A 55-year-old man undergoes elective laparoscopic totally extraperitoneal (TEP) repair of a right inguinal hernia. During the procedure, the surgeon dissects the myopectineal orifice (Fruchaud's orifice). The mesh placed must cover this entire orifice to prevent recurrence. Which of the following does NOT pass through Fruchaud's orifice?
- A Indirect inguinal hernia (lateral defect)
- B Direct inguinal hernia (medial defect)
- C Obturator hernia ✓
- D Femoral hernia
Explanation
The myopectineal orifice (Fruchaud's orifice) is bounded by the internal oblique and transversus abdominis muscles superiorly, the iliopsoas muscle laterally, and the pubic bone inferiorly. It encompasses all potential groin hernia sites: the deep inguinal ring (indirect/lateral hernias), the Hesselbach triangle (direct/medial hernias), and the femoral canal (femoral hernias). The obturator foramen and obturator canal lie deep and medial to Fruchaud's orifice — obturator hernias pass through the obturator canal and are NOT covered by the standard mesh placed during TEP/TAPP repair.
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.