This article will consider the topography of the femoral canal. Between the pelvic bones and the inguinal ligament, a person has a special space, which is divided into muscular and vascular lacunae through the iliac crest ligament. The first is located outside and is the place through which the femoral nerve and the iliopsoas muscle pass to the thigh. Thanks to the iliac fascia, firmly fused with the ligament of the groin and the periosteum of the pelvic bones, a common sheath is formed for the nerve and muscle.
Anatomy of the femoral canal
There is a significant barrier between the thigh area and the abdominal cavity. That is why hernias come out through the muscle gap in rare cases. The vascular lacuna is located inside, limited behind the lateral-iliac-comb, medial-lacunar and pubic (Cooper) ligaments, in front - inguinal. An artery and a vein of the thigh, lymphatic vessels, and nerves are laid through it. What is the femoral canal? Let's look further.
Bunch of nerves and blood vesselsis located inside the thinnest fascial sheath, originating from the transverse fascia. It is in the vascular lacuna that femoral hernias most often form. From this point of view, its weakest department is the femoral ring, inside which there is fatty tissue and a large lymph node, called the Rosenmuller-Pirogov node. In women, the diameter of the ring is 1.8 cm, and in men it is 1.2 cm. The anatomy of the femoral canal is of interest to many.
About violations
Under normal conditions, the lacunae of muscles and blood vessels do not have free slots, spaces. Such violations can appear only with certain pathologies. With the formation of a hernia, it is in this place that the femoral canal may occur. The femoral ring becomes its inner opening, and the outer hole in the wide femoral fascia (fossa ovale), where the great saphenous vein is located. This fossa has a limitation in the form of legs of a sickle-shaped fold, it seems to be an elongated semi-oval transversely. Ahead, it is covered with a lattice plate, which collapses when a hernia passes here.
In the case of the formation of the latter, the septum of the thigh protrudes, crowds the lymph node and creates a space that allows the protruding insides to pass through. They descend between the deep and superficial layers of the fascia lata. The resulting space between the sheets of the fascia is just the cavity of the channel, which is a pyramid of three faces. The anterior wall of the femoral canal is formed by the inguinal ligament and the superior horn of the falciform margin, whichbelongs to the broad fascia, the back - a deep sheet of the wide fascia, the lateral - the femoral vein. Having reached the most vulnerable area of the wide fascia of the thigh, the hernial sac pulls the ethmoid fascia and bulges under the skin through the foramen ovale. The length of the femoral-popliteal canal can vary from one to three centimeters.
The abnormal location of the vessels in this area is of great importance in some cases. Most often, only its lateral wall, where the vein is located, carries a threat, and there is a possibility of damage to it (for example, squeeze, tear, stitch) both in the process of isolating the neck of the hernial sac and during suturing the hernial orifice.
Femoral hernia and how to fix it
Femoral hernia is a condition when various organs of the abdominal cavity protrude beyond the boundaries of the anterior abdominal wall through the femoral canal. The protrusions in this case look like a bag in the area of the femoral triangle, while the body is in an upright position, they give off pain. If there is an infringement, intestinal obstruction may develop. Such a pathology is recognized during a surgical examination and additional ultrasound of the small pelvis, hernial protrusion and bladder, as well as herniography and irrigoscopy.
Hernias of the hip occur in five to eight percent of cases in the total volume of abdominal hernias. More often they develop in women, which is associated with the peculiarities of the structure of the pelvis, as well as in children under the age ofone year due to weak connective tissue in the abdominal wall.
Facts such as sudden weight loss, abdominal wall trauma or genetic weakness, a large number of pregnancies, various postoperative scars, etc. can also lead to a hernia. Situations that increase intra-abdominal pressure: constant strong cough, long labor, constipation, heavy lifting, any physical effort, etc. Therefore, you need to know the structure of the femoral canal to minimize the risk.
Types of surgery
Operations to correct it are divided into two types:
- Methods in which the hernial ring is closed from the side of the thigh.
- Closing the hernial orifice through the inguinal canal.
Bassini Method
Closing the hernia ring at the hip. Plastic surgery of the inner ring of the femoral canal is performed by stitching the pectinate and inguinal ligaments to each other. In this way, the femoral ring is closed. The lunate side of the gap under the skin and the pectinate fascia are also sutured. With this method, disadvantages are noted: since the ligament of the groin goes down and thereby increases the inguinal gap, conditions are created for the formation of hernias in the groin area.
Inguinal hernia repair expands the inguinal canal. In addition, the posterior wall of the inguinal canal is weakened in patients. For this reason, the Bassini technique has proven itself well, because thanks to it, not only the front is strengthened, but alsoback wall.
This is a reliable way to treat hernia.
Ruji's way
Closing the hernial orifice through the inguinal canal by opening its anterior and posterior walls. The hernial sac is extracted into the preperitoneal tissue and processed. Then the inguinal ligament is sutured to the pectinate, the femoral ring is closed. After that, the inguinal canal is restored by suturing the transverse fascia, as well as the edge of the aponeurosis of the oblique muscle of the abdomen, located outside. The same shortcomings are found as in the previous method.
Parlavecchio method
An operation similar to Ruji's method is being carried out. The difference lies in the fact that after the inguinal ligament is sutured to the pectinate ligament, plastic surgery of the posterior wall of the groin canal is performed by suturing the free edges of the transverse and internal oblique abdominal muscles to the groin ligament. Next, plastic surgery is performed on the anterior wall of the inguinal canal using a specially created duplicate of the aponeurosis of the external oblique muscle. This method has a great advantage: the elimination of the possibility of hernias in the groin area.
We looked at what the femoral canal is, as well as its anatomy.
