The pectineal line (pecten pubis) is the ridge on the superior pubic ramus that receives tendinous attachments from the pectineal ligament (Cooper ligament), the pectineus muscle, and contributes to the femoral ring medial boundary. Its tendinous attachments are key landmarks in inguinal hernia surgery.
Cooper ligament repair (McVay repair) sutures the transversalis fascia to the pectineal line, the strongest tendinous structure in the floor of the femoral canal. In laparoscopic TAPP/TEP hernia repair, the pectineal line is a key bony landmark for mesh positioning — the mesh must extend below the pectineal line to prevent femoral hernia recurrence.
Suture of the transversalis fascia to the pectineal line tendinous attachment in McVay repair for femoral hernia, providing a strong bony-tendinous anchor that prevents femoral ring recurrence.
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