Anatomical characteristics of the iliopubic tract: Implications for repair of inguinal hernias

The high recurrence rate of inguinal hernias following primary repair has prompted us to re‐examine the anatomy of the inguinal region with particular emphasis on the iliopubic tract (IPT). The IPT is described as an aponeurotic band forming the inferior margin of the transversus abdominis lamina. We documented the presence and degree of development of the IPT in dissections of 151 embalmed inguinal regions and in serial sagittal sections of four body halves. The iliopubic tract was identified in all specimens. It stretched between the anterior superior iliac spine laterally and the pubic tubercle and the pubic tubercle and pectineal line medially. The intervening arch formed a discrete structure of variable thickness and was substantial in 63 specimens. Histological sections demonstrated that the IPT is connected to the inguinal ligament, fascia lata, and anterior femoral sheath and is composed primarily of collagenous fibers with a minor elastic component. These data indicate that the iliopubic tract is a consistent and easily identified structure in the inguinal regions. These results suggest that dissection of the iliopubic tract, like the inguinal ligament, should become an integral part of the assessment of groin anatomy during hernia repair. © 1992 Wiley‐Liss, Inc.