The pectineal ligament anatomical study and surgical applications

Faure, Jean‐Pierre; Hauet, Thierry; Scépi, M.; Chansigaud, J P; Kamina, Pascal; Richer, Jean‐Pierre

doi:10.1007/s00276-001-0237-1

Cited by 13 publications

(14 citation statements)

References 9 publications

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“…The ilipectineal ligament is an extension of the lacunar ligament that runs on the pectineal line of the pubic bone ( 14 ) ( Figure-1 ), and is significantly stronger than the sacrospinous ligament and the arcus tendineus of the pelvic fascia ( 15 ). The structure is strong, and holds suture well.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic pectopexy: initial experience of single center with a new technique for apical prolapse surgery

Kale¹,

Biler

Terzi³

et al. 2017

Int. braz j urol.

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Objective:To share our first experience with laparoscopic pectopexy, a new technique for apical prolapse surgery, and to evaluate the feasibility of this technique.Materials and Methods:Seven patients with apical prolapse underwent surgery with laparoscopic pectopexy. The lateral parts of the iliopectineal ligament were used for a bilateral mesh fixation of the descended structures. The medical records of the patients were reviewed, and the short-term clinical outcomes were analyzed.Results:The laparoscopic pectopexy procedures were successfully performed, without intraoperative and postoperative complications. De novo apical prolapse, de novo urgency, de novo constipation, stress urinary incontinence, anterior and lateral defect cystoceles, and rectoceles did not occur in any of the patients during a 6-month follow-up period.Conclusion:Although laparoscopic sacrocolpopexy has shown excellent anatomical and functional long-term results, laparoscopic pectopexy offers a feasible, safe, and comfortable alternative for apical prolapse surgery. Pectopexy may increase a surgeon's technical perspective for apical prolapse surgery.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic pectopexy: initial experience of single center with a new technique for apical prolapse surgery

Kale¹,

Biler

Terzi³

et al. 2017

Int. braz j urol.

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“…In this study, we measured the total length of pectineal ligament as 5.9±0.76 cm and 6.5±0.1.14 cm on the left and right side, respectively, and the midpoint of the pectineal ligament was 2.8±0.52 cm and 3.6±0.47 cm far from the pubic tubercle on the left and right side, respectively. Faure et al (1) found similar results that the average total length was 53 (range, 25-65) mm, and the midpoint of the pectineal ligament was 3-4 cm away from the medial insertion. On the far lateral portion, the pectineal ligament becomes thinner and fuses with the transversalis fascia at the part of iliopubic eminence; however, the medial portion of the pectineal line, which corresponds to the midpoint of pectineal ligament, just below the lacunar ligament, constitutes a strong band (12) .…”

Section: Resultsmentioning

confidence: 69%

“…Rouviere (11) stated that the pectineal ligament was the thickening of the fascia of the pectineus muscle, and therefore it had a strong structure. Additionally, the anatomic and histologic findings of Faure et al (1) in a cadaveric dissection study also showed that the pectineal ligament was the thickening of the pectineus fascia, rather than thickening of the periosteum. On the other