Cooper's ligament (pectineal ligament) is the thick fibrous band overlying the pectineal line of the superior pubic ramus, a lateral continuation of the lacunar ligament. It forms the posterior boundary of the femoral ring and is the strongest structure in the groin available for suture or mesh fixation. It is distinct from Cooper's suspensory ligaments of the breast.
| Origin | Base of the lacunar ligament near the pubic tubercle |
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| Insertion | Pectineal line (pecten pubis) of the superior pubic ramus, extending laterally toward the iliopubic eminence |
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Reinforces the pectineal line and provides a strong anchor for sutures in inguinal and femoral hernia repair.
In the McVay (Cooper's ligament) repair, the transversus abdominis aponeurotic arch is sutured to Cooper's ligament, closing the femoral ring and repairing medial inguinal and femoral hernias. In laparoscopic hernia repair (TAPP and TEP), mesh is fixed to Cooper's ligament medially for secure repair. In Burch colposuspension for stress urinary incontinence, the paravaginal fascia beside the bladder neck is sutured to Cooper's ligament on each side. The corona mortis vessel often crosses the ligament and must be avoided.
Cooper's ligament is the primary fixation point for sutures or mesh in femoral hernia repair, providing the strongest available tissue for femoral ring closure.
Bladder neck hypermobility treated by suspending the paravaginal fascia from Cooper's ligament on each side.
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