Umbilical Folds

Expansion

Seen from inside at laparoscopy, five folds converge on the umbilicus:

• Median umbilical fold - one only, containing the urachus (median umbilical ligament), the remnant of the allantois
• Medial umbilical folds - a pair, containing the obliterated umbilical arteries
• Lateral umbilical folds - a pair, containing the inferior epigastric vessels, the only ones still carrying blood

Between them lie the fossae that determine hernia type:

• Supravesical fossa - between median and medial folds
• Medial inguinal fossa - between medial and lateral folds; the site of a direct hernia
• Lateral inguinal fossa - lateral to the lateral fold, at the deep ring; the site of an indirect hernia

The single-versus-paired distinction between median and medial is the commonest slip here.