Document Detail


Lateral ligaments of the rectum: an anatomical study.
MedLine Citation:
PMID:  10215819     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The lateral ligaments of the rectum are surrounded by confusion and misconception. Their identification before 'hooking them on the finger', clamping and ligating is considered in many surgical texts to be an essential step in mobilization of the rectum. By contrast, it is the experience of many colorectal surgeons that the mesorectum can be dissected out either by diathermy or sharp dissection alone. METHODS: Dissection in the mesorectal plane was performed on 28 cadaveric pelves. RESULTS: In ten of the pelves, no connective tissue structure crossed from the pelvic side wall to the rectum. The remaining 18 had only very insubstantial connective tissue strands crossing this space. A total of 17 middle rectal arteries were found, all of them unilateral. Fourteen of these vessels crossed the mesorectum independent of any structure, while the remainder were part of a neurovascular bundle with a connective tissue element. CONCLUSION: It is proposed that the 'lateral ligaments' of the rectum do not exist and that the term should be dropped from surgical texts. When present, the middle rectal artery is a small vessel, close to the pelvic floor. The entire rectum may be mobilized by sharp dissection without the need for clamping or ligation of any significant structure.
Authors:
O M Jones; N Smeulders; O Wiseman; R Miller
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  86     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-05-17     Completed Date:  1999-05-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  487-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Anatomy, University of Cambridge, Cambridge, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cadaver
Female
Humans
Ligaments / anatomy & histology*
Male
Middle Aged
Rectum / anatomy & histology*

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


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