Variability in the Origin of the Obturator Artery

Abstract

INTRODUCTIONGeneral surgeons dealing with laparoscopic herniorrhaphy should be aware of the aberrant obturator artery that crosses the superior pubic ramus and is susceptible to injuries during dissection of the Bogros space and mesh stapling onto Cooper’s ligament. The obturator artery is usually described as a branch of the anterior division of the internal iliac artery, although variations have been reported.MATERIALS AND METHODSThe present study was conducted on 98 pelvic halves of embalmed cadavers, and the origin and course of the obturator artery were traced and noted.RESULTSIn 79% of the specimens, the obturator artery was a branch of the internal iliac artery. It branched off at different levels either from the anterior division or posterior division, individually or with other named branches. In 19% of the cases, the obturator artery branched off from the external iliac artery as a separate branch or with the inferior epigastric artery. However, in the remaining 2% of the specimens, both the internal and the external iliac arteries branched to form an anastomotic structure within the pelvic cavity.CONCLUSIONThe data obtained in this study show that it is more common to find an abnormal obturator artery than was reported previously, and this observation has implications for pelvic surgeons and is of academic interest to anatomists. Surgeons dealing with direct, indirect, femoral, or obturator hernias need to be aware of these variations and their close proximity to the femoral ring.

Anatomical Study on the Variations in the Branching Pattern of Internal Iliac Artery

“…It lies along the medial margin of lacunar ligament, which possesses an alarming threat during hernia surgeries, wherein it is likely to be cut, when an attempt is made during the routine enlargement of the femoral ring. Unusual selection of channels from the primary capillaries is thought to account for the anomalies affecting the arterial patterns [11,12].…”

“…Conditions that indicate ligation as a prophylactic measure include post abortion bleeding, postpartum hemorrhage, abdominal ectopic pregnancies, etc. So general surgeons dealing with laparoscopic herniorrhaphy should be aware of the abnormal obturator artery, crossing superior pubic ramus, which is more susceptible to injuries during mesh stapling into lacunar Cooper ligament [12].…”

Variant Origin of Obturator Artery: A Branch of Inferior Epigastric Artery from External Iliac Artery

“…Within the pelvis, the obturator artery gives off several branches, which supply the surrounding structures including the iliacus muscle and urinary bladder. After the obturator artery leaves the pelvic cavity through the obturator foramen and obturator canal, it supplies the adductor muscles of the thigh and head of the femur [1][2][3].It has been widely known that there is variation in the origin of obturator artery, which has been reported in cadaveric studies from several countries [4][5][6][7][8][9][10]. According to these reports, the obturator artery arises from the external iliac arterial system instead of the internal iliac artery in approximately 8 to 40% of cases.…”

Variation in the Arterial Branching Pattern of Internal Iliac Artery In human cadavers (South Indian Population)

“…Striking variations in the Branching pattern of Internal iliac artery have long received attention of Anatomists surgeons and always been a subject of controversy . 6 The first attempt to group the variations in the origin of the parietal branches of the internal iliac artery into definite pattern was undertaken by jastschinski grouped into four types 7 and later modified by Adachy into five types. 8 The first reported case of Ligation of hypogastric artery was performed for the treatment of an aneurysm of gluteal artery in 1812 by Stephens.…”