In laparoscopic totally extraperitoneal (TEP) repair, the 'triangle of doom' and 'triangle of pain' are critical anatomical danger zones. What passes through the 'triangle of doom'?
- A External iliac vessels (iliac artery and vein) ✓
- B Femoral nerve and lateral femoral cutaneous nerve of the thigh
- C Genitofemoral nerve and gonadal vessels
- D Inferior epigastric vessels
Correct answer: A. External iliac vessels (iliac artery and vein)
Explanation
The 'triangle of doom' is the medial triangle formed by the vas deferens (medially), the gonadal vessels (laterally), and the inferior border of the peritoneum (apex). It contains the external iliac vessels (artery and vein), which can be catastrophically injured if a tacker or staple is misplaced. The 'triangle of pain' is the lateral triangle containing the femoral branch of the genitofemoral nerve and the lateral femoral cutaneous nerve — injury causes chronic groin pain/paresthesia. No fixation devices should be placed in either triangle.
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.