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Uterine Devascularization
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Prasantha Wijesinghe
The most common adverse complication is damage to the internal iliac vein which lies beneath the internal iliac artery. If there is damage to the internal iliac vein, then direct pressure should be applied in order to prevent haemorrhage. Vascular clamps can then be applied above and below the injury, and with the help of a vascular surgeon, the tear should be repaired with a figure of eight suture using a non-absorbable vascular suture material, such as 4.0 polypropylene on a round-bodied needle. Incorporating the adventitia of the internal iliac artery into the suture adds support to the vein at the site of injury. Meticulous separation of the internal iliac artery from the internal iliac vein should prevent this complication.
Normal Anatomy of the Female Pelvis and Sonographic Demonstration of Pelvic Abnormalities
Published in Asim Kurjak, Ultrasound and Infertility, 2020
Pelvic vessels are much more clearly defined on an ultrasound scan. They are sonographically demonstrated as tubular structures characterized by an anechoic lumen and hyperechoic walls. The internal iliac artery is seen by performing an oblique scan posteriorly and laterally to the ovaries. It can be easily distinguished from the internal iliac vein, which is typically located posterior to the artery. If a real-time machine is used, pulsations of the artery are easily seen while the diameter of the vein is constant. The external iliac artery and vein are also routinely imaged on an oblique scan directed through the bladder to the contralateral pelvic wall. The external iliac vein sometimes can be compressed by an overfull urinary bladder, so that only the artery is visualized. The ovarian artery approaches the ovary from its lateral and posterior aspect, and being relatively thin, is not regularly seen. However, meticulous scanning of the lateral periovarian space will demonstrate in 60 to 70% of examined women the ovarian artery and vein which reach the ovaries via the mesovarium. Because of their small diameter and variable ovarian position, it is difficult to distinguish between the artery and vein. Although there were several reports describing marked dilatation of the ovarian vessels at the periovulatory phase of the cycle,25 we were not able to confirm this in spite of systematic scanning of patients during the late follicular phase of the cycle until ovulation (Figures 16 to 20).28
Venous anatomy
Published in Joseph A. Zygmunt, Venous Ultrasound, 2020
The common iliac vein is formed by the joining of the external iliac and internal iliac veins at approximately the level of the sacroiliac joints. The external iliac vein drains the lower extremity and the internal iliac vein drains the pelvis and gluteal regions.
Three-Dimensional in Vivo Anatomical Study of Female Iliac Vein Variations
Published in Journal of Investigative Surgery, 2022
Wenling Zhang, Chunlin Chen, Guidong Su, Hui Duan, Zhiqiang Li, Ping Shen, Jiaxin Fu, Ping Liu
Lymph node metastasis is an important factor affecting prognosis, and pelvic lymphadenectomy (PL) is an important step in gynecological tumors [1–4]. Since the development of PL, particularly after the introduction of laparoscopy by Canis and Nezhat [5,6], many cases of conversion to laparotomy due to intraoperative macrovascular injury have been reported. Vascular injuries are among the most common intraoperative complications, with an incidence of approximately 1.10%–4.44% [2,7–10]. The most common vascular injury is iliac vein injury [10–13], including injury to the common iliac vein (CIV), external iliac vein (EIV) and internal iliac vein (IIV). Iliac vein variation increases the risk of vascular damage. Practically, iliac vein variations impact many pelvic neoplasms, including not only gynecological but also rectal, colon, bladder, kidneys, etc. Therefore, it is necessary to study iliac vein variations.
Diagnostic Dilemma of Retroperitoneal Schwannomas Encountered in a Specialized Gynecology Hospital
Published in Journal of Investigative Surgery, 2022
Chunbo Li, Luopei Guo, Keqin Hua
As far as most authors concerned, the correct diagnosis of a RS could only be made in surgery and histological examination. It is more important to identify benign and malignant masses than to determine its location in a specialized gynecology hospital. Although the correct diagnosis of a RS is difficult, it is relatively easy to determine its nature according to the common characteristics of benign tumors (e.g. homogeneity, regular margin, no signs of adjacent organ involvement and normal tumor markers). At this point, surgical resection of the mass may be considered. Two goals of the surgery are complete resection without injuring the nerve and prevention of severe hemorrhage. Schwannoma is an isolated, well-defined capsule tumor with little change in local tissue. Thus, it is easy to dissect from adjacent tissue, which make complete resection possible. However, there is also a higher risk of mass extension to the sacral nerve root or adhesion to the common iliac vein or internal iliac vein, making the procedure more complicated. It is necessary to ask a general surgeon or neurosurgeon to help achieve complete resection.
Safety and efficacy of intravesical chemotherapy and hyperthermia in the bladder: results of a porcine study
Published in International Journal of Hyperthermia, 2020
Wei Phin Tan, Andrew Chang, Steven C. Brousell, Dominic C. Grimberg, Joseph J. Fantony, Thomas A. Longo, Wiguins Etienne, Ivan Spasojevic, Paolo Maccarini, Brant A. Inman
Hair was removed by clippers at the operation sites. Standard sterile surgical technique was used throughout the procedure. Lower abdominal laparotomy was performed to place the temperature monitoring devices around the bladder. The temperature monitoring devices consisted of the Luxtron® Fiber Optic Thermometry Probes (Lumasense Technologies, Santa Clara, CA, USA) and the Ge or Si High Temperature NTC thermistors (Adsem Inc, Mountain View, CA, USA). All probes were cleaned with 70% ethanol and gas sterilized prior to use in the animals. We placed probes at 7 locations: rectum, vagina, internal bladder, external bladder (serosa), transmural bladder (mucosa), core body temperature at the esophagus and internal iliac vein. The rectal and vagina thermistors were placed manually and sutured in place. The internal and external bladder microprobes were fixed in place using 4-0 to 5-0 sutures, sterile Dermabond tissue adhesive (Johnson & Johnson, New Brunswick, NJ, USA) or sterile fibrin glue/sealant. The internal iliac vein probe was placed by accessing the ipsilateral femoral vein with a 16 Ga vascular access catheter and sutured in placed after it was connected to a 3-way stopcock, which was used for simultaneous blood draws and temperature measurement. The abdominal incision sites were then sutured closed.