Document Detail

Intertransversalis fascia approach in urologic laparoscopic operations.
MedLine Citation:
PMID:  22351911     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To study the clinical anatomy of the transversalis fascia (TF) and to explore the intertransversalis fascia approach in urologic laparoscopic operations (ULOs).
DESIGN: Prospective study.
SETTING: Two academic hospitals.
OTHER PARTICIPANTS: Data from 1217 urologic laparoscopic or open operations and 10 laparoscopic hernia repairs were analyzed between January 1, 2009, and April 30, 2011. Findings from 3 fresh autopsies were also included.
MAIN OUTCOME MEASURES: The anatomy of the TF was studied and the intertransversalis fascia approach was explored in ULOs; furthermore, they were proved in the open operations and fresh autopsies. Photographs were taken from the intertransversalis fascia approach in ULOs, micrographs were obtained to examine the microscopic structure of the TF, and the color atlas of TF anatomy (cross and sagittal sections) was drawn.
RESULTS: The TF is a general plane of connective tissue lying between the inner surface of the transversus abdominis and the extraperitoneal fat. It can be divided into 2 layers (superficial and deep), with an amorphous fibroareolar space between them. The intertransversalis fascia approach in ULOs is the approach between the 2 layers of the TF.
CONCLUSIONS: The intertransversalis fascia approach is described for the first time, to our knowledge. Surgeons can obtain a clean, clear, and bloodless operating space in ULOs using the intertransversalis fascia approach.
Gang Li; Yeyong Qian; Hongwei Bai; Zhigang Song; Baofa Hong; Jinfeng Jia; Bingyi Shi; Xu Zhang
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  147     ISSN:  1538-3644     ISO Abbreviation:  Arch Surg     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-21     Completed Date:  2012-04-10     Revised Date:  2012-11-29    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  159-67     Citation Subset:  AIM; IM    
Institute of Organ Transplant of Chinese PLA, 309 Hospital of PLA, Beijing, China.
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MeSH Terms
Adipose Tissue / anatomy & histology
Adrenalectomy / methods
Cystectomy / methods
Fascia / anatomy & histology,  surgery*
Hernia, Inguinal / surgery
Nephrectomy / methods
Peritoneum / anatomy & histology
Prostatectomy / methods
Urologic Surgical Procedures* / methods
Comment In:
Arch Surg. 2012 Feb;147(2):167   [PMID:  22351912 ]
Arch Surg. 2012 Oct;147(10):980; author reply 980-2   [PMID:  23070421 ]
Erratum In:
Arch Surg. 2012 May;147(5):442

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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