Features of the Arcuate Line of the Rectus Sheath (arcuate line by J. Douglas) Location in Individuals with Different Body Type

Abstract

The aim was to study the features of typical and variant anatomy of the arcuate line of the rectus sheath (arcuate line by J. Douglas) in individuals with different body types. Material and methods . In a topographic and anatomical study, we studied 54 corpses of both sexes without signs of pathology of the anterior abdominal wall, who died at the age of 44.9±7.9 years. Among them were 29 (53.8%) men and 25 (46.2%) women. At autopsy, we investigated the features of the arcuate line location relative to the umbilical ring, depending on the body type. The differences were considered significant at a confidence level of p≤0.05. Results . Most often, the arcuate line of the rectus sheath was below the umbilical ring (n = 47; 87%). In some cases, the arcuate line of the of the rectus sheath was at the level of the umbilical ring (n=4; 7.4%). In other cases, and only in individuals with brachymorphic type, the arcuate line of the rectus sheath was not detected (n=3; 5.6%). The location of the arcuate line of the rectus sheath in the upper third in the midline from the umbilical ring to the upper edge of the pubic symphysis was significantly more often observed in individuals with dolichomorphic body type (83.3%), in the lower third – in individuals with brachymorphic body type (46.2%) [p=0.005]. Conclusion . New data can predict the arcuate line location and correctly prepare the aponeurotic structures of the rectus abdominis muscle to fix the mesh by posterior separation hernioplasty (“sublay”, TAPP).