A Lichtenstein tension-free repair is performed for an indirect inguinal hernia. The hernia sac is found to arise lateral to the inferior epigastric vessels within the inguinal canal. Anatomically, the deep inguinal ring through which the sac passes is located just lateral to which structure?
- A Medial umbilical ligament
- B Conjoint tendon
- C Inferior epigastric vessels ✓
- D Lacunar ligament
Correct answer: C. Inferior epigastric vessels
Explanation
The deep inguinal ring is an opening in the transversalis fascia located approximately 1.25 cm above the midpoint of the inguinal ligament, just lateral to the inferior epigastric vessels. This anatomical relationship forms the basis for distinguishing indirect hernias (sac lateral to inferior epigastics, through deep ring) from direct hernias (sac medial to inferior epigastics, through Hesselbach's triangle). The inferior epigastric vessels serve as the key landmark in laparoscopic hernia repair (TEP/TAPP) for this differentiation.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.