This composite visual contains an anatomical illustration (a) and a corresponding clinical intraoperative photograph (b) detailing the surgical repair of a femoral hernia. Panel (a) provides a labeled anatomical diagram of the right inguinal-femoral region. It depicts the spermatic cord and falx inguinalis retracted cranially, exposing the orificium of the femoral hernia. Key landmarks are identified: the transversalis fascia (opened), the inguinal ligament of Poupart (ventral border), and the lacunar ligament of Gimbernat (medial border). An instrument is shown passing through the femoral orifice to demonstrate the pathology. Panel (b) is a clinical photograph of the surgical field during an open repair. It demonstrates the clinical application of the anatomy shown in panel (a), with retractors maintaining exposure. A surgical instrument is seen incising the lacunar ligament to enlarge the femoral space for mesh placement. The image illustrates the relationship between the inguinal ligament, femoral vessels, and the hernia orifice. The content is intended for intermediate to advanced surgical education, specifically regarding open femoral hernia repair and the anatomy of the femoral canal.

A multi-panel educational figure illustrating the key procedural steps of a Transabdominal Preperitoneal (TAPP) inguinal hernia repair. (a) Schematic diagram of the abdomen showing the laparoscopic port arrangement: a 12 mm umbilical port and two 5 mm lateral ports. (b) Intraoperative laparoscopic photograph showing the internal inguinal anatomy and the hernial orifice, classified as EHS-L2 (European Hernia Society classification for a medium indirect lateral hernia). (c) Surgical view demonstrating mesh fixation; a semi-transparent, macroporous polypropylene mesh is positioned in the preperitoneal space to cover the defect and is secured with visible surgical tacks. (d) Final procedural step showing the closure of the peritoneal flap using continuous suturing to exclude the mesh from the peritoneal cavity, preventing contact with abdominal viscera. The series emphasizes proper anatomical orientation, mesh placement, and peritoneal closure in minimally invasive hernia surgery.

This composite image illustrates the surgical repair of a femoral hernia using a mesh-based approach. Figure (a) is an anatomical diagram of the inguinal and femoral regions during surgery. Key structures identified include the spermatic cord (superior-medial), femoral vessels (lateral), inguinal ligament of Poupart (ventral), and the pectineal ligament of Cooper (dorsal). The diagram shows the placement of a vertical femoral mesh covering the orificium of the femoral hernia, secured over Cooper’s ligament while maintaining an overlay medially and laterally over the femoral vessels. The falx inguinalis is shown in a retracted state. Figure (b) is an intraoperative clinical photograph corresponding to the diagram, showing the surgical field with metal retractors and a circular wound protector. A white, woven surgical mesh is visible, positioned over the femoral orifice and held in place with instruments. The image demonstrates the 'Lichtenstein-like' open technique for femoral hernia reinforcement, highlighting the spatial relationship between the prosthetic mesh and pelvic floor ligaments to prevent recurrence.

This dual-panel image provides an anatomical and clinical overview of a femoral hernia and its surgical exposure. Panel (a) is a detailed anatomical diagram of the right inguinal and femoral regions. It illustrates a femoral hernia as a distinct bulge emerging medially to the femoral vessels (artery and vein) and caudal to the inguinal canal. Labeled structures include the external oblique fascia, the 'pink triangle' (an area formed by the diversion of fascial vessels toward the external inguinal orifice), the spermatic cord, and femoral vessels. Panel (b) is a clinical photograph showing the intraoperative view after the incision of the external oblique fascia. The surgical field is exposed using three metal claw-style retractors, revealing the underlying fascia and fatty tissue in the femoral region. Sutures are visible along the superior aspect of the skin incision. This content is designed for medical education regarding hernia pathology and surgical repair, demonstrating the critical landmarks needed to differentiate femoral hernias from inguinal hernias and to safely navigate the femoral canal during surgery.