The lateral umbilical ligaments (lateral umbilical folds) are peritoneal folds overlying the inferior epigastric vessels on each side of the midline, running from the arcuate line to the umbilicus.
Form the lateral boundaries of the medial inguinal fossa (Hesselbach triangle), serve as the landmarks for direct versus indirect hernia classification in laparoscopic hernia repair, and mark the course of the inferior epigastric vessels.
In laparoscopic inguinal hernia repair (TAPP/TEP), the lateral umbilical fold (inferior epigastric vessels) is the critical landmark dividing direct from indirect hernias — direct hernias protrude medial to the fold and lateral hernias protrude lateral to it through the deep ring.
The inferior epigastric vessels within the lateral umbilical fold distinguish direct (medial) from indirect (lateral) inguinal hernias during laparoscopic TAPP or TEP repair.
Inadvertent division of the inferior epigastric vessels within the lateral umbilical fold during laparoscopic hernia dissection, requiring clip ligation to control haemorrhage.
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