The lacunar ligament (Gimbernat's ligament) is the medial triangular extension of the inguinal ligament that turns posteriorly to attach to the pectineal line of the pubis. Its tendinous fibres form the medial boundary of the femoral ring, making it a critical structure in femoral hernia repair and groin anatomy.
The lacunar ligament is the structure incised (Gimbernat's manoeuvre) to release an irreducible femoral hernia at emergency surgery — the strangulated bowel is freed by carefully dividing this firm medial boundary. The inferior epigastric artery has an anomalous medial origin in approximately 20% of individuals that passes over the lacunar ligament, making Gimbernat's manoeuvre potentially hazardous. The lacunar ligament is the medial anchor in McVay (Cooper's ligament) inguinal hernia repair.
Irreducible femoral hernia with bowel strangulation compressed at the rigid lacunar ligament medial boundary, requiring emergency Gimbernat's manoeuvre (lacunar ligament division) to reduce the hernia and assess bowel viability.
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