During laparoscopic totally extraperitoneal (TEP) inguinal hernia repair, the surgeon encounters the 'triangle of doom.' Which structure lies WITHIN this triangle and is at risk of injury?

• A External iliac vessels ✓
• B Inferior epigastric vessels
• C Femoral nerve
• D Obturator nerve

Explanation

The triangle of doom in laparoscopic inguinal hernia repair is bounded medially by the vas deferens and laterally by the gonadal vessels (spermatic vessels), with the apex at the peritoneal reflection. The external iliac artery and vein traverse this triangle and are at risk of catastrophic vascular injury if the space is dissected or tacked. The triangle of pain (lateral to the gonadal vessels) contains the femoral, lateral femoral cutaneous, and genitofemoral nerves.

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.