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Inferior hypogastric plexus

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https://www.readbyqxmd.com/read/28708591/an-improved-nerve-sparing-radical-hysterectomy-technique-for-cervical-cancer-using-the-paravesico-vaginal-space-as-a-new-surgical-landmark
#1
Yuqin Zhang, Tingyan Shi, Sheng Yin, Sining Ma, Di Shi, Jun Guan, Libing Xiang, Yang Liu, Yulan Ren, Deyan Tan, Rongyu Zang
Bladder dysfunction remains a major postoperative challenge for early stage cervical cancer patients. The present prospective phase 2 trial in patients with stage IB1 and IIA1 cervical cancer follows up on our previous, unpublished work describing a new surgical landmark, the paravesico-vaginal space. We describe a novel nerve-sparing radical hysterectomy (NSRH) approach to treat early stage cervical cancer without compromising local control rate or survival. Between September 2015 and August 2016, 49 patients were enrolled to receive NSRH...
July 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28676368/interventional-management-for-pelvic-pain
#2
REVIEW
Ameet S Nagpal, Erika L Moody
Interventional procedures can be applied for diagnostic evaluation and treatment of the patient with pelvic pain, often once more conservative measures have failed to provide relief. This article reviews interventional management strategies for pelvic pain. We review superior and inferior hypogastric plexus blocks, ganglion impar blocks, transversus abdominis plane blocks, ilioinguinal, iliohypogastric and genitofemoral blocks, pudendal nerve blocks, and selective nerve root blocks. Additionally, we discuss trigger point injections, sacroiliac joint injections, and neuromodulation approaches...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28537567/intraoperative-neuromonitoring-of-hypogastric-plexus-branches-during-surgery-for-rectal-cancer-preliminary-report
#3
Piotr Wałęga, Michał Romaniszyn, Maciej Wałęga, Jarosław Szymon Świrta, Wojciech Nowak
AIM: The aim of this study was to present our preliminary experience with intraoperative neuromonitoring during rectal resection. MATERIALS AND METHODS: We qualified 4 patients (2 women, 2 men; age 42 - 53 years) with rectal cancer for surgery with intraoperative neuromonitoring. In all patients, functional tests of the anorectal area were performed before surgery. Action potentials from the sphincter complex in response to nerve fiber stimulation were recorded with electrodes implanted before surgery...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28463672/genito-urinary-function-and-quality-of-life-after-elective-totally-laparoscopic-sigmoidectomy-after-at-least-one-episode-of-complicated-diverticular-disease-according-to-two-different-vascular-approaches-the-ima-low-ligation-or-the-ima-preservation
#4
RANDOMIZED CONTROLLED TRIAL
Giulio Mari, Jacopo Crippa, Andrea Costanzi, Michele Mazzola, Carmelo Magistro, Giovanni Ferrari, Dario Maggioni
The arterial ligation during elective laparoscopic sigmoidectomy for diverticular disease can affect genito-urinary function injuring the superior hypogastric plexus, and can weaken the distal colonic stump arterial perfusion. Ligation of the inferior mesenteric artery distal to the left colic artery or the complete preservation of the inferior mesenteric artery can therefore be compared in terms of preservation of the descending sympathetic fibres running along the aorta to the rectum resulting in a different post operative genito urinary function...
March 2017: Chirurgia
https://www.readbyqxmd.com/read/28323222/laparoscopic-nerve-preserving-sacropexy
#5
Alfredo Ercoli, Stefano Cosma, Francesca Riboni, Giuseppe Campagna, Paolo Petruzzelli, Daniela Surico, Saverio Danese, Giovanni Scambia, Chiara Benedetto
STUDY OBJECTIVE: To demonstrate our developed nerve-preserving technique during laparoscopic sacropexy (LSP) for multicompartment pelvic organ prolapse. DESIGN: A step-by-step demonstration of our surgical procedure on video (Canadian Task Force classification II-2). Informed consent was obtained from the subject, and the applicable Institutional Review Board provided approval. SETTING: Although sacropexy does remain the 'gold standard' procedure for apical prolapse [1], the subjective outcome of the procedure has been reported to be not so satisfactory as its anatomic outcome [2]...
