Tv

femoral sheath Fossa ovalis Fascia iliaca

Fascia iliaca Psoas

IIiac artery and vein

Femoral artery and vein

Figure 14.7. The bilaminar fascia transversalis in the groin.

Figure 14.8. The myopectineal orifice of Fruchaud: the area of the groin closed by fascia transversalis with the inguinal canal above and femoral canal below the rigid inguinal canal.

orifice of Fruchaud are superiorly the 'arch' of the transversus muscle, laterally the iliopsoas muscle, medially the rectus muscle and inferiorly the pecten of the pubis. The space is utilized in both the trans-abdominal preperitoneal (TAPP) and the totally extraperitoneal (TEP) laparoscopic approaches to the repair of inguinal and femoral repairs. A thorough understanding of the limits of this myopectineal orifice is necessary to accomplish an effective repair of the inguinal floor with the laparoscopic methodology.

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