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Aust N Z J Obstet Gynaecol ; 53(3): 283-6, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23551084

RESUMO

BACKGROUND: Minimally invasive procedures, such as the TVT-Secur™, have been linked to injury to the corona mortis. Injury during the insertion of the TVT-Secur™ happens due to the vessel's position close to the place of the margin (25-30 mm from the symphysis pubis). AIMS: Systematic description of the aberrant vessel anatomy so as to help gynaecologists determine the risk of peri- and postoperative complications during the TVT-Secur™ and related procedures. METHODS: In a cadaver study, the lesser pelvis of ten female cadavers with venous or arterial coronae mortis was dissected. The origin, diameter and course of the aberrant vessels, as well as the distance from the symphysis pubis, were documented. RESULTS: Arterial coronae mortis were found in eight hemipelvises. All vessels originated from the ipsilateral inferior epigastric artery and all crossed over the superior pubic rami. Average distance from the symphysis pubis was 52.4 mm. Average vessel diameter was 3 mm. Venous coronae mortis were identified in ten hemipelvises. Eight drained into the external iliac and four into the inferior epigastric artery. Nine vessels crossed over the superior pubic rami. Average distance from the symphysis pubis was 46.7 mm. Average vessel diameter was 3.13 mm. CONCLUSION: Although individual variation makes direct contact with the vessel possible, in most cases there is a window of eight millimetres at least between the margin of the TVT-Secur™ and most aberrant veins. Possible aberrant arteries seem to lie even further.


Assuntos
Artérias Epigástricas/anormalidades , Procedimentos Cirúrgicos Minimamente Invasivos , Sínfise Pubiana/irrigação sanguínea , Artérias Epigástricas/anatomia & histologia , Artérias Epigástricas/lesões , Feminino , Humanos , Complicações Intraoperatórias , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Complicações Pós-Operatórias , Sínfise Pubiana/anatomia & histologia , Telas Cirúrgicas
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