Open Access
CC BY 4.0 · Arch Plast Surg 2025; 52(01): 003-010
DOI: 10.1055/a-2350-8420
Breast/Trunk
Original Article

Relation of Transversus Abdominis to Rectus Abdominis Muscle in Various Anatomical Landmark Levels: A Cadaveric Study

Totsapol Surichamorn 
1   Division of Plastic and Maxillofacial Surgery, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
,
Thiti Tantitham 
1   Division of Plastic and Maxillofacial Surgery, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Funding None.
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Abstract

Background Posterior Component Separation (PCS) is a surgical technique used in abdominal wall reconstruction. Understanding the relationship between the rectus abdominis and transversus abdominis muscles and the location of intercostal nerves is crucial for minimizing nerve injury during PCS. This cadaveric study aimed to investigate these anatomical relationships and propose practical guidelines for safer PCS procedures.

Methods Eighteen fresh cadavers were dissected to assess the overlap or separation of the rectus abdominis and transversus abdominis muscles at seven abdominal levels. The distance of intercostal nerves from the lateral border of the rectus abdominis was measured.

Results The study found that the muscles overlapped at the xiphoid and upper abdominal levels but began to separate below the 2/4 upper to umbilicus level. Intercostal nerves entered at varying distances from the lateral edge of the rectus abdominis, suggesting that levels above the 3/4 upper to umbilicus level are relatively safe for dissection.

Conclusion The study recommends initiating the first incision for PCS between the subxiphoid and 2/4 upper to the umbilicus, based on observed muscle relationships and nerve distances. This practical approach enhances safety and simplifies decision-making during surgery.

Keywords

transversus abdominis - rectus abdominis - posterior component separation

Authors' Contributions

Co-written by both authors.


Ethical Approval

This study has received IRB approval from Mahidol University. IRB approval number is COA. MURA2019/818


Patient Consent

Informed consent has been obtained fromthe patients for the use of clinical photographs and medical images.




Publication History

Received: 19 September 2023

Accepted: 12 May 2024

Accepted Manuscript online:
24 June 2024

Article published online:
06 August 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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