The lacunar ligament (Gimbernat's ligament) is the medial expansion of the inguinal ligament turning posteriorly at the pubic tubercle to attach to the pectineal line of the superior pubic ramus, forming the sharp medial boundary of the femoral ring.
Creates the unyielding medial wall of the femoral canal, provides the medial anchor of the inguinal ligament system, and forms the border that causes strangulation of femoral hernias when they enlarge.
The lacunar ligament's sharp free edge is the structure that strangulates femoral hernias — its division is required for hernia reduction. The aberrant obturator artery (corona mortis) from the external iliac or inferior epigastric courses over the medial lacunar ligament and must be identified before division to prevent catastrophic haemorrhage.
The sharp medial edge of the lacunar ligament constricting a femoral hernia requiring surgical division for reduction, with mandatory identification of the corona mortis beforehand.
Aberrant obturator artery coursing over the medial lacunar ligament present in 20-30% of patients, creating a lethal vascular injury risk if divided without recognition during femoral hernia repair.
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