Anat Cell Biol 2024; 57(3): 363-369
Published online September 30, 2024
https://doi.org/10.5115/acb.23.305
Copyright © Korean Association of ANATOMISTS.
Pauline Shanthi1 , Femina Sam1
, Jenny Jacob1
, Beulah Roopavathana S2
, Suganthy Rabi1
1Department of Anatomy, Christian Medical College, Affiliated to the Tamil Nadu Dr. MGR Medical University, Vellore, 2Department of General Surgery, Christian Medical College, Affiliated to the Tamil Nadu Dr. MGR Medical University, Vellore, India
Correspondence to:Femina Sam
Department of Anatomy, Christian Medical College, Affiliated to the Tamil Nadu Dr. MGR Medical University, Vellore 632002, India
E-mail: femina.sam@cmcvellore.ac.in
Femina Sam’s current affiliation: Human Anatomy Unit, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords: Rectus abdominis, Epigastric, Transversus abdominis, Linea alba, Umbilicus