已入深夜,您辛苦了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!祝你早点完成任务,早点休息,好梦!

Easy Standardized Technique for Dissection of the Anterior Leaf of the Vesicouterine Ligament

医学 韧带 解剖(医学) 解剖 输尿管 髂外静脉 淋巴结切除术 静脉 髂内动脉 子宫动脉 外科 淋巴结 生物 怀孕 病理 遗传学 妊娠期
作者
Kenro Chikazawa,Ken Imai,Tomoyuki Kuwata,Ryo Konno
出处
期刊:Gynecology and Minimally Invasive Therapy [Medknow]
卷期号:13 (3): 198-199
标识
DOI:10.4103/gmit.gmit_154_23
摘要

OBJECTIVE Standardizing surgical techniques is difficult. However, achieving standardization, maintaining the adequacy of radical procedures, and adhering to the principles of oncologic concepts are crucial in treating cervical cancer and obtaining high survival rates.[1-3] Dissecting the anterior leaf of the vesicouterine ligament is notably difficult and hemorrhage-prone; thus, skeletonizing the uterine artery and vesicouterine ligament is emphasized.[4] The anterior leaf of the vesicouterine ligament receives branches from the uterine artery and the superior vesical vein; these branches ultimately drain into the superficial uterine vein [Figure 1].[5,6] The arteries, veins, lymphatics, and nerves form a net-like arrangement around the ureter. To dissect the anterior leaf of the vesicouterine ligament, it is useful to suspend the umbilical artery. In addition, a precise and complete lymphadenectomy should be performed on the lateral iliac, internal iliac, and cardinal ligament lymph nodes. The central and lateral sides of the ureter are located farther from the vesicouterine ligament, thereby creating some distance between the ureter and potential sources of hemorrhage (primarily lymph and vesical vein). Dissecting lymph nodes facilitates the identification of anatomical structures around the ureter, thus simplifying hemostasis.[7]Figure 1: The anterior leaf of the vesicouterine ligament is supplied by the uterine artery and superior vesical vein, draining into the superficial uterine vein. Precision in lymphadenectomy is vital for ligament dissection, reducing hemorrhage risk. Lymph node dissection allows the identification of ureteral anatomical structures, simplifying hemostasis http://www.apagemit.com/page/video/show.aspx?num=315&kind=2&page=1DESIGN A step-by-step explanation of the procedure with surgical video footage [Video]. PATIENT A Japanese female patient diagnosed with early-stage cervical cancer. INTERVENTIONS The standardized procedure was as follows: Lymph nodes were dissected starting from the internal iliac artery and subsequently from the internal iliac vein The internal iliac nodes run along the hypogastric nerves, which innervate the rectum, uterus, and bladder. The lymph nodes were dissected from the hypogastric nerve/ureterohypogastric fascia and branches of the hypogastric nerves up to the rectum The umbilical artery was suspended; however, the uterine artery was not resected. This suspension caused traction between the ureter and uterine artery, as well as between the ureter and superior vesical artery. This technique helps surgeons to easily dissect the ureter branch Subsequently, the cardinal ligament lymph nodes and connective tissue between the uterine artery and superior vesical artery were dissected Direct resection of the cervicovesical vessels is considered dangerous and is, therefore, not performed. Before resecting these vessels, the bladder was further dissected toward the medial side of the cervicovesical vessels. It is crucial to dissect the loose connective tissue from both sides of these vessels. RESULTS This easy, safe, and standardized technique enabled the successful dissection of the anterior vesicouterine ligament. CONCLUSION We presented our standardized method for resecting the anterior leaf of the vesicouterine ligament. This video can guide gynecologists in performing radical hysterectomies. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patients have given their consent for their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. The study was approved by The Institutional Review Board (approval No.S23-107). Author contributions Kenro Chikazawa: Conceptualization, Methodology, Original draft preparation. Ken Imai: Data curation, Visualization, Conceptualization. Tomoyuki Kuwata: Supervision. Ryo Konno: Writing- Reviewing and Editing. Data availability statement Data sharing not applicable to this article as no datasets were generated or analyzed during the current study. Financial support and sponsorship Nil. Conflicts of interest K. Chikazawa received lecture honoraria from Ethicon (Tokyo, Japan), Terumo (Tokyo, Japan), and Chugai Pharmaceutical Co. (Tokyo, Japan). K. Imai received lecture honoraria from AstraZeneca (Tokyo, Japan). R. Konno received research funds from Yakult Pharmaceutical Industry Co. (Tokyo, Japan) and Chugai Pharmaceutical Co. (Tokyo, Japan) and lecture honoraria from Japan Vaccine Co. (Tokyo, Japan), MSD Japan (Tokyo, Japan), and Chugai Pharmaceutical Co. (Tokyo, Japan). The funding organizations did not contribute to the design or outcome of the study. The remaining authors declare that they have no conflicts of interest.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
3秒前
俊逸海豚完成签到 ,获得积分10
4秒前
隐形曼青应助chen采纳,获得10
5秒前
kangw完成签到,获得积分20
6秒前
曹大壮发布了新的文献求助10
7秒前
小谢完成签到,获得积分10
8秒前
饭ff发布了新的文献求助10
8秒前
执着的冬瓜完成签到 ,获得积分10
8秒前
10秒前
11秒前
DAYDAY完成签到 ,获得积分10
16秒前
16秒前
xcf驳回了orixero应助
17秒前
Nowind发布了新的文献求助10
18秒前
19秒前
20秒前
111完成签到,获得积分10
20秒前
健壮保温杯完成签到,获得积分10
23秒前
东华帝君完成签到,获得积分10
23秒前
漂亮白枫发布了新的文献求助10
25秒前
Nowind完成签到,获得积分10
26秒前
27秒前
28秒前
29秒前
曹大壮完成签到,获得积分10
29秒前
兆兆完成签到 ,获得积分10
31秒前
edisondc发布了新的文献求助10
32秒前
菜头完成签到,获得积分10
35秒前
37秒前
39秒前
Smiling应助文茵采纳,获得10
40秒前
星辰大海应助饭ff采纳,获得10
40秒前
42秒前
wab完成签到,获得积分0
42秒前
酷波er应助雪白的夏山采纳,获得10
44秒前
leezh完成签到,获得积分10
45秒前
Trtr7985发布了新的文献求助10
46秒前
慕青应助漂亮白枫采纳,获得10
47秒前
华仔应助VIAI采纳,获得10
52秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
Aktuelle Entwicklungen in der linguistischen Forschung 300
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989868
求助须知:如何正确求助?哪些是违规求助? 3531994
关于积分的说明 11255752
捐赠科研通 3270793
什么是DOI,文献DOI怎么找? 1805053
邀请新用户注册赠送积分活动 882215
科研通“疑难数据库(出版商)”最低求助积分说明 809208