| [ Summary ] |
In function-preserving operations of the recturn, precise knowledge of the topographical anatomy of the autonomic nerves, blood vessels and lymphatics is crucial. Due to the limited operational field the structural relationships in the pelvis are difficult to view especially during surgery. Minute dissection from a lateral aspect, after removal of the hip bones, enables us to have a clear view of the composition, course and distribution of the nerves, blood vessels and lymphatics within the pelvis. A general review of the above-mentioned structures is given. In addition, critical and specific branches of the pelvic plexus (inferior hypogastric plexus), such as the circumureteral loop with the direct vesico-ureteral branches of the superior hypogastric nerves, the branches to the seminal vesicle, the small branches to the anteromedial margin of the levator ani, and the cavernous nerves of the penis are demonstrated. A typical middle rectal artery, which passes through the pelvic plexus before reaching the lower rectum, as well as a lymph vessel along this artery, are also demonstrated. These dissection photographs may form a basis for the development of novel function-preserving surgical techniques. |