Autor: |
Kostov S; Research Institute, Medical University Pleven, 5800 Pleven, Bulgaria.; Department of Gynecology, Hospital 'Saint Anna', Medical University-'Prof. Dr. Paraskev Stoyanov', 9002 Varna, Bulgaria., Kornovski Y; Department of Gynecology, Hospital 'Saint Anna', Medical University-'Prof. Dr. Paraskev Stoyanov', 9002 Varna, Bulgaria., Yordanov A; Department of Gynecologic Oncology, Medical University Pleven, 5800 Pleven, Bulgaria., Watrowski R; Department of Obstetrics and Gynecology, Helios Hospital Müllheim, 79379 Müllheim, Germany.; Faculty Associate, Medical Center-University of Freiburg, 79106 Freiburg, Germany., Slavchev S; Department of Gynecology, Hospital 'Saint Anna', Medical University-'Prof. Dr. Paraskev Stoyanov', 9002 Varna, Bulgaria., Ivanova Y; Department of Gynecology, Hospital 'Saint Anna', Medical University-'Prof. Dr. Paraskev Stoyanov', 9002 Varna, Bulgaria., Ganev T; Department of Urology, Hospital 'Saint Anna', Medical University-'Prof. Dr. Paraskev Stoyanov', 9002 Varna, Bulgaria., Yalçın H; Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Maternity Hospital, 06800 Ankara, Turkey., Selçuk I; Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Maternity Hospital, 06800 Ankara, Turkey. |
Abstrakt: |
Radical hysterectomy is a central surgical procedure in gynecological oncology. A nerve-sparing approach is essential to minimize complications from iatrogenic injury to the pelvic nerves, resulting in postoperative urinary, anorectal, and sexual dysfunction. The hypogastric plexus (HP), a complex network of sympathetic and parasympathetic nerves, plays a critical role in pelvic autonomic innervation. This article offers a comprehensive overview of the surgical anatomy of the HP and provides a step-by-step description of HP dissection, with a particular emphasis on preserving the bladder nerve branches of the inferior HP. A thorough understanding and mastery of the anatomical and surgical nuances of HP dissection are crucial for optimizing outcomes in nerve-sparing gynecologic-oncological procedures. |