The possibility of nervus ilioinguinalis and nervus iliohypogastricus injury in lower abdominal incisions and effects on hernia formation.
OBJECTIVE
The aim of this study was to determine the distances of nervus ilioinguinalis and nervus iliohypogastricus to McBurney's and paramedian incisions.


METHODS
This study was performed on 12 adult cadavers. Right and left inguinal regions of the cadavers were dissected by inguinal incision. The points where the nerves perforated the internal obliquus muscles were determined, and the distances of these points to the spina iliaca anterior superior (SIAS) and to the umbilicus were measured. These distances were marked over a diagram, and distances of the nerves to McBurney's and paramedian incisions were measured by illustrating these incisions on the same diagram.


RESULTS
While the distance of the iliohypogastric nerve from the SIAS was 1.5-8 cm on the right and 2.3-3.6 cm on the left, the distance of the ilioinguinal nerve from the SIAS was 3-6.4 cm on the right and 2-5 cm on the left. The distance of the ilioinguinal nerve from McBurney's incision was 0.2-6.1 cm on the right and 1.8-7.5 cm on the left, and that of the iliohypogastric nerve was 2.2-6.9 cm on the right and 2.9-6.2 cm on the left. The distances of the nerves from paramedian incision were found to be 4.6-10 cm on the right and 6.4-11.2 cm on the left for the ilioinguinal nerve and 5-11.2 cm on the right and 7.4-11.6 cm on the left for the iliohypogastric nerve.


CONCLUSIONS
Both nerves perforate the musculus obliquus internus, scattered in a wide area. Considering the distances, the paramedian incision seems to be more reliable with respect to the risk of nerve injury. Incisions performed in the lower abdomen carry the risk of injury to the ilioinguinal and iliohypogastric nerves.
Avsar
Fatih Mehmet
FM
First Department of Surgery, Ankara Numune Training and Research Hospital, Turkey.
Sahin
Mustafa
M
Arikan
Bulent Umit
BU
Avsar
A Filiz
AF
Demirci
Salim
S
Elhan
Alaiddin
A
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D001062:Appendectomy / Q000009:adverse effects; D005260:Female; D006552:Hernia, Inguinal / Q000209:etiology*; D006801:Humans; D007264:Inguinal Canal / Q000294:innervation*; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000033:anatomy & histology