An Approach to Vesicouterine Peritoneum Through a New Surgical Space
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A novel surgical window in the uterocervical broad ligament space provides a safe plane for dissecting adhesions between the bladder and cervix during hysterectomy, as demonstrated in 131 cases.
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Abstract
A surgical window in the uterocervical broad ligament space is described for the first time, with a detailed account of its anatomy. The author has made use of this window to develop a safe plane of cleavage between the urinary bladder and the uterocervical surface during vaginal or abdominal hysterectomy in cases where dense adhesions are encountered or anticipated. In 131 cases with anticipated adhesions in the anterior pouch or vesicocervical septum because of previous uterine surgery, such as caesarean section, myomectomy, and suspension, or because of endometriosis in the vesicouterine fold of the peritoneum, hysterectomy was satisfactorily carried out by using this surgical window. Increasing use of this technique will make the surgeon more familiar with the intricacies of the procedure and less dependent on laparoscopic assistance during vaginal hysterectomy. (J GYNECOL SURG 12:135, 1996)
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