Scribd Logo
Upload

Welcome to Scribd!

  • 120 views

    Retroperitoneal Anatomy in Gynaecology

    Uploaded by

    Shashidhara Puttaraj
    The document discusses the retroperitoneal anatomy relevant to gynecologic laparoscopic surgery. It describes the superficial and deeper layers of the anterior abdominal wall, pelvic brim, pelvic side wall, and avascular spaces. Applied anatomy is discussed for procedures like Burch urethropexy, mesh fixation, radical hysterectomy, and lymph node dissection. A thorough understanding of retroperitoneal anatomy is essential for advanced laparoscopic gynecologic surgery.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    Retroperitoneal Anatomy in Gynaecology

    Uploaded by

    Shashidhara Puttaraj
    120 views45 pages
    The document discusses the retroperitoneal anatomy relevant to gynecologic laparoscopic surgery. It describes the superficial and deeper layers of the anterior abdominal wall, pelvic brim, pelvic side wall, and avascular spaces. Applied anatomy is discussed for procedures like Burch urethropexy, mesh fixation, radical hysterectomy, and lymph node dissection. A thorough understanding of retroperitoneal anatomy is essential for advanced laparoscopic gynecologic surgery.

    Original Description:

    Gynaecological Laparoscopy

    Copyright

    © © All Rights Reserved

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The document discusses the retroperitoneal anatomy relevant to gynecologic laparoscopic surgery. It describes the superficial and deeper layers of the anterior abdominal wall, pelvic brim, pelvic side wall, and avascular spaces. Applied anatomy is discussed for procedures like Burch urethropexy, mesh fixation, radical hysterectomy, and lymph node dissection. A thorough understanding of retroperitoneal anatomy is essential for advanced laparoscopic gynecologic surgery.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    120 views45 pages

    Retroperitoneal Anatomy in Gynaecology

    Uploaded by

    Shashidhara Puttaraj
    The document discusses the retroperitoneal anatomy relevant to gynecologic laparoscopic surgery. It describes the superficial and deeper layers of the anterior abdominal wall, pelvic brim, pelvic side wall, and avascular spaces. Applied anatomy is discussed for procedures like Burch urethropexy, mesh fixation, radical hysterectomy, and lymph node dissection. A thorough understanding of retroperitoneal anatomy is essential for advanced laparoscopic gynecologic surgery.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    You are on page 1of 45

    Laparoscopic

    Retroperitoneal Anatomy
    in
    Gynaecologic Surgery
    Superficial intraperiotoneal
    anatomy
    Landmark of anterior abdominal wall
    • Inferior epigastric artery
    • Medial umbilical ligament/obliterated
    umbilical artery
    • Median umbilical ligament/urachus
    Pelvic brim
    Superficial
    • Pelvic peritoneum
    • Ovarian vessels in the infundibulopelvic
    ligament
    • Ureters
    • Bifurcation of common iliac artery and
    common iliac vein
    Deeper
    • Medial edge of psoas muscle
    • Obturator nerve
    • Lumbosacral trunk
    Pelvic side wall
    First layer prietal peritoneum with ureter attached to it
    Second layer consists of internal iliac vs with visceral
    branches- uterine,superior vesical,inferior vesical,vaginal and
    middle rectal arteries
    Third layer
    • psoas muscle
    • External iliac artery and vein
    • Obturator internus muscle with its nerve and vs coursing
    towards obturator canal
    Avascular spaces
    • Prevesical space of Retzius
    • Paravesical space
    • Pararectal space
    • Vesicovaginal space
    • Rectovaginal space
    • Presacral space
    Applied anatomy of space of
    Retzius
    Space is bounded anteriorly by transversalis fascia, urethra, paraurethral ligament and
    bladder neck forms floor,Pubic symphysis ,superior pubic rami with coopers
    ligament(pectineus ligament) represents inferior limit.

    Management of stress urinary incontinence


    Burch urethropexy
    post
    hysterectomy
    fixation of mesh
    Applied anatomy
    • Fixation of posterior mesh (vault prolapse)
    • Laparoscopic treatment of rectovaginal
    septum adenomyosis/endometriosis
    • Laparoscopic management of deep
    endometriosis
    • Radical hysterectomy for carcinoma cervix
    Rresection of
    endometriotic
    deposits
    Applied anatomy
    • Laparoscopic sling surgery
    • promontofixation (post hysterectomy vault
    prolapse)
    Laparoscopic
    radical
    hysterectomy
    Lymphatic drainage
    • Pelvic lymph nodes external pelvic nodes along ext iliac vs
    • Obturator nodes in the obturator fossa
    • Hypogastric nodes along hypogastric vs .up to the
    bifurcation of common iliac artery
    • Lumber lymph nodes(above,lateral and below aorta on Lt. and
    inferior venacava on Rt.)
    • Applied anatomy-laparoscopic radical
    hysterectomy for early stage cervical cancer
    • Surgical staging of carcinoma vulva,ovary and
    endometrium.
    conclusion
    Knowledge of the retroperitoneal anatomy is
    essential to the success
    in advanced gynecologic laparoscopic surgery.

    The anatomical advantage of laparoscopy is a


    wonderful tool
    for progress in pelvic surgery.

    You might also like