Description

Objective

Endometriosis is a challenging condition, which may disrupt, severely, normal pelvic anatomy. Its surgical treatment may be considered one of the hardest procedures among all gynecological surgeries. Our goal is to describe and demonstrate some important and practical anatomical features of the posterior compartment from a laparoscopic perspective.

Methods

Video abstract illustrating a step by step approach developing the paths to unravel surgical procedures, identifying and recognizing important anatomical structures (Video 1).

Video 1: Anatomical Features of the Posterior Compartment

Results

The MCN branches to the coracobrachialis, biceps, and brachialis muscles arise at approximately 17%, 45%, and 60% of the distance between the coracoid process and the medial epicondyle. Intraneural dissection revealed that sensory fascicles occupied the medial segment of the MCN at the proximal level and the lateral segment at the distal level. In contrast, motor fascicles occupied the anterolateral, lateral, and posterior segments of the MCN at the proximal level and the medial segment at the distal level [1-4].

Conclusion

Some basic rules should be followed in order to achieve a good,Safe and complete result in endometriosis surgery. Deep anatomical knowledge is crucial. Vascular, urinary and innervation landmarks must be recognized and reached when needed.

References

1. Balaya V, Metzger U, Lecuru F (2016) [Ultrasonographic features in the preoperative diagnosis of primitive fallopian tube carcinoma]. J Gynecol Obstet Biol Reprod (Paris) 45(1): 11-20.
2. Ceccaroni M, Clarizia R, Roviglione G, Ruffo G (2013) Neuro-anatomy of the posterior parametrium and surgical considerations for a nerve-sparing approach in radical pelvic surgery. Surg Endosc 27(11): 4386-94.
3.  Kanao H, Fujiwara K, Ebisawa K, Hada T, Ota Y, et al. (2014) Various types of total laparoscopic nerve-sparing radical hysterectomies and their effects on bladder function. J Gynecol Oncol 25(3): 198-205.
4. Baggish M, Karram M (2015) Atlas of Pelvic Anatomy and Gynecologic Surgery. 4th ed: Elsevier: 1408 p.