Book contents
- Atlas of Surgical Techniques in Trauma
- Atlas of Surgical Techniques in Trauma
- Copyright page
- Dedication
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Section 1 The Trauma Operating Room
- Section 2 Resuscitative Procedures in the Emergency Room
- Section 3 Head
- Section 4 Neck
- Section 5 Chest
- Section 6 Abdomen
- Chapter 22 General Principles of Abdominal Operations for Trauma
- Chapter 23 Damage Control Surgery
- Chapter 24 Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)
- Chapter 25 Gastrointestinal Tract
- Chapter 26 Duodenum
- Chapter 27 Liver and Biliary Tract Injuries
- Chapter 28 Splenic Injuries
- Chapter 29 Pancreas
- Chapter 30 Urological Trauma
- Chapter 31 Abdominal Aorta and Splachnic Vessels
- Chapter 32 Iliac Vessel Injuries
- Chapter 33 Inferior Vena Cava
- Chapter 34 Cesarean Section
- Chapter 35 Emergency Hysterectomy
- Section 7 Pelvic Fractures and Bleeding
- Section 8 Upper Extremities
- Section 9 Lower Extremities
- Section 10 Orthopedic Damage Control
- Section 11 Soft Tissues
- Index
Chapter 35 - Emergency Hysterectomy
from Section 6 - Abdomen
Published online by Cambridge University Press: 21 October 2019
- Atlas of Surgical Techniques in Trauma
- Atlas of Surgical Techniques in Trauma
- Copyright page
- Dedication
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Section 1 The Trauma Operating Room
- Section 2 Resuscitative Procedures in the Emergency Room
- Section 3 Head
- Section 4 Neck
- Section 5 Chest
- Section 6 Abdomen
- Chapter 22 General Principles of Abdominal Operations for Trauma
- Chapter 23 Damage Control Surgery
- Chapter 24 Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)
- Chapter 25 Gastrointestinal Tract
- Chapter 26 Duodenum
- Chapter 27 Liver and Biliary Tract Injuries
- Chapter 28 Splenic Injuries
- Chapter 29 Pancreas
- Chapter 30 Urological Trauma
- Chapter 31 Abdominal Aorta and Splachnic Vessels
- Chapter 32 Iliac Vessel Injuries
- Chapter 33 Inferior Vena Cava
- Chapter 34 Cesarean Section
- Chapter 35 Emergency Hysterectomy
- Section 7 Pelvic Fractures and Bleeding
- Section 8 Upper Extremities
- Section 9 Lower Extremities
- Section 10 Orthopedic Damage Control
- Section 11 Soft Tissues
- Index
Summary
The uterus, adnexa, superior bladder, and upper rectum are peritonealized. These structures attach to the pelvis and to one another via a variety of peritoneal reflections and vascular and fibrous ligaments and pedicles.
Pelvic organs:
Reproductive organs: uterus, fallopian tubes, ovaries
Rectum: separated from the uterus by the posterior cul-de-sac, or Pouch of Douglas
Urinary system:
Bladder: shares a common peritoneal lining with the lower uterine segment and cervix
Ureters: Common sites for injury during gynecologic procedures:
Near the pelvic brim when the ovarian vessels are divided for oophorectomy
Along the peritoneum during retroperitoneal pelvic dissection
At the cardinal ligament during transection of the uterine arteries, where the ureter crosses under the uterine vasculature (“water under the bridge”)
At the lateral angles of the vaginal cuff closure
Vascular pedicles:
Ovarian vessels: branch from the aorta (right ovarian vein drains to IVC and left ovarian vein to the left renal vein) and supply the adnexa
Uterine vessels: branch medially from internal iliac vessels and course toward then along the uterus
Parametrial/vaginal vessels: branches of the internal iliac arteries that course through the parametria
Ligaments and peritoneal reflections:
Utero-ovarian ligament: connects ovaries to uterus
Mesosalpinx: peritoneal reflection that suspends the fallopian tube and contains mesosalpingeal vessels
Round ligament: extends from the bilateral uterine cornua and courses through the deep inguinal ring
Broad ligament: peritoneal reflection attaching the uterus to the round ligament, adnexa, and sidewall
Cardinal ligament: the connection between the lower uterine segment/cervix and pelvic sidewall
Uterosacral ligament: connects the base of the cervix to the sacrum
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- Atlas of Surgical Techniques in Trauma , pp. 321 - 334Publisher: Cambridge University PressPrint publication year: 2020