Intraoperative electrical stimulation of the pelvic splanchnic nerves during nerve-sparing radical hysterectomy

Katahira, A.; Niikura, Hitoshi; Kaiho, Yasuhiro; Nakagawa, Haruo; Kurokawa, K; Arai, Yoichi; Yaegashi, Nobuo

doi:10.1016/j.ygyno.2005.05.004

Cited by 46 publications

(31 citation statements)

References 9 publications

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“…Methods for identifying pelvic autonomic nerve preservation by measuring intraoperative vesical detrusor electromyographic activity have been considered useful (10,11). However, intraoperative electrical stimulation is an indirect method for evaluating nerve preservation.…”

Section: Discussionmentioning

confidence: 99%

Proteomic Analysis of Pelvic Autonomic Nerve in Nerve-sparing Radical Hysterectomy for Cervical Carcinoma

Lee

Kim

Moon

et al. 2018

Cancer Genomics Proteomics

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Section: Discussionmentioning

confidence: 99%

Proteomic Analysis of Pelvic Autonomic Nerve in Nerve-sparing Radical Hysterectomy for Cervical Carcinoma

Lee

Kim

Moon

et al. 2018

Cancer Genomics Proteomics

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“…Identification and division of the VUL's deep layer are necessary to access a deep surgical space along the vagina, as well as mobilize the cervix. Recently, our group reported that intrasurgical electrostimulation of the VUL's deep layer results in detrusor activity in the bladder (Katahira et al 2005). Thus, the deep layer probably contains detrusor nerve fibers and ganglions originating from the pelvic splanchnic nerve and going toward the bladder neck via the pelvic plexus (Katahira et al 2007).…”

Section: Methodsmentioning

confidence: 99%

“…Although the terminology for pelvic fasciae and ligaments has not yet systematically been determined (Ercoli et al 2005), we tried to work toward future consensus by using terms very familiar in the literature for urologic and rectal surgery along with standard gynecological vic fasciae, specially vesico-uterine ligament (VUL), because most of injuries to the nerves occurred during incision of the VUL in radical hysterectomy procedures (Katahira et al 2005).…”

Section: Methodsmentioning

confidence: 99%

Surgical Anatomy of Intrapelvic Fasciae and Vesico-Uterine Ligament in Nerve-Sparing Radical Hysterectomy with Fresh Cadaver Dissections

Niikura

Katahira

Utsunomiya

et al. 2007

Tohoku J. Exp. Med.

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Radical hysterectomy has been performed for invasive cervical cancer, and autonomic nerve-sparing procedures have been developed to preserve bladder function. To perform and improve the nerve-sparing radical hysterectomy, it is important to understand anatomy of the intra pelvic fasciae, specially vesico-uterine ligament (VUL), because most of injuries to the nerves occurred during incision of the VUL in radical hysterectomy procedures. The objectives of the present study were to provide histological understanding of major structures found in nervesparing radical hysterectomy. Serial macroscopic slices (15-20 mm thick) from five female pelves were trimmed and prepared for paraffin-embedded histology. We noted an anatomical entity as "the visceroparietal fascial bridge", which corresponds with the macroscopically identified arcus tendineus fasciae pelvis. A histologically identifiable neurovascular pedicle to the bladder neck corresponded with the deep portion of VUL. These findings could help better preservation of autonomic nerves during radical hysterectomy and improve patient's quality of life after the operation. Translation of surgical anatomy into anatomic terminology enables us to have fruitful discussions with persuasive power by excluding any bias from individual surgeons.vesico-uterine ligament; paracolpium; parietal fascia; levator ani; radial hysterectomy; autonomic nerve © 2007 Tohoku University Medical Press Radical hysterectomy has been performed for invasive cervical cancer, and autonomic nervesparing procedures have been developed to preserve bladder function. To perform and improve the nerve-sparing radical hysterectomy, it is important to understand anatomy of the intrapel-

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“…Despite the curative effects of conventional radical hysterec-tomy, nerve sparing procedures have been proposed to reduce postoperative neurologic problems. Nervesparing concepts via a laprarotomy approach have focused on the hypogastric nerve, the pelvic splanchnic nerve, and the distal part (vesical and uterovaginal branches) of the IHP during the dissection of the posterior leaf of the VUL (Trimbos et al, 2001;Raspagliesi et al, 2004;Katahira et al, 2005;Todo et al, 2006). The efferent branches of the IHP and vascular structures of the VUL have also been described (Sakuragi et al, 2005;Fujii et al, 2007a,b).…”

Section: Discussionmentioning

confidence: 99%

“…Although the pelvic anatomy of nerve-sparing radical hysterectomy has been described via laparotomy and cadaver dissection (Höckel et al, 1998;Trimbos et al, 2001;Raspagliesi et al, 2004;Katahira et al, 2005;Sakuragi et al, 2005;Yabuki et al, 2005;Fujii et al, 2007b), gynecologic oncologists have not reached a consensus on neurovascular pelvic anatomy, including the nomenclature of sympathetic and parasympathetic nerves and vessels in the posterior leaf of the vesicouterine ligament (VUL). Ercoli et al attempted to establish an agreement between Terminologia Anatomica (FCAT, 1998) and unofficial nomenclature by dissecting fresh cadavers with injection of colored latex solution into vessels (Ercoli et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic pelvic anatomy of nerve‐sparing radical hysterectomy

et al. 2010

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Many reports regarding nerve-sparing radical hysterectomy have been published. However, most reports have been based on systematic descriptions via laparotomy or cadaver dissection. The aim of this work was to describe the pelvic anatomy of nerve-sparing radical hysterectomy via laparoscopy, with specific focus on the inferior hypogastric plexus. This study is based on 125 patients with FIGO stage IB cervical cancer who had undergone laparoscopic nerve-sparing radical hysterectomies since 1999. The inferior hypogastric plexus was demonstrated via laparoscopy and was comprised of afferent fibers from the sacral root (S2, S3, and S4), sacral sympathetic ganglion, and hypogastric nerve, and efferent fibers forming its vesical, uterovaginal, and rectal branches. During the dissection of the posterior leaf of the vesicouterine ligament, various vesical veins were identified. If the cut edge of an inferior vesical vein was pulled medially with upward traction, the vesical branches of the inferior hypogastric plexus were exposed and these were divided into medial and lateral branches. The magnified view of laparoscopy made it possible to dissect nerves and vessels meticulously and to secure a clear resection margin during the dissection of the deep part of the cardinal ligament, uterosacral ligament, and posterior leaf of the vesicouterine ligament.

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Intraoperative electrical stimulation of the pelvic splanchnic nerves during nerve-sparing radical hysterectomy

Cited by 46 publications

References 9 publications

Proteomic Analysis of Pelvic Autonomic Nerve in Nerve-sparing Radical Hysterectomy for Cervical Carcinoma

Proteomic Analysis of Pelvic Autonomic Nerve in Nerve-sparing Radical Hysterectomy for Cervical Carcinoma

Surgical Anatomy of Intrapelvic Fasciae and Vesico-Uterine Ligament in Nerve-Sparing Radical Hysterectomy with Fresh Cadaver Dissections

Laparoscopic pelvic anatomy of nerve‐sparing radical hysterectomy

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