ABSTRACT
In certain cases (i.e. selectively and not routinely) of radical lymphadeno-colpo-hysterectomy for uterine carcinoma, the authors section the uterosacral ligaments at the outset, which enables the uterus to be brought up and thus facilitates dissection, ligation and section of the supra-uterine vesico-uterine pedicles, avoiding damage to the terminal (juxta-vesical) ureter.
Subject(s)
Hysterectomy, Vaginal/adverse effects , Hysterectomy, Vaginal/methods , Intraoperative Complications/prevention & control , Lymph Node Excision/adverse effects , Lymph Node Excision/methods , Ureter/injuries , Uterine Neoplasms/surgery , Dissection , Fasciotomy , Female , Humans , Ligaments/surgery , Ligation , Surgical Flaps/methods , Ureter/pathology , Wounds and Injuries/prevention & controlABSTRACT
The authors studied the topographical anatomy of the areas involved in urethro-vesical suspension, type Burch, in 25 female cadavers. They notice that, with the Burch procedure, the specific haemorrhagic risks are represented by lesions of the external iliac vein and sometimes lesions of the anastomosis between epigastric and obturator artery, which may be caused when the needle goes through the most lateral portion of Cooper's ligament, if this needle is directed upwards and outwards.
