A band of fascial thickening, termed the iliopubic tract, lies
on the posterior aspect of the inguinal region
and has been described in the surgical literature as playing an important
role during herniorraphy. This
study was undertaken to examine the gross and microscopic anatomy of the
iliopubic tract in 12 cadavers.
The results confirmed that the iliopubic tract can be readily identified
as a thickening of the transversalis
fascia running deep and parallel to the inguinal ligament. It attaches
to the superomedial part of the pubic
bone medially, but laterally its fibres fan out within the fascia transversalis
and fascia iliaca without bony
attachment to the iliac spines. In contrast to the inguinal ligament, the
histological analysis of the iliopubic
tract shows a high elastin to collagen ratio. The functional signficance
of this structure merits further study,
but there is no doubt that it is important in many approaches to inguinal
herniorraphy. For this reason it is
considered that the iliopubic tract deserves greater emphasis in the anatomy
teaching of the inguinal region.