 this is with respect to laparoscopic hernia surgery when we are doing a laparoscopic surgery and we are trying to reduce the neck of the sac from the internal ring this is the location of the internal ring because we know that the testicular artery in the testicular vein is coming out and the ductus difference is coming out so this is the location of the internal ring as seen from inside this is the opening of the internal ring in the fascia transversalis we notice that the testicular artery testicular vein is running a little laterally and then they are coming and joining with the ferrota and the inferior vena cava the ductus difference goes medially into the pelvis and below we have the external iliac artery and the external iliac vein which will go under the inguinal ligament so this is the region where the surgeon laparoscopic surgeon has to operate to reduce the hernia sac in the internal ring this is referred to as the triangle of doom because there are so many important vascular structures which are here which may be injured so this is the triangle of doom on the right side now let me show you the triangle of doom on the left side the left side of the cadaver to show you the same thing this is the testicular vein and the testicular artery the testicular vein as we know on the left side it opens directly to the left ring vein and this is the testicular artery they are coming through the internal ring where my instrument is located and medially is this ductus difference so when the laparoscopic surgeon is operating by means of laparoscopy and he's trying to reduce the indirect hernia sac through the internal ring he will have to operate in this triangular region medially bounded by the ductus difference laterally bounded by the testicular vessels and external iliac artery and external iliac vein so this is the triangle of doom on the left side now i would like to draw your attention to yet one more vessel which is running on the inner surface of the rectus abdominis muscle we can see an artery running in the posterior wall of the inguinal canal on the left side and that is this artery here this is the inferior epigastric artery this inferior epigastric artery it runs behind the facial transversalis and i have picked it up here this is the inferior epigastric artery it is located media to the internal ring and it runs on the posterior surface of the rectus abdominis muscle so this is one artery and also arising from the external iliac artery we can see this artery here this is the deep circumflex iliac artery which runs along the inner surface of the iliac rest and this anastomosis with this artery here and this artery here this is the ilio lumbar artery which anastomosis with the l5 lumbar artery ilio lumbar artery and the deep circumflex iliac artery and they form an arterial anastomosis on this region this is what is seen on the left side let us take a look at the same thing on the right side so again we are on the right side on the inguinal canal and here we can see let me just reflect this out to show you this is the femoral artery which is the continuation of the external iliac artery and the femoral artery is given rise to a superficial circumflex iliac artery which we can see here and further inside we can see it is giving rise to this artery here which is the deep inferior epigastric artery and we can see the inferior epigastric artery is running on the posterior surface of the rectus abdominis inferior epigastric artery on both the sides is a very important landmark with respect to inguinal canal and inguinal hernia surgery because the inferior epigastric artery is located just medial to the internal ring or the deep inguinal ring and that is used as a landmark just lateral to that is the internal ring let's take a look at a branch from the external iliac artery which I mentioned showed on the left side this is that branch which I was talking about and we can see clearly on this side it is arising from the external iliac artery this is the deep circumflex iliac artery this deep circumflex iliac artery runs on the inner surface of the iliac breast and it anastomosis with the l5 artery coming from the lumbar aorta and it forms an arterial anastomosis and it also receives a communication from the ilio lumbar artery which is a branch from the posterior division from the internal iliac the upper the smallest posterior division so this is another arterial anastomosis which happens on the inner side surface of the greater pelvis thank you for watching have a nice day