Do the dimensions of the femoral canal play a role in the genesis of femoral hernia?

Summary

The possibility of a biometric explanation for the genesis of femoral hernia has motivated several studies on the anatomy and dimensions of the femoral canal. However, because of methodologic flaws, there is still a lack of consistent results regarding this matter. The aim of this paper was to improve the understanding of the biometry of the femoral ring and canal and development of femoral hernia by a preperitoneal access. The longitudinal and transverse diameters and the depth of the femoral canal were measured in 50 male cadavers between 22 and 76 years of age. A great variability of diameters was found, and the right longitudinal and transverse diameters (1.65 ± 0.28 and 1.71 ± 0.37 cm) were significantly larger than the left (1.53 ± 0.26 and 1.53 ± 0.34 cm); p=0.021 and p=0.013, respectively. However, the depth of the left femoral canal (1.60 ± 0.41 cm) was significantly larger than the right (1.40 ± 0.38 cm); p=0.011. The wider femoral ring could explain the higher incidence of right femoral hernias. On the other hand, the great variability of diameters found, as large as 2.58 cm with the absence of femoral hernia, indicates that femoral ring diameter is not the only factor involved in the etiology of femoral hernia. We conclude that widened dimensions of the femoral ring alone are not a sufficient condition for the genesis of femoral hernias, but play a role in their formation, explaining their higher incidence in the right groin.