Preliminary embryological study of the radiological concept of retroperitoneal interfascial planes: what are the interfascial planes?

Abstract

Through this developmental study, we provided the hypothesis that the compressed loose connective tissue and both opposed fasciae compose the interfascial planes. Analysis of the thickened retroperitoneal fasciae in computed tomography images supported this hypothesis. Further developmental or histological studies are required to verify our hypothesis.

The retroperitoneal interfascial planes: current overview and future perspectives

“…In our observations, just as in the classical anatomical researches, the retroperitoneal organs were embedded in the homogeneous loose mesenchymal tissues in the embryonic stage, and around the 12th week of fetal life, fibrous structures, considered as the primordial renal or transversalis fascia, were identified in the homogeneous connective tissue. Then, around the 25th week, both the renal and transversalis fasciae became clearly identifiable, and primitive adipose tissue developed.…”

“…According to the theory, a potential space in the fusion fascia is highly improbable, and, at least, an “interfascial” structure never forms because of the bilaterally vanished peritoneum. Therefore, we re‐examined the embryological development of the retroperitoneal fasciae in light of the interfascial planes …”

“…Surprisingly, the structure of the retroperitoneum has not been entirely clarified . Even the famous tricompartmental theory for retroperitoneal structures advocated by Meyers et al .…”

“…Recently, the concept has become requisite knowledge for radiologists, and furthermore, it has appeared in a popular anatomy textbook for medical students . However, the concept remains incomplete and has been fundamentally misunderstood in terms of embryological development . We have been studying the interfascial planes since 2001 in the belief that having a definitive understanding of the planes not only will completely clarify the retroperitoneal anatomy but also will revolutionize the understanding of the pathology of retroperitoneal injuries and diseases, which are often difficult to diagnose and treat, and might bring a breakthrough in the treatment for such trauma and diseases .…”

“…However, the concept remains incomplete and has been fundamentally misunderstood in terms of embryological development . We have been studying the interfascial planes since 2001 in the belief that having a definitive understanding of the planes not only will completely clarify the retroperitoneal anatomy but also will revolutionize the understanding of the pathology of retroperitoneal injuries and diseases, which are often difficult to diagnose and treat, and might bring a breakthrough in the treatment for such trauma and diseases . Therefore, for physicians focusing on acute medicine and surgery, we review the concept of interfascial planes, present its future perspectives, and introduce our unpublished data and the latest studies.…”