Alumi Laparoscopic Discussion Board

Hypogastric artery injury radical hysterectomy
Discussion in 'All Categories' started by Dr Catherine Mullen - Jul 23rd, 2016 8:12 am.
Dr Catherine Mullen
Dr Catherine Mullen

My field of interest is radical hysterectomy. Although other methods can stem hemorrhage in patients who undergo radical hysterectomy and lymphadenectomy but my question is how to avoid injury of hypogastric artery during this surgery.
re: Hypogastric artery injury radical hysterectomy by Dr R K Mishra - Jul 24th, 2016 8:33 am
Dr R K Mishra
Dr R K Mishra
Dear Dr Catherin

Thanks for your good question. Radical hysterectomy with pelvic lymphadenectomy remains the treatment of choice for women with Stages IA2 and IB1 carcinoma of the cervix, and selected patients with Stage II endometrial cancer.

During Radical hysterectomy and lymphadenectomy uterine artery has to be ligated near its origin from internal iliac and surrounding lymph node has to be removed and this is the time when it get accidently injured. In open surgery you can palpate it but in laparoscopic surgery due to tactile feedback you need to see it by careful dissection.

Following measure can reduce the incidence of injury.

1. Correct knowledge of Anatomy
2. Good quality 3 Chip High definition camera.
3 Tracing the Internal iliac just above where ureter is crossing the common iliac.
4 Avoiding excessive sharp dissection (Using more blunt dissection)
5. it is essential for gynecologist to be aware of the technique of internal iliac artery ligation. Pelvic ischemia due to bilateral hypogastric artery ligation was once a fear among gynecologists, but it has been shown by evidenced based surgery that little morbidity, either short-term or long-term, results if the procedure is performed appropriately.
re: Hypogastric artery injury radical hysterectomy by Dr Alsha - Sep 10th, 2016 11:05 pm
Dr Alsha
Dr Alsha
Why The internal iliac artery is called the hypogastric artery?
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