open access

Vol 80, No 1 (2021)
Original article
Submitted: 2020-02-07
Accepted: 2020-02-16
Published online: 2020-03-18
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Anatomy of the superior hypogastric plexus and its application in nerve-sparing paraaortic lymphadenectomy

H. Kim1, Y. S. Nam, U.-Y. Lee, I.-B. Kim, Y.-S. Kim
·
Pubmed: 32207848
·
Folia Morphol 2021;80(1):70-75.
Affiliations
  1. Department of Anatomy, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-Gu, 06591 Seoul, Korea, Republic Of

open access

Vol 80, No 1 (2021)
ORIGINAL ARTICLES
Submitted: 2020-02-07
Accepted: 2020-02-16
Published online: 2020-03-18

Abstract

Background: The purpose of this study was to clarify the anatomy of the superior hypogastric plexus, which would contribute to advancement of nerve-sparing paraaortic lymphadenectomy.

Materials and methods: Eighteen cadavers were dissected and morphometrically analysed based on photographic images. Anatomical landmarks such as aortic bifurcation, transitional points of abdominal aorta to bilateral common iliac arteries, and cross point of the right ureter and pelvic brim, and cross point of sigmoid mesentery and pelvic brim were selected as reference points.

Results: The left lowest lumbar splanchnic nerve was located more laterally to transitional point of abdominal aorta to in 11/18 specimens, whereas the right lowest lumbar splanchnic nerve passed onto the right transitional point in only one specimen. The lowest lumbar splanchnic nerves or the superior hypogastric plexus covered the aortic bifurcation in 11/18 specimens. The superior hypogastric plexus was separate from the cross point of right ureter and pelvic brim as well as cross point of sigmoid mesentery and pelvic brim.

Conclusions: The superior hypogastric plexus is at risk of injury during paraaortic lymphadenectomy because of its topography. Preservation of the superior hypogastric plexus regarding its anatomic basis during paraaortic lymphadenectomy is required.

Abstract

Background: The purpose of this study was to clarify the anatomy of the superior hypogastric plexus, which would contribute to advancement of nerve-sparing paraaortic lymphadenectomy.

Materials and methods: Eighteen cadavers were dissected and morphometrically analysed based on photographic images. Anatomical landmarks such as aortic bifurcation, transitional points of abdominal aorta to bilateral common iliac arteries, and cross point of the right ureter and pelvic brim, and cross point of sigmoid mesentery and pelvic brim were selected as reference points.

Results: The left lowest lumbar splanchnic nerve was located more laterally to transitional point of abdominal aorta to in 11/18 specimens, whereas the right lowest lumbar splanchnic nerve passed onto the right transitional point in only one specimen. The lowest lumbar splanchnic nerves or the superior hypogastric plexus covered the aortic bifurcation in 11/18 specimens. The superior hypogastric plexus was separate from the cross point of right ureter and pelvic brim as well as cross point of sigmoid mesentery and pelvic brim.

Conclusions: The superior hypogastric plexus is at risk of injury during paraaortic lymphadenectomy because of its topography. Preservation of the superior hypogastric plexus regarding its anatomic basis during paraaortic lymphadenectomy is required.

Get Citation

Keywords

lowest lumbar splanchnic nerves, nerve-sparing surgery, superior hypogastric plexus

About this article
Title

Anatomy of the superior hypogastric plexus and its application in nerve-sparing paraaortic lymphadenectomy

Journal

Folia Morphologica

Issue

Vol 80, No 1 (2021)

Article type

Original article

Pages

70-75

Published online

2020-03-18

Page views

1692

Article views/downloads

3399

DOI

10.5603/FM.a2020.0037

Pubmed

32207848

Bibliographic record

Folia Morphol 2021;80(1):70-75.

Keywords

lowest lumbar splanchnic nerves
nerve-sparing surgery
superior hypogastric plexus

Authors

H. Kim
Y. S. Nam
U.-Y. Lee
I.-B. Kim
Y.-S. Kim

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