ArticleInternational urogynecology journal2017
Characterization of the median sacral artery course at the sacral promontory using contrast-enhanced computed tomography.
Article in International urogynecology journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 7 citations in OpenAlex.
- Intraoperative Fluorescent Navigation of the Ureters, Vessels, and Nerves during Robot-Assisted Sacrocolpopexy.Journal of personalized medicine · 2024Article
- The Surgical Vascular Anatomy of the Lower Lumbar Arteries and Its Implications in Minimally Invasive Spine Surgery: A Cadaveric Study.International journal of spine surgery · 2022Article
- Exploration of the safe suture area of the presacral space in sacrocolpopexy by 3-dimensional (3D) models reconstructed from CT.International urogynecology journal · 2021Article
- Fetal median sacral artery anatomy study by micro-CT imaging.Surgical and radiologic anatomy : SRA · 2018Article
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6 authors at 2 institutions in 1 country.
Funding
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Abstract
introduction and hypothesisLaparoscopic sacral colpopexy (SC) is increasingly utilized in the surgical management of apical prolapse. It involves attachment of a synthetic mesh to the sacral promontory and to the prolapsed vaginal walls. The median sacral artery (MSA) runs close to the site of mesh attachment and is therefore prone to intraoperative injury, which may lead to profound hemorrhaging. The aim of this study was to determine the location of the MSA at the level of the sacral promontory with regard to adjacent visible anatomical landmarks. Surgeons may use this information to reduce the risk for presacral bleeding.
methodsSixty consecutive contrast-enhanced pelvic computed tomography scans were revised, and the location of the MSA at the level of the sacral promontory was determined in relation to the ureters, iliac arteries, sacral midline, and aortic bifurcation.
resultsThe MSA runs 0.2 ± 3.9 mm left to the midline of the sacral promontory and 48.0 ± 15.4 mm caudal to the aortic bifurcation. The ureters, internal and external iliac arteries on the right were significantly closer to the MSA than on the left (30.0 ± 7.1 vs 35.2 ± 8.8 mm, p = 0.001; 21.5 ± 6.8 vs 30.3 ± 8.4 mm, p < 0.0001; 32.8 ± 10.2 vs 41.9 ± 14.5 mm, p = 0.005 respectively).
conclusionsThe MSA, which runs left to the midline of the sacral promontory, and its location can be determined intraoperatively in relation to adjacent visible anatomical structures. The iliac vessels and ureter on the right are significantly closer to the MSA than those on the left. This information may help surgeons performing SC to avoid MSA injury, thus reducing operative morbidity.
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