March 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28154838/surgical-anatomy-of-the-ligamentous-mesometrium-and-robotically-assisted-icg-guided-resection-in-cervical-cancer
#6
Rainer Kimmig, Paul Buderath, Peter Rusch, Bahriye Aktas
The ligamentous mesometrium is a 3-dimensional structure consisting of a rectouterine/-vaginal part with attachment to the anterior lateral mesorectum and a sacrouterine part surrounding the mesorectum attached to the pelvic fascia and the mesorectum dorsolaterally. The lymphatic network draining the posterior cervix connected caudally ventrally to the deep venous lymph network of the vascular mesometrium is running at the lateral surface of the sacrouterine part and dorsomedially of the inferior hypogastric plexus; it drains to the deep internal iliac, prespinal and preischiadic nodes...
May 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/27956200/anatomic-relationships-of-the-pelvic-autonomic-nervous-system-in-female-cadavers-clinical-applications-to-pelvic%C3%A2-surgery
#7
Christopher M Ripperda, Lindsey A Jackson, John N Phelan, Kelley S Carrick, Marlene M Corton
BACKGROUND: The integrity of the pelvic autonomic nervous system is essential for proper bowel, bladder, and sexual function. OBJECTIVE: The purpose of this study was to characterize the anatomic path of the pelvic autonomic system and to examine relationships to clinically useful landmarks. STUDY DESIGN: Detailed dissections were performed in 17 female cadavers. Relationships of the superior hypogastric plexus to aortic bifurcation and midpoint of sacral promontory were examined; the length and width of plexus was documented...
April 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27813139/levator-ani-muscle-innervation-anatomical-study-in-human-fetus
#8
Krystel Nyangoh Timoh, Thomas Bessede, Cedric Lebacle, Mazen Zaitouna, Jelena Martinovic, Djibril Diallo, Maud Creze, Jean-Marc Chevallier, Emile Darai, Gérard Benoît, David Moszkowicz
AIMS: To characterize the nature and function of the levator ani muscle innervation pathways and to perform a comprehensive three-dimensional reconstruction of female pelvic innervation. METHODS: A computer-assisted anatomical dissection protocol was applied to seven female human fetuses, after approval from the national biomedicine agency. Specimens were serially sectioned and immunostained for overall (antibody against protein S100), somatic (antibody against peripheral myelin protein 22), adrenergic (antibody against tyrosine hydroxylase), cholinergic (antibody against vesicular acetylcholine transferase), and nitrergic (antibody against the neural isoform of nitric oxide synthase) nerve fibers...
August 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27672677/left-paraaortic-inframesenteric-lymphadenectomy-preserving-the-superior-hypogastric-plexus-supported-by-indocyanine-green-icg-labeling-of-the-lymphatic-compartment-in-cervical-cancer
#9
Rainer Kimmig, Peter Rusch, Paul Buderath, Bahriye Aktas
Superior hypogastric plexus (SHG) contains mainly sympathetic and most probably also postganglionic parasympathetic fibers. Thus, surgical damage of SHG may cause autonomic pelvic organ dysfunction (Kraima et al., 2015). As already shown for rectal cancer, preservation of the autonomic nerves is facilitated by robotic surgery and may avoid sexual dysfunctions and voiding disorders (Kim et al., 2015). In this educational video, we demonstrate left lower paraaortic lymph node dissection preserving the SHG using ICG fluorescence to label the lymphatic compartment...
November 2016: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/27614758/laparoscopic-fixation-of-the-vaginal-cuff-to-the-uterosacral-ligaments-at-the-time-of-hysterectomy
#10
Kazuaki Nishimura, Kazuaki Yoshimura, Kaori Hoshino, Toru Hachisuga
INTRODUCTION AND HYPOTHESIS: Transvaginal ipsilateral uterosacral ligament colpopexy for pelvic organ prolapse (POP), which was reported by Shull et al. (Shull's colpopexy) in 2000, is one of the most frequently performed non-mesh pelvic floor reconstructive surgical procedures. Despite its excellent anatomical outcomes, ureteral injury and difficulty in uterosacral ligament detection (especially in patients with severe POP) are typical issues with this procedure. METHOD: This video demonstrates the procedure in a 58-year-old woman, gravida 2 para 2, with POP-Q stage II uterine prolapse and stage I cystocele...
