Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Jean-Louis Petit

Jean Louis Petit
(1674 – 1750)

French surgeon and anatomist, Jean Louis Petit was born in Paris in on March 13, 1674.  His family rented an apartment at his house to Alexis Littre (1658 – 1726), a French anatomist. Petit became an apprentice of Littre at seven years of age, helping him in the dissections for his lectures and at an early age became the assistant in charge of the anatomic amphitheater.

Because of Petit’s dedication to anatomy and medicine, in 1690 at the age of sixteen, became a disciple of a famous Paris surgeon, Castel.

In 1692, Petit entered the French army and performed surgery in two military campaigns. By 1693 he started delivering lectures and was accepted as a great surgeon, being invited to the most difficult operations.  In 1700 he was appointed Chief Surgeon of the Military School in Paris and in the same year he received the degree of Master of Surgery from the Faculty of Paris.

In 1715 he was made a member of the Royal Academy of Sciences and an honorary member of the Royal Society of London. He was appointed by the King as the first Director General of the Royal Academy of Surgery when it was founded in 1731.

Petit’s written works are of historical importance.  “Traite des Maladies des Os” ( A Treatise on Bone Diseases);  “Traite des Maladies Chirurgicales et des Operation” (A Treatise on Surgical Diseases and their Operations” This last book was published posthumously in 1774. He also published a monograph on hemorrhage, another on lachrymal fistula, and others.

He was one of the first to perform choIecystotomy and mastoidotomy. His original tourniquet design for amputations saved many in the battlefield and the design of the same surgical instrument today has not changed much since its invention by him.

His name is remembered in the lumbar triangle, also called the "triangle of Petit", and the abdominal hernia that can ensue through that area of weakness, the lumbar hernia or "Petit's hernia".

Sources:
1. “Jean Louis Petit – A Sketch of his Life, Character, and Writings” Hayne, AP San Fran Western Lancet 1875 4: 446-454
2. “Oeuvres compl?tes de Jean-Louis Petit” 1837 Imprimerie de F. Chapoulaud
3. Extraits de l'eloge de Jean-Louis Petit Ius dans Ia seance publique de I' Academie royale de chirurgie du 26 mai 1750” Louis A. Chirurgie 2001: 126 : 475- 81


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Lacunar (Gimbernat's) ligament

The [lacunar ligament] is a half-moon shaped ligament that extends between the inguinal  ligament (Poupart's ligament) superiorly and the pectineal ligament (Cooper's ligament) inferiorly.  The lacunar ligament is at its narrowest at the point where the inguinal ligament and the pectineal ligament meet at the pubic tubercle where all three ligaments insert. The lacunar ligament is the medial boundary of the femoral ring.

The lacunar ligament was first described in 1765 by Don Antonio de Gimbernat y Arbós (1734 - 1816), who also described the importance of this ligament in the reduction of a strangulated femoral hernia.

In the anterior (open) approach to a strangulated femoral hernia, there is very little space at the femoral ring to enlarge it and allow reduction of the hernia contents. What Gimbernat did was to carefully cut the ligament from lateral to medial, enlarging the femoral ring and allowing reduction of the hernia. This was against the technique practiced at the time, which was to cut trough the inguinal ligament.

Lacunar (Gimbernat's) ligament
Image property of: CAA.Inc.Artist: David M. Klein
One of concerns when using this technique is the presence of the Corona Mortis, an anatomical variation in the area. Since the Corona Mortis is found posterior to the lacunar ligament, it can be unknowingly transected when repairing a femoral hernia from the anterior aspect.
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