1 / 82

Pelvic Anatomy from a Laparoscopic Perspective

Pelvic Anatomy from a Laparoscopic Perspective. Tommaso Falcone MD Professor & Chairman Cleveland Clinic Foundation. Anatomy & Advanced Laparoscopic Surgery Course. Anatomic Areas. Anterior abdominal wall Pelvic sidewall Extra-peritoneal spaces Retropubic space Presacral space

Download Presentation

Pelvic Anatomy from a Laparoscopic Perspective

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Pelvic Anatomy from a Laparoscopic Perspective • Tommaso Falcone MD • Professor & Chairman • Cleveland Clinic Foundation

  2. Anatomy & Advanced Laparoscopic Surgery Course

  3. Anatomic Areas • Anterior abdominal wall • Pelvic sidewall • Extra-peritoneal spaces • Retropubic space • Presacral space • Pararectal space

  4. Anterior Abdominal Wall • Relationship of the vessels & nerves to potential entry sites for trocars

  5. Retroperitoneal Vessels & Umbilicus • Bifurcation of the aorta • thin patients at umbilicus • More caudad with increasing weight • Left common iliac vein • inferior to the bifurcation of the aorta • crosses the sacrum

  6. Left Upper Quadrant Insertion • 2-cm below the subcostal margin mid-clavicular line • Organs • Aorta-11 cm • Spleen-12cm • Stomach-4.4cm • Liver-4.0cm • Left kidney 13.2cm

  7. Laparoscopic view of the spleen • Spleen is far from the LUQ, unless splenomegaly is present

  8. Pelvic Sidewall Anatomy • 3 layers • Ureter • Branches of the int.iliac artery • Muscle & nerve

  9. Pelvic Sidewall: ureter • Pelvic brim • over the common or external iliac • under ovarian vessels • Courses anterior to the internal iliac • UNDER THE OVARY • 1.5 -2 CM LATERAL UTERO-SACRAL LIGAMENTS • Cervix • WITHIN 2CM

  10. Pelvic Sidewall: Blood vessels • Internal iliac artery • anterior & posterior division • Umbilical artery • obliterated • medial umbilical ligament • relationship to the uterine artery

  11. Pelvic Arteriogram

  12. Pelvic & Inguinal Nerves • Genito-femoral nerve • Femoral nerve

  13. Retropubic Space • Anterior • Pubic bone • Lateral • Obturator internus muscle, fasciae, neurovascular bundle • Posteriorly • bladder & pubocervical fasciae

More Related