Answer:
Based on the deep circumflex iliac artery and venae comitantes.
-Place patient in supine position on the operating table.
-Skin incision in the inguinal crease distally, and just pass the border of the ASIS proximally.
-Skin incision in inguinal crease, dissect through subcutaneous tissue and external oblique, divide external oblique aponeurosis, retract round ligament of uterus or spermatic cord medially and upward to expose DCI A and V. Retract vessels laterally.
- The fibers of the internal oblique and transversus muscle are divided and the vessel traced laterally to the level of the ASIS where the ascending branch is divided.
- The DCIA is dissected as it courses laterally along the curvature of the iliac crest.
- Just below the vessel, the iliac fascia is divided exposing the ilium. Dissect until desired length of iliac crest is reached.
- Vessel is then divided.
- If full thickness crest is needed then tensor fascia lata and gluteus muscles are divided.
- Oscillating saw to divide the bone. ASIS should be spared.