Anatomy of the round ligament in female infants and children with an inguinal hernia

BACKGROUND: The ligament which runs along an inguinal hernia sac in females is believed to be the round ligament of the uterus. According to most standard textbooks, the round ligament of the uterus terminates at the labium majorum. This study examined the termination of the ligament. METHODS: The anatomy of the ligament was examined in 248 female children (aged 1 month to 11 years) with an inguinal hernia. The anterior wall of the hernia sac, consisting of the inner and outer membranes, was opened and the inner membrane of the sac was pulled up with forceps; the hernia sac was then separated from the surrounding tissue. The termination of the ligament was observed. RESULTS: The ligament did not end at the labium majorum but terminated in the hernia sac. The ligament was attached to the mid portion of the fallopian tube near the ovary. CONCLUSION: These findings suggest that the ligament which runs along the hernia sac is the suspensory ligament of the ovary.