edge, which belongs to the wide fascia, the back - the deep leaf of the wide fascia, the lateral - the femoral vein. Having reached the most vulnerable area of the wide fascia of the thigh, the hernial sac pulls the ethmoid fascia and protrudes through the oval hole under the skin. The length of the femoral-popliteal canal can range from one to three centimeters.
The abnormal arrangement of blood vessels in this area in some cases is of great importance. Most often, only the lateral wall where the vein is located is a threat, and there is a chance of damage (for example, squeezing, tearing, stitching) both in the process of isolating the neck of the hernial sac and during suturing of the hernial portal.
Femoral hernia and how to fix it
A femoral hernia is a condition where various organs of the abdominal cavity protrude beyond the boundaries of the anterior abdominal wall through the femoral canal. The protrusions in this case have the appearance of a bag in the area of the femoral triangle, while the body is in an upright position, they are given in pain. If an infringement has occurred, bowel obstruction may develop. Such a pathology is recognized during a surgical examination and an additional pelvic ultrasound, hernial protrusion and bladder, as well as herniography and irrigoscopy.
Hip hernias occur in five to eight percent of cases in the total volume of abdominal hernias. More often they develop in women, which is associated with structural features of the pelvis, as well as in children under the age of one year due to fragile connective tissue in the abdominal wall.
Hernia can also be caused by factors such as sudden weight loss, trauma of the abdominal wall or its genetic weakness, a large number of pregnancies, various postoperative scars, etc. This also includes situations that increase intra-abdominal pressure: persistent coughing , long birth, constipation, weight lifting, any physical effort, etc. Therefore, you need to know the structure of the femoral canal to minimize risk.
Types of Surgery
The operations for its correction are divided into two types:
- Ways in which the hernia gate closes from the hip.
- The closure of the hernia gate through the inguinal canal.
Bassini's Way
Hernia closure at the hip. Plastic surgery of the inner ring of the femoral canal is performed by stitching the comb and inguinal ligaments to each other. In this way, the femoral ring closes. Sutures are also placed on the half-moon side of the gap under the skin and the comb fascia. With this method, disadvantages are noted: since the ligament of the groin goes down and this increases the inguinal gap, conditions are created for the formation of hernias in the groin area.
Gernioplasty of an inguinal hernia expands the inguinal canal. In addition, the posterior wall of the inguinal canal is weakened in patients. For this reason, the Bassini technique is well established, because thanks to it, not only the front, but also the back wall is strengthened.
This is a reliable way to treat hernias.
Rudge Way
The closure of the hernia gate through the inguinal canal by opening its front and rear walls. The hernial sac is removed into the preperitoneal tissue and processed. Then the inguinal ligament is sutured to the comb, the femoral ring closes. After that, the inguinal canal is restored by stitching the transverse fascia, as well as the edge of the aponeurosis of the oblique muscle of the abdomen located outside. The same disadvantages are found as in the previous method.
Method Parlaveccio
An operation is performed similar to the method of Ruggi. The difference lies in the fact that after the inguinal ligament is sewn to the crest, the posterior wall of the groin canal is plasticized by stitching the free edges of the transverse and internal oblique muscles of the abdomen to the groin ligament. Next, plastic surgery of the anterior wall of the inguinal canal is performed using a specially created duplicate of the aponeurosis of the external oblique muscle. This method has a great advantage: eliminating the possibility of hernias in the groin area.
We examined what the femoral canal is, as well as its anatomy.