TissueDB/Tissues/Internal Inguinal Ring

The internal (deep) inguinal ring is the abdominal opening of the inguinal canal — a defect in the transversalis fascia located approximately one centimetre above the inguinal ligament, midway between the anterior superior iliac spine and the pubic tubercle.^[1] The ring transmits the spermatic cord (or round ligament) and is the site at which an indirect inguinal hernia first develops, when the persistent vaginal process or peritoneal extension protrudes through. In laparoscopic inguinal hernia repair (LIHR), correct closure of the peritoneum at the internal ring is a defining technical step. The pediatric LIHR trainer described by Duboureau et al. uses the neck of a plastic bottle of more than one litre as a geometric proxy for the ring — the bottle-neck calibre approximates the diameter of an infant's deep ring and provides a fixed boundary for simulated intracorporeal knotting.

Materials

Material	Visual	Tactile	Simulator	Notes
Plastic-bottle neck			Pediatric Laparoscopic Inguinal Hernia Repair Simulator (Duboureau)	Neck of the plastic bottle — the source specifies "a plastic bottle (volume: >1 L)" — with cap and plastic ring removed. The bottle-neck calibre was selected because it mimicked the internal inguinal ring; smaller bottles were tested and rejected because the mouth size did not resemble the infant's anatomy. Source: Duboureau H et al. 2021, J Pediatr Surg 56(4):674–677. DOI 10.1016/j.jpedsurg.2020.05.044. PMID 32631609.

References

↑ Picasso R, Pistoia F, Zaottini F, Airaldi S, Perez MM, Pansecchi M, Tovt L, Sanguinetti S, Möller I, Bruns A, Martinoli C. High-resolution ultrasound of spigelian and groin hernias: a closer look at fascial architecture and aponeurotic passageways. Journal of Ultrasonography 2021;21(84):e53–e62. DOI 10.15557/JoU.2021.0008. PMID 33791116. PMC PMC8008201. States that the internal inguinal ring "is located on a plane crossing the midpoint of the inguinal ligament, approximately 11 mm above it".

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Created	May 18, 2026 by Arturo Pelayo
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Cite as	Arturopelayo (2026). "TissueDB/Tissues/Internal Inguinal Ring". Appropedia. Retrieved August 23, 2026.
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[picasso2021-1] Picasso R, Pistoia F, Zaottini F, Airaldi S, Perez MM, Pansecchi M, Tovt L, Sanguinetti S, Möller I, Bruns A, Martinoli C. High-resolution ultrasound of spigelian and groin hernias: a closer look at fascial architecture and aponeurotic passageways. Journal of Ultrasonography 2021;21(84):e53–e62. DOI 10.15557/JoU.2021.0008. PMID 33791116. PMC PMC8008201. States that the internal inguinal ring "is located on a plane crossing the midpoint of the inguinal ligament, approximately 11 mm above it".

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