Hesselbach Triangle Boundaries

trigonum inguinale (Hesselbach)

Hesselbach triangle is a weak area of the posterior inguinal wall bounded laterally by the inferior epigastric vessels, medially by the lateral border of the rectus abdominis, and inferiorly by the inguinal ligament. Direct inguinal hernias protrude through this triangle.

Region: Abdomen

Biomechanics

Function & Actions

The triangle represents the weak posterior inguinal wall where the transversalis fascia and internal oblique are not reinforced by the inguinal ring — the site of direct inguinal hernia formation from abdominal wall weakness.

Clinical Relevance

Clinical Notes

Identification of Hesselbach triangle in laparoscopic hernia repair distinguishes direct from indirect hernias and guides mesh positioning. Mesh in Lichtenstein repair covers the entire posterior inguinal wall including the triangle. Groin pain after repair may reflect mesh edge impingement on the triangle boundaries.

Pathology

Common Injuries & Conditions

Direct Inguinal Hernia Through Hesselbach Triangle

Peritoneum and abdominal contents protruding directly through the posterior inguinal wall within the triangle from transversalis fascia weakness, repaired by posterior wall reinforcement with mesh.

Laparoscopic Hernia Assessment of Hesselbach Triangle

Direct inspection of the posterior inguinal wall in laparoscopic TAPP or TEP identifies the lateral umbilical fold and triangle to classify hernia type before mesh placement.