February 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/27568405/-anatomical-consideration-for-the-technique-of-nerve-sparing-during-radical-hysterectomy-for-cervical-cancer
#11
V Balaya, C Ngo, L Rossi, C Cornou, C Bensaid, R Douard, A S Bats, F Lecuru
Radical hysterectomy (RH) is an effective treatment for early-stage cervical cancer IA2 to IIA1 but RH is often associated with several significant complications such as urinary, anorectal and sexual dysfunction due to pelvic nerve injuries. Pelvic autonomic nerves including the superior hypogastric plexus (SHP), hypogastric nerves (HN), pelvic splanchnic nerves (PSN), sacral splanchnic nerves (SSN), inferior hypogastric plexus (IHP) and efferent branches of the IHP. We aimed to precise the neuroanatomy of the female pelvis in order to provide key-points of surgical anatomy to improve NSRH for cervical cancer...
September 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27118342/-deep-infiltrating-endometriosis-surgical-management-and-pelvic-nerves-injury
#12
M Fermaut, K Nyangoh Timoh, C Lebacle, D Moszkowicz, G Benoit, T Bessede
OBJECTIVES: Deep pelvic endometriosis surgery may need substantial excisions, which in turn expose to risks of injury to the pelvic nerves. To limit functional complications, nerve-sparing surgical techniques have been developed but should be adapted to the specific multifocal character of endometriotic lesions. The objective was to identify the anatomical areas where the pelvic nerves are most at risk of injury during endometriotic excisions. METHODS: The Medline and Embase databases have been searched for available literature using the keywords "hypogastric nerve or hypogastric plexus [Mesh] or autonomic pathway [Mesh], anatomy, endometriosis, surgery [Mesh]"...
May 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27101584/careful-dissection-of-the-distal-ureter-is-highly-important-in-nerve-sparing-radical-pelvic-surgery-a-3d-reconstruction-and-immunohistochemical-characterization-of-the-vesical-plexus
#13
Anne C Kraima, Marloes Derks, Noeska N Smit, Cornelis J H van de Velde, Gemma G Kenter, Marco C DeRuiter
OBJECTIVE: Radical hysterectomy with pelvic lymphadenectomy (RHL) is the preferred treatment for early-stage cervical cancer. Although oncological outcome is good with regard to recurrence and survival rates, it is well known that RHL might result in postoperative bladder impairments due to autonomic nerve disruption. The pelvic autonomic network has been extensively studied, but the anatomy of nerve fibers branching off the inferior hypogastric plexus to innervate the bladder is less known...
June 2016: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/27029753/single-port-laparoscopic-transperitoneal-infrarenal-para-aortic-lymphadenectomy-as-part-of-staging-operation-for-early-ovarian-cancer-and-high-grade-endometrial-cancer
#14
Yoon Soon Lee
OBJECTIVE: The aim of this paper was to demonstrate the techiniqes of single-port laparoscopic transperitoneal infrarenal paraaortic lymphadenectomy as part of surgical staging procedure in case of early ovarian cancer and high grade endometrial cancer. METHODS: After left upper traction of rectosigmoid, a peritoneal incision was made caudad to inferior mesenteric artery. Rectosigmoid was mobilized, and then the avascular space of the lateral rectal portion was found by using upward traction of rectosigmoid mesentery...
May 2016: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/26952718/anatomical-basis-of-the-coordination-between-smooth-and-striated-urethral-and-anal-sphincters-loops-of-regulation-between-inferior-hypogastric-plexus-and-pudendal-nerve-immuno-histological-study-with-3d-reconstruction
#15
M M Bertrand, B Alsaid, S Droupy, J Ripoche, G Benoit, P Adalian, C Brunet, M D Piercecchi-Marti, M Prudhomme
PURPOSE: (1) Describe both nervous pathways to the sphincters, and highlight the anatomical support of their coordination. (2) Obtain a 3D representation of this complex innervation system. METHODS: A computer-assisted anatomical dissection technique was used. Serial histological sections were cut in the pelvis of four female human foetuses (aged 19-32 weeks of gestation). The sections were treated with conventional staining, and with seven different immunostainings...
