Abdominal Wall Anatomy: Surgical Landmarks and Functional Layers in Hernia Repair

A thorough understanding of abdominal wall anatomy is foundamental to safe and effective hernia repair. The complex and highly organized arrangement of muscular, fascial, and neurovascular structures and their relationships demands careful analysis, particularly in the context of modern surgical techniques such as component separation and minimally invasive approaches like extended totally extraperitoneal and robotic transversus abdominis release. This chapter will provide a comprehensive, clinically oriented review of the functional anatomy of the abdominal wall, progressing sistematically from the superficial layers to the posterior rectus sheath and transversalis fascia. Particular attention is given to the anatomical planes and potential spaces that are critical to both open and minimal invasive surgical approaches. Key surgical landmarks, including the semilunar line, arcuate line, and major neurovascular bundles, are described in detail, along with common anatomical variations that may influence operative strategy and surgical decision-making. An emphasis is placed on the biomechanical role of each abdominal wall layer and its relevance to defect formation, hernia classification, and reconstructive planning. Understanding these principles allows for more accurate selection of surgical techniques, improved restoration of abdominal wall function, and reduced rates of recurrence and postoperative morbidity. By integrating anatomical knowledge with practical surgical application, this chapter aims to serve as a valuable resource for both general and specialist surgeons involved in abdominal wall reconstruction. Illustrative diagrams and intraoperative images will support the anatomical descriptions, enhancing both didactic clarity and practical relevance for clinical decision-making.