Defining the position of deep inguinal ring in patients with inguinal hernia

Introduction: Identification of the exact position of the deep inguinal ring is important in classifying inguinal hernias. This information is often used in evaluating short cases in undergraduate as well as postgraduate examinations in Surgery.

Methods: Consenting patients undergoing routine inguinal herniotomy and mesh repair in a Surgical Unit of the Teaching Hospital Karapitiya were included in the study. The length between the anterior superior iliac spine (ASIS) and the pubic tubercle (PT) was measured using a sterilized metal ruler.

Results: Twenty five patients participated in this study. Fifteen had right inguinal hernia and others had left inguinal hernia. The mean distance from the PT to theASIS in those with left inguinal hernia (LIH) was 6.61cm. (SD=0.34 cm). The mean distance from the left PT to the actual position of the deep inguinal ring was 3.05 (0.14) cm. In patients who had right inguinal hernia the mean distance from the PT to the right ASIS was 6.65 (0.32) cm. The mean distance from the right PTto the actual position of the deep inguinal ring was 3.07 (0.15) cm.

Conclusion: The exact position of the deep inguinal ring is medial to the mid-point of the inguinal ligament. Our data reveal that it is not lying in the mid-point of the inguinal ligament.

Key words: Deep inguinal ring; inguinal hernia

DOI: http://dx.doi.org/10.4038/gmj.v16i2.3747

GMJ 2011; 16(2): 17-19