October 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/26690361/concepts-of-the-rectovaginal-septum-implications-for-function-and-surgery
#16
REVIEW
Charles Dariane, David Moszkowicz, Frédérique Peschaud
INTRODUCTION: In the pelvis, the rectogenital septum (RGS) separates the urogenital compartment from the digestive compartment. In men, it corresponds to Denonvilliers' rectoprostatic fascia or rectovesical septum (RVS). Its purpose-and, indeed, its existence-are controversial in women. The purpose of this review was to update knowledge about the RGS in women and, in particular, to clarify its relationship to pelvic nerves in order to deduce practical consequences of pelvic surgery and compare it to the RVS in men...
June 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/26415858/bladder-symptoms-and-urodynamic-observations-of-patients-with-endometriosis-confirmed-by-laparoscopy
#17
COMPARATIVE STUDY
Pierre Panel, Cyrille Huchon, Sonia Estrade-Huchon, Arnaud Le Tohic, Xavier Fritel, Arnaud Fauconnier
INTRODUCTION AND HYPOTHESIS: Patients with deep infiltrating pelvic endometriosis (DIE) often describe having lower urinary tract symptoms (LUTS). Bladder pain syndrome in women is also often associated with endometriosis. In this study, we aimed to describe the characteristics of LUTS and urodynamic observations in patients with posterior endometriosis versus those with posterior and anterior endometriosis. METHODS: This was a prospective observational study of 30 patients from two gynecologic surgical settings with experience in DIE surgery...
March 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/26260200/laparoscopic-anatomy-of-the-autonomic-nerves-of-the-pelvis-and-the-concept-of-nerve-sparing-surgery-by-direct-visualization-of-autonomic-nerve-bundles
#18
Nucelio Lemos, Caroline Souza, Renato Moretti Marques, Gil Kamergorodsky, Eduardo Schor, Manoel J B C Girão
OBJECTIVE: To demonstrate the laparoscopic neuroanatomy of the autonomic nerves of the pelvis using the laparoscopic neuronavigation technique, as well as the technique for a nerve-sparing radical endometriosis surgery. DESIGN: Step-by-step explanation of the technique using videos and pictures (educational video) to demonstrate the anatomy of the intrapelvic bundles of the autonomic nerve system innervating the bladder, rectum, and pelvic floor. SETTING: Tertiary referral center...
November 2015: Fertility and Sterility
https://www.readbyqxmd.com/read/26108760/-techniques-of-autonomic-nerve-preservation-in-laparoscopic-radical-resection-for-rectal-cancer
#19
Hongbo Wei, Zongheng Zheng
Pelvic autonomic nerve is a three-dimensional structure surrounding the rectum. There are several key points related to nerve injury during laparoscopic radical resection for rectal cancer. Hypogastric nerve has close relation with the upper and middle part of the rectum. Combined with S2-S4 pelvic splanchnic nerve, hypogastric nerve forms pelvic plexus. Incorrect operation in pelvic parietal peritoneum during dissection of upper rectum will lead to nerve injury. When performing dissection of inferior mesenteric artery, bilateral nerve tracts should be pushed to posterior abdominal wall and anterior fascia of the abdominal aorta should be well protected to avoid nerve injury...
June 2015: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/25872326/nerve-sparing-radical-hysterectomy-in-early-stage-cervical-cancer-latest-developments-and-review-of-the-literature
#20
REVIEW
A Kavallaris, D Zygouris, A Dafopoulos, I Kalogiannidis, E Terzakis
BACKGROUND: Cervical cancer is the second most common malignancy of the female genital tract worldwide. Radical hysterectomy with pelvic lymphadenectomy exemplifies the treatment of choice for early stage disease, whereas even if it is performed by gynaecologist-oncologist, still has the drawback of significant postoperative morbidity, especially for urinary bladder function. Nerve-sparing radical hysterectomy (NSRH) is a technique in which the neural part of the cardinal ligament which encloses the inferior hypogastric plexus, as well as the bladder branch (distal part of the plexus), remains intact...
2015: European Journal of Gynaecological Oncology
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