{"title":"Surgical anatomy of transversus abdominis muscle for transversus abdominis release.","authors":"Pauline Shanthi, Femina Sam, Jenny Jacob, Beulah Roopavathana S, Suganthy Rabi","doi":"10.5115/acb.23.305","DOIUrl":null,"url":null,"abstract":"<p><p>Transversus abdominis release (TAR) is a myofascial release technique which helps in surgical repair of large ventral abdominal wall defects. In this procedure, the medial margin of muscular part of transversus abdominis (TA) is of great importance. Hence, the authors sought to describe the extent of medial margin of TA muscle. The surgical steps of TAR were performed in 10 formalin-fixed cadavers and distance between medial margin of TA muscle, lateral margin of rectus abdominis, to linea alba at five anatomical levels were documented respectively. The distance between the inferior epigastric vessels and the medial border of TA muscle was also noted. The TA muscle was within the posterior rectus sheath in all cadavers, at the xiphisternum (R, 61.6 mm; L, 58.9 mm), and at midway between xiphisternum and umbilicus (R, 25.4 mm; L, 27.1 mm). The TA muscle exited the posterior rectus sheath between this point and the umbilicus. The mean incongruity at the next three levels were -24.6 mm, -24.9 mm, and -22.9 mm respectively on the right and -21.4 mm, -19.9 mm, and -18.9 mm respectively on the left. The mean distance between the medial border of TA and inferior epigastric vessels was 18.9 mm on the right and 17.2 mm on the left. The muscular part of TA was incorporated within the posterior rectus sheath above the umbilicus, and it completely exited the rectus sheath at the umbilicus. This is contrary to the traditional understanding of posterior rectus sheath formation.</p>","PeriodicalId":7831,"journal":{"name":"Anatomy & Cell Biology","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424560/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anatomy & Cell Biology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5115/acb.23.305","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/27 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ANATOMY & MORPHOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Transversus abdominis release (TAR) is a myofascial release technique which helps in surgical repair of large ventral abdominal wall defects. In this procedure, the medial margin of muscular part of transversus abdominis (TA) is of great importance. Hence, the authors sought to describe the extent of medial margin of TA muscle. The surgical steps of TAR were performed in 10 formalin-fixed cadavers and distance between medial margin of TA muscle, lateral margin of rectus abdominis, to linea alba at five anatomical levels were documented respectively. The distance between the inferior epigastric vessels and the medial border of TA muscle was also noted. The TA muscle was within the posterior rectus sheath in all cadavers, at the xiphisternum (R, 61.6 mm; L, 58.9 mm), and at midway between xiphisternum and umbilicus (R, 25.4 mm; L, 27.1 mm). The TA muscle exited the posterior rectus sheath between this point and the umbilicus. The mean incongruity at the next three levels were -24.6 mm, -24.9 mm, and -22.9 mm respectively on the right and -21.4 mm, -19.9 mm, and -18.9 mm respectively on the left. The mean distance between the medial border of TA and inferior epigastric vessels was 18.9 mm on the right and 17.2 mm on the left. The muscular part of TA was incorporated within the posterior rectus sheath above the umbilicus, and it completely exited the rectus sheath at the umbilicus. This is contrary to the traditional understanding of posterior rectus sheath formation.
腹横肌松解术(TAR)是一种肌筋膜松解技术,有助于腹壁大面积缺损的手术修复。在这种手术中,腹横肌(TA)肌肉部分的内侧缘非常重要。因此,作者试图描述腹横肌内侧缘的范围。在 10 具福尔马林固定的尸体上进行了 TAR 的手术步骤,并分别记录了 TA 肌肉内侧缘、腹直肌外侧缘到白线之间在五个解剖层次上的距离。此外,还记录了上腹部下血管与 TA 肌肉内侧缘之间的距离。所有尸体的腹直肌都在后直肌鞘内,分别位于腹股沟(R,61.6 毫米;L,58.9 毫米)和腹股沟与脐之间的中间位置(R,25.4 毫米;L,27.1 毫米)。TA肌在该点和脐之间从后直肌鞘退出。接下来三个水平的平均不一致性分别为右侧-24.6毫米、-24.9毫米和-22.9毫米,左侧-21.4毫米、-19.9毫米和-18.9毫米。TA内侧边界与上腹下血管之间的平均距离右侧为18.9毫米,左侧为17.2毫米。TA的肌肉部分被纳入脐部上方的后直肠鞘内,并在脐部完全退出直肠鞘。这与人们对后直肌鞘形成的传统理解相反。