Anterior abdominal wall nerve and vessel anatomy: clinical implications for gynecologic surgery

David D. Rahn, John N. Phelan, Shayzreen M. Roshanravan, Amanda B. White, Marlene M. Corton

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Objective: We sought to describe relationships of clinically relevant nerves and vessels of the anterior abdominal wall. Study Design: The ilioinguinal and iliohypogastric nerves and inferior epigastric vessels were dissected in 11 unembalmed female cadavers. Distances from surface landmarks and common incision sites were recorded. Additional surface measurements were taken in 7 other specimens with and without insufflation. Results: The ilioinguinal nerve emerged through the internal oblique: mean (range), 2.5 (1.1-5.1) cm medial and 2.4 (0-5.3) cm inferior to the anterior superior iliac spine (ASIS). The iliohypogastric emerged 2.5 (0-4.6) cm medial and 2.0 (0-4.6) cm inferior. Inferior epigastric vessels were 3.7 (2.6-5.5) cm from midline at the level of the ASIS and always lateral to the rectus muscles at a level 2 cm superior to the pubic symphysis. Conclusion: Risk of anterior abdominal wall nerve and vessel injury is minimized when lateral trocars are placed superior to the ASISs and >6 cm from midline and low transverse fascial incisions are not extended beyond the lateral borders of the rectus muscles.

Original languageEnglish (US)
Pages (from-to)234.e1-234.e5
JournalAmerican journal of obstetrics and gynecology
Volume202
Issue number3
DOIs
StatePublished - Mar 2010

Keywords

  • iliohypogastric
  • ilioinguinal
  • inferior epigastric
  • nerve injury
  • vascular injury

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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