A hernial sac containing the small intestine was identified intraoperatively, laterally to the rectus abdominis muscle, below the arcuate line, and protruding through a defect of the transversalis fascia and the transversus abdominis muscle
. Preperitoneal fat adhered to the tip of the hernial sac was the first to be recognized (Figure 1c).
Free flaps used for reconstruction were: Antero Lateral Thigh Free Flap (ALTF) (n=8; 40%), Radial Forearm Free Flap (RFFF) (n=6, 30%), free latissimus dorsi (n=4, 20%) and Transversus Abdominis muscle
(TRAM) flap (n=2, 10%).
Transversus abdominis plane block (TAP block) [4,5] is a regional technique where abdominal wall neural afferents are blocked by depositing local anaesthetic into the neurofascial plane between internal oblique and transversus abdominis muscle
. [4,5] It is gaining popularity as an alternative to subarachnoid opioids due to fewer side effects and the ease and accuracy of administration.
Laurentino, "Measurement properties of the pressure biofeedback unit in the evaluation of transversus abdominis muscle
activity: a systematic review," Physiotherapy, vol.
Then, the probe was moved anterolaterally in order to visualize the anterolateral margin of the QL and the aponeurosis of the two abdominal wall muscles (IO: internal oblique muscle; TA: transversus abdominis muscle
Ultrasound assessment of transversus abdominis muscle
contraction ratio during abdominal hollowing: a useful tool to distinguish between patients with chronic low back pain and healthy controls?
Rackwitz et al., "Reliability of a test measuring transversus abdominis muscle
recruitment with a pressure biofeedback unit," Physiotherapy, vol.
It involves the injection of a local anesthetic solution into a plane between the internal oblique muscle and transversus abdominis muscle
. Since the thoracolumbar nerves originating from the T6 to L1 spinal roots run into this plane and supply sensory nerves to the anterolateral abdominal wall , the local anesthetic spread in this plane can block the neural afferents and provide analgesia to the anterolateral abdominal wall.
The anatomical compartment between the transversus abdominis muscle
and abdominal oblique internus muscle was described as TAP in clinical practice [3,7].
The hernial ring was like a linear slit between psoas major and transversus abdominis muscle
below 4th and 5th lumbar vertebrae.
Additionally, the abdominal draw-in maneuver activates contraction of the transversus abdominis muscle