The laparoscopic anatomy of the inguino-femoral region viewed with a telescope by laparoscopic surgeon or robotic surgeon with laparoscope placed in intra-abdominal position differs radically from the anatomy which we observed via an open or anterior approach. The laparoscopic surgeon has to understand the laparoscopic anatomical structure of the region. Poor familiarity with the complex anatomy of the posterior inguinal view by beginers is an important contributor to the steepness of the laparoscopic inguinal herniorrhaphy or ureteric surgery or gynecological surgery learning curve. World Laparoscopy Hospital guidelines to the performance of an secure TAPP laparoscopic inguinal hernia repair, mandate the subsequent structures should be clearly and unequivocally identified by laparoscopic surgeon: 

 

The Cooper's Ligament

The Inferior Epigastric Vessels

The Spermatic Cord or even the Round Ligament 

The Femoral Canal along with the Iliac Vessels

The Median Umbilical Ligament

The Medial Umbilical Ligament

The Lateral Umbilical Ligament

 

In addition, the laparoscopic anatomical distinction direct, indirect inguinal and femoral hernias ought to be well understood. Before a surgeon attempts to carry out a laparoscopic inguinal or femoral hernia repair, he should memorize and be very informed about the following diagrams. 

 

It is also important to recognize the ureter and to learn the anatomy of three dangerous area like.

 

Triangle of Doom

Triangle of Pain

Trapezoid of Disaster

 

As all laparoscopic anatomical landmarks are engrossed in peritoneum, from the TAPP technique the peritoneum needs to be first incised along with a lower flap developed in order to expose the location adequately. In the TEP repair, the anatomical landmarks need to be meticulously exposed with blunt dissection.

The median umbilical ligament is often a remnant in the embryonic urachus. It forms the center divide by arising within the midline from your apex from the bladder toward the umbilicus. Laterally, the paired medial umbilical ligaments, vestiges from the fetal umbilical arteries, arise through the superior vesicle arteries toward the umbilicus. Relating to the median and medial ligaments lie the supravesical fossae, where external supravesical hernias occur. Most lateral would be the paired lateral umbilical ligaments, which contain the inferior epigastric arteries. Together and the medial ligaments lies the medial fossa, which contains the Hesselbach triangle, the zone of direct hernias. Lateral towards the inferior epigastric arteries is the lateral fossa, the site of indirect hernias. Thus, the lateral umbilical ligaments separate the lateral and medial fossae, and delineate between indirect and direct hernias, respectively.