open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2020-03-18
Submitted: 2020-02-07
Accepted: 2020-02-16
Get Citation

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

H. Kim, Y. S. Nam, U.-Y. Lee, I.-B. Kim, Y.-S. Kim
DOI: 10.5603/FM.a2020.0037
·
Pubmed: 32207848

open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2020-03-18
Submitted: 2020-02-07
Accepted: 2020-02-16

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 analyzed 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 SHP 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 analyzed 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 SHP 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

Ahead of Print

Published online

2020-03-18

DOI

10.5603/FM.a2020.0037

Pubmed

32207848

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

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By  "Via Medica sp. z o.o." sp.k., Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl