目的:探讨腹股沟区泌尿生殖道筋膜(UGF)的解剖结构,为腹腔镜腹股沟疝修补术(LIHR)提供解剖学指导。
方法:对10具福尔马林固定尸体进行解剖。小心解剖腹膜及其较深的筋膜组织。
结果:UGF的双侧浅层延伸并终止于腹主动脉前方。在后腋窝线处,表层向内翻转,扩展表示UGF的深层。UGF的双侧深层在椎体旁内侧延伸,然后与横肌筋膜继续。输尿管,生殖器血管,上腹下丛在两层之间移动。输精管和精索血管,被两层包裹着,穿过腹股沟深环。从腹股沟深环到中线,浅层延伸到膀胱的后壁,而深层延伸到其前壁。两层都包裹膀胱,并沿着脐内侧韧带延伸到脐部和骶骨海角,沿着骶骨延伸,形成骶前筋膜.浅层在S4骶椎形成直肠骶骨筋膜,深层延伸到骨盆隔膜,终止于肛提肌。
结论:UGF覆盖肾脏,输尿管,输精管,生殖器血管,上腹下丛,精囊,前列腺,还有膀胱.了解UGF在腹股沟区的解剖结构将有助于找到正确的LIHR目标并减少出血和其他并发症。
OBJECTIVE: To investigate the urogenital fascia (UGF) anatomy in the inguinal region, to provide anatomical guidance for laparoscopic inguinal hernia repair (LIHR).
METHODS: The anatomy was performed on 10 formalin-fixed cadavers. The peritoneum and its deeper fascial tissues were carefully dissected.
RESULTS: The UGF\'s bilateral superficial layer extended and ended in front of the abdominal aorta. At the posterior axillary line, the superficial layer medially reversed, with extension represented the UGF\'s deep layer. The UGF\'s bilateral deep layer medially extended beside the vertebral body and then continued with the transversalis fascia. The ureters, genital vessels, and superior hypogastric plexus moved between both layers. The vas deferens and spermatic vessels, ensheathed by both layers, moved through the deep inguinal ring. From the deep inguinal ring to the midline, the superficial layer extended to the urinary bladder\'s posterior wall, whereas the deep layer extended to its anterior wall. Both layers ensheathed the urinary bladder and extended along the medial umbilical ligament to the umbilicus and in the sacral promontory, extended along the sacrum, forming the presacral fascia. The superficial layer formed the rectosacral fascia at S4 sacral vertebra, and the deep layer extended to the pelvic diaphragm, terminating at the levator ani muscle.
CONCLUSIONS: The UGF ensheaths the kidneys, ureters, vas deferens, genital vessels, superior hypogastric plexus, seminal vesicles, prostate, and urinary bladder. This knowledge of the UGF\'s anatomy in the inguinal region will help find correct LIHR targets and reduce bleeding and other complications.