The pectineal ligament (Cooper ligament) is a strong fibrous band along the pecten pubis on the superior pubic ramus. It is formed mainly by fibres continuing laterally from the lacunar ligament, blended with the periosteum and the fascia over pectineus. It lies behind the femoral ring and is a reliable anchor for hernia repair sutures and mesh.
| Origin | Medial end of the lacunar ligament |
|---|---|
| Insertion | Pecten pubis (pectineal line) along the superior pubic ramus |
Forms part of the posterior border of the femoral ring and is a strong anchor point for sutures and mesh in hernia repair
The pectineal ligament is the posterior anchor in the McVay hernia repair (Cooper's ligament repair) for femoral and inguinal hernias. It is the strongest available tissue in the medial groin for suture fixation. In laparoscopic hernia repair (TEP/TAPP), mesh is fixed to Cooper's ligament posteriorly. The iliopectineal arch runs adjacent to the ligament, dividing the lacuna musculorum from the lacuna vasorum.
Avulsion or disruption of the pectineal ligament in high-energy pelvic trauma producing loss of the posterior inguinal floor support and contributing to femoral or inguinal hernia formation.
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