Viewing Inguinal anatomy through a different lens: Its relevance in an integrated curriculum

Abstract

Introduction Across the USA, clinical integration early on in the preclinical years of medical school is becoming the norm. It is not uncommon to see surgeons participating in integrated sessions and introducing the anatomical terms necessary for laparoscopic surgery to first and second year medical students. Anatomical structures imperative to the success of laparoscopic surgery include the myopectineal orifice, iliopubic tract, inferior epigastric vessels, inguinal triangle, umbilical folds, the transversalis fascia, Cooper's Ligament, preperitoneal space Triangle of Pain and Triangle of Doom. However, some of these anatomical structures and terminologies are totally alien to medical students. Studies have shown a very steep learning curve associated with laparoscopic hernia repair, ranging from 50 to 250 cases (Hope and Pfeifer, 2020). Therefore, it is long overdue to reconsider the anatomy taught during the preclinical years of medical school. The aim of this presentation is to address the current anatomical teaching of the inguinal region and consider what additional anatomy could be emphasized in an integrated curriculum. Materials and Methods: We have created illustrations that incorporate pertinent anatomical structures from posterior, medial, superior and anterior views of the inguinal region using online software. Additionally, we have acquired operative surgical images for comparison. Results By utilizing both traditional anatomical teachings and these illustrations, students will better understand the overall inguinal anatomy and, furthermore, will be able to apply their knowledge during clinical years. Conclusion With an increased emphasis on clinically integrated curriculum at schools like OUWB, it is necessary to update anatomical teachings with the current surgical trends. While laparoscopic hernia repair need not be taught explicitly, an introduction to the anatomical structures relevant to it could greatly improve the learning curve faced by residents and surgeons alike.