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Laparoscopic Radical Cystoprostatectomy
Published in Qais Hooti, Sung-Hoo Hong, Minimally Invasive Urologic Surgery, 2023
The ureteric dissection usually comes to end once it crosses the vas and superior vesical artery.The ureter is clipped at most distal part by two XL-size Hem-o-lok clips and divided in-between (Figure 9.10). A frozen section for histological examination is sent from the proximal ureteric stump and the ureter is placed in the upper abdomen to avoid injury during the rest of procedure.
Lymphatic anatomy: lymphatics of the cervix
Published in Charles F. Levenback, Ate G.J. van der Zee, Robert L. Coleman, Clinical Lymphatic Mapping in Gynecologic Cancers, 2022
Anca Chelariu-Raicu, Katherine C. Kurnit
The anterior trunk leaves the anterior cervix and courses along the posterior surface of the bladder to the superior vesical artery. From there it travels to the obliterated umbilical vessel and terminates in the distal interiliac nodal basins anteriorly. Separate but parallel vessels run along the cardinal ligament, where they meet without intermixing with the lateral trunk and drain into that trunk’s distribution.
Embryology, Anatomy, and Physiology of the Bladder
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Allan Johnston, Tarik Amer, Omar Aboumarzouk, Hashim Hashim
Superior vesical arteryFirst large anterior branch of the internal iliac arteryRuns inferior to the pelvic brimTraverses the pelvis from its sidewall medially towards the upper portion of the bladder.Supplies:Distal ureter, bladder, the proximal end of the vas deferens, seminal vesicles.Gives rise to the umbilical artery in the foetus (medial umbilical ligament in adults).
A Modification of Laparoscopic Type C1 Hysterectomy to Reduce Postoperative Bladder Dysfunction: A Retrospective Study
Published in Journal of Investigative Surgery, 2019
Wei Jiang, Meirong Liang, Douxing Han, Hui Liu, Ling Li, Meiling Zhong, Lin Luo, Siyuan Zeng
We disrupted the round ligament of the uterus at the middle-lateral one-third junction and incised the anterior leaf of the broad ligament and peritoneal reflection. The infundibulopelvic ligaments were detached and dissected at a high level. In cases where one ovary was preserved, we conducted incision of the proper ovarian ligament, followed by a biopsy and ectopic suspension of the ovary and salpingectomy contralaterally. The ureter was separated by resecting the posterior leaf of the broad ligament. After the incision of the uterorectal peritoneal reflection, we developed the rectovaginal space. The pararectal space was also developed between the uterosacral ligament and ureteral mesentery, sparing the inferior hypogastric nerve. In between the two spaces, the uterosacral ligament was dissected immediately adjacent to the rectal wall. The development of the paravesical space along the superior vesical artery to the top and posterior to the bladder was done to isolate the origin of the uterine artery, which was cauterized and divided centrifugally adjacent to the internal iliac artery. We developed the ureter tunnel according to established methods and cut the anterior leaf of the vesicocervical ligament. We then separated and laterally shifted the ureter. By extirpation of the superior fatty and lymph tissues, the DUV was isolated to where it emits the vesical and cervical branches, at which plane the paracervical space was developed. The posterior leaf of the vesicocervical ligament was cut, preserving the bladder branches of the DUV and the nervous tissues below. We cut the cervical branch of the DUV and the vascular portion of the cardinal ligament (CL) between the pararectal space and paracervical space. We also cut the vessels in the paracolpium and ligated them at the appropriate plane. After performing the same procedure on the opposite side, the uterus was amputated, leaving 3–4 cm of the vagina intact.