Navigating surgical anatomy of the Denonvilliers' fascia and dissection planes of the anterior mesorectum with a cadaveric simulation model.

Autor: García-Gausí M; Surgical Anatomy Unit, Department of Human Anatomy and Embryology, Faculty of Medicine and Dentistry, University of Valencia, Avenida Blasco Ibañez, 15, 46010, Valencia, Spain. magargau@alumni.uv.es.; Coloproctology Unit, European Center for Colorectal Surgery, Vithas Valencia 9 of October Hospital, Valencia, Spain. magargau@alumni.uv.es.; Department of General and Digestive Surgery, Punta de Europa Hospital, Algeciras, Spain. magargau@alumni.uv.es., García-Armengol J; Surgical Anatomy Unit, Department of Human Anatomy and Embryology, Faculty of Medicine and Dentistry, University of Valencia, Avenida Blasco Ibañez, 15, 46010, Valencia, Spain.; Coloproctology Unit, European Center for Colorectal Surgery, Vithas Valencia 9 of October Hospital, Valencia, Spain., Pellino G; Surgical Anatomy Unit, Department of Human Anatomy and Embryology, Faculty of Medicine and Dentistry, University of Valencia, Avenida Blasco Ibañez, 15, 46010, Valencia, Spain.; Coloproctology Unit, European Center for Colorectal Surgery, Vithas Valencia 9 of October Hospital, Valencia, Spain.; Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy., Mulas C; Surgical Anatomy Unit, Department of Human Anatomy and Embryology, Faculty of Medicine and Dentistry, University of Valencia, Avenida Blasco Ibañez, 15, 46010, Valencia, Spain.; Coloproctology Unit, Department of General and Digestive Surgery, University General Hospital Consortium, Valencia, Spain., Roig JV; Surgical Anatomy Unit, Department of Human Anatomy and Embryology, Faculty of Medicine and Dentistry, University of Valencia, Avenida Blasco Ibañez, 15, 46010, Valencia, Spain.; Coloproctology Unit, European Center for Colorectal Surgery, Vithas Valencia 9 of October Hospital, Valencia, Spain., García-Granero A; Surgical Anatomy Unit, Department of Human Anatomy and Embryology, Faculty of Medicine and Dentistry, University of Valencia, Avenida Blasco Ibañez, 15, 46010, Valencia, Spain.; Coloproctology Unit, Department of General and Digestive Surgery, Son Espases University Hospital, Palma, Spain., Moro D; Surgical Anatomy Unit, Department of Human Anatomy and Embryology, Faculty of Medicine and Dentistry, University of Valencia, Avenida Blasco Ibañez, 15, 46010, Valencia, Spain.; Coloproctology Unit, Department of General and Digestive Surgery, Clinic University Hospital, Valencia, Spain., Valverde A; Surgical Anatomy Unit, Department of Human Anatomy and Embryology, Faculty of Medicine and Dentistry, University of Valencia, Avenida Blasco Ibañez, 15, 46010, Valencia, Spain.
Jazyk: angličtina
Zdroj: Updates in surgery [Updates Surg] 2022 Apr; Vol. 74 (2), pp. 629-636. Date of Electronic Publication: 2022 Mar 14.
DOI: 10.1007/s13304-022-01252-2
Abstrakt: Anterior dissection of the rectum in the male pelvis represents one of the most complex phases of total meso-rectal excision. However, the possible existence of different anatomical planes is controversial and the exact anatomical topography of Denonvilliers' fascia is still debated. The aim of the study is to accurately define in a cadaveric simulation model the existence and boundaries of Denonvilliers' fascia, identifying the anatomical planes suitable for surgical dissection. The pelvises of 31 formalin-preserved male cadavers were dissected. Careful and detailed dissection was carried out to visualize the anatomical structures and the potential dissection planes, simulating an anterior meso-rectum dissection. Denonvilliers' fascia was identified in 100% of the pelvises, as a single-layer fascia that originates from the peritoneal reflection and descends until its firm adhesion to the prostate capsule. The fascia divides the space providing an anterior and a posterior plane. Anteriorly to the fascia, during the caudal dissection, its firm adhesion to the prostate capsule forces to section it sharply. The cadaveric simulation model allowed an accurate description of Denonvilliers' fascia, defining several planes for anterior dissection of the meso-rectum.
(© 2022. The Author(s).)
Databáze: MEDLINE
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