A 55-year-old man undergoes laparoscopic totally extraperitoneal (TEP) repair of a right indirect inguinal hernia. During dissection, a vessel running in the 'triangle of doom' is injured, causing significant haemorrhage. Which structure was most likely injured?
- A External iliac vessels ✓
- B Inferior epigastric artery
- C Obturator artery
- D Femoral nerve
Correct answer: A. External iliac vessels
Explanation
The 'triangle of doom' in laparoscopic hernia repair is bounded medially by the vas deferens and laterally by the spermatic vessels, with the apex at the internal ring. The external iliac artery and vein pass through this triangle and must be protected. Injury to these vessels causes life-threatening haemorrhage. The 'triangle of pain' (lateral to the spermatic vessels and below the iliopubic tract) 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.