From the Guidelines
Hesselbach triangle is an anatomical region in the lower anterior abdominal wall that serves as a clinically important landmark for identifying direct inguinal hernias, bounded medially by the lateral edge of the rectus abdominis muscle, laterally by the inferior epigastric vessels, and inferiorly by the inguinal ligament. This definition is crucial in distinguishing between direct and indirect inguinal hernias, as the surgical approach may differ depending on the type of hernia. The Hesselbach triangle represents a potential weakness in the abdominal wall because it lacks the reinforcement of the conjoint tendon, making it a common site for direct inguinal hernias to protrude through. Some key points to consider when identifying the Hesselbach triangle include:
- Its boundaries: medially by the lateral edge of the rectus abdominis muscle, laterally by the inferior epigastric vessels, and inferiorly by the inguinal ligament
- Its significance in identifying direct inguinal hernias
- The potential weakness in the abdominal wall due to the lack of reinforcement by the conjoint tendon The provided evidence does not directly address the definition of the Hesselbach triangle, but the definition is widely accepted in the field of surgery 1.
From the Research
Definition of Hesselbach's Triangle
- Hesselbach's triangle, also known as the inguinal triangle, is an anatomical region in the groin area 2
- It is defined by its boundaries and relationship to other anatomical structures, such as the myopectineal orifice (MPO) and Hessert's triangle 2, 3
- The triangle is formed by the inguinal ligament, the lateral border of the rectus sheath, and the inferior epigastric artery 4
Anatomical Characteristics
- The surface area of Hesselbach's triangle can vary, with a mean surface area of 4.23 +/- 2.21 cm(2) in primary hernias and 2.09 +/- 2.10 cm(2) in recurrent hernias 2
- The size and shape of the triangle can be affected by anatomical changes after inguinal hernia treatment, which may contribute to chronic pain and recurrent hernia 2
Clinical Significance
- Understanding the anatomy of Hesselbach's triangle is essential for a satisfactory outcome in hernia repair, particularly in laparoscopic and minimally invasive techniques 5, 4
- The triangle plays a critical role in the etiology of inguinal hernia, and its size and shape can influence the development of hernias 3