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Oct 2012

“Intertransversalis” Approach for Laparoscopic Urology: Surgical Anatomy Concerns—Reply

Arch Surg. 2012;147(10):980-982. doi:10.1001/archsurg.2012.2221

In reply

We have read the letter by Dr Petros Mirilas concerning the intertransversalis fascia (TF) approach and appreciate his comments. However, we do not agree that the concept of a bilaminar TF is outdated. Although some scholars state that the TF is a single-layer structure,1 some other scholars,2,3 including Petros Mirilas,4 have described the TF as a bilaminar structure. In our study,5 we observed the 2 layers of the TF not only in laparoscopic operations (see Figures 2-4 in Li et al5) but also in a histological examination (see Figure 6 in Li et al5). That is why we believe that the TF is a 2-layer structure.