Anatomy observation of the inguinal canal        JIANG Zhi-peng, YANG Bin, LI Ying-ru,et al. Center of Hernia Therapy of South China, Department of Gastrointestinal Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
Corresponding author: CHEN Shuang, E-mail: chensh2@mail.sysu.edu.cn
Abstract    Objective    Analysis of the inguinal canal anatomical structures and their significance by intraoperative observation. Methods    From June 2011 to  May 2012,a total of 115 male patients(10 patients with bilateral hernias) whom were undergone open tension-free hernioplasty were involved in the observation. In open operation field, with high definition video equipment for recording and playback of the procedure, distribution of cremaster and nerves inside the inguinal canal and the relationship between spermatic cord and the inguinal canal rings were analyzed. Results    The visible rates of the genital branch of genitofemoral nerve, ilioinguinal and iliohypogastric nerves were 90.4%, 98.4% and 38.4%, respectively. Cremaster muscle was “Ω” shape wrapping the spermatic cord. There were natural anatomic planes between spermatic cord and the inguinal ligament and inguinal falx. The spermatic cord was relatively fixed inside the inguinal canal by attachment of the inner and outer rings. Conclusion    Ilioinguinal nerve is relatively constant in the inguinal canal, which theoretically could be safely cut off alike with the iliohypogastric nerve, as they are cutaneous branch in this position. The fixation of spermatic cord by the inguinal rings is a protective mechanism to prevent indirect hernia occurs. The anatomical planes between the spermatic cord and the inguinal canal can be used of division.