Ligamento de Cooper
Summary
Cooper's ligament most often means the pectineal ligament, a strong fibrous band along the pectineal line of the superior pubic ramus, lying deep and inferior to the inguinal ligament and used as an anchor in hernia repair. The same name also denotes the suspensory ligaments of the breast.
Detail
The pectineal (Cooper) ligament is a lateral extension of the lacunar ligament running along the pecten pubis. Its strength makes it the fixation point for the McVay (Cooper ligament) repair, historically favoured for femoral hernias because it closes the femoral canal, and it is a landmark in laparoscopic preperitoneal repair. Surrounding anatomy is examinable: the femoral canal lies medial to the femoral vein within the femoral sheath and is the route of a femoral hernia, which passes below the inguinal ligament and lateral to the pubic tubercle and carries the highest risk of strangulation; inguinal hernias pass above and medial to the pubic tubercle, with indirect hernias traversing the deep ring lateral to the inferior epigastric vessels and direct hernias pushing through Hesselbach triangle medial to them. Separately, the suspensory ligaments of Cooper anchor the breast to the dermis; when invasive ductal carcinoma causes desmoplasia and shortens them, the overlying skin retracts and dimples, a classic malignant sign, and lymphatic obstruction produces peau d'orange.
Sources
- Gray's Anatomy for Students
- Schwartz's Principles of Surgery
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