Three-dimensional reconstruction under computed tomography and myopectineal orifice measurement under laparoscopy for quality control of inguinal hernia treatment

Figure 1  Pelvic and abdominal muscles in the 3-dimensional model.

Figure 2 The four anatomical landmarks used to determine the boundaries of the myopectineal orifice. Before the operation, point A is the innermost edge of the iliopsoas muscle; point B is the lowest point of the transverse abdominal muscle; point C is the intersection point of the horizontal line passing through point A and the iliopsoas muscle; and point D is the intersection point of the vertical line passing through point B and the pubis.

Figure 3 Measurement points marked during the surgical procedure. During the operation, point E is the convergence point of the spermatic cord vessels, the vas deferens and the inferior epigastric vessels. Point A is the intersection point of the horizontal line passing through point E and the medial border of the rectus abdominis muscle. Point B is the intersection point of the vertical line passing through point E and the lower border of the transverse abdominal muscle. Point C is the intersection point of the horizontal line passing through point E and the medial border of the iliopsoas muscle. Point D is the intersection point of the vertical line passing through point E and the pubis.

Figure 4  Distribution of the inguinal hernias.