Three-dimensional visualization and measurement of myopectineal orifice in non-inguinal hernia patients

Surg Radiol Anat. 2020 Nov;42(11):1315-1322. doi: 10.1007/s00276-020-02543-2. Epub 2020 Sep 29.

Abstract

Purpose: The myopectineal orifice (MPO) is a weak area at lower part of the anterior abdominal wall that directly determines the mesh size required in inguinal hernia repair. However, MPO data have mainly been acquired from measurements of cadavers or anesthetized patients. Furthermore, there are very few reports on the measurement of the MPO in Chinese patients. The present study aimed to use three-dimensional visualization technology to measure the MPO in live non-anesthetized Chinese patients, and to use this information to indicate the appropriate mesh size required for inguinal hernia repair.

Methods: In this study, we used the parameters of the MPO and the pelvis that were measured in 40 patients with peripheral arterial disease of the lower limb arteries (80 inguinal regions) using Medraw software (Image Medraw Technology Co., Ltd., China).

Results: The result showed that the average width and height of the MPO were 5.71 ± 0.99 cm and 4.96 ± 0.69 cm, respectively (5.22 ± 0.77 cm and 5.13 ± 0.63 cm in males, and 6.20 ± 0.95 cm and 4.80 ± 0.71 cm in females). The average projected area of the MPO was 16.06 ± 4.37 cm2 on the left, and 15.61 ± 4.10 cm2 on the right (P > 0.05).

Conclusion: Three-dimensional visualization was used to measure the area, width, and height of the MPO in living non-anesthetized Chinese patients. MPO area was correlated with age, but not with pelvic parameters.

Keywords: Inguinal hernia repair; Inguinal region; Medraw software; Myopectineal orifice; Three-dimensional visualization.

MeSH terms

  • Abdominal Wall / anatomy & histology*
  • Abdominal Wall / diagnostic imaging
  • Abdominal Wall / physiopathology
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Anatomic Landmarks
  • Computed Tomography Angiography
  • Groin / anatomy & histology*
  • Groin / diagnostic imaging
  • Groin / physiopathology
  • Hernia, Inguinal / physiopathology
  • Hernia, Inguinal / surgery
  • Herniorrhaphy / instrumentation
  • Herniorrhaphy / methods
  • Humans
  • Imaging, Three-Dimensional*
  • Middle Aged
  • Peripheral Arterial Disease / diagnosis
  • Surgical Mesh
  • Young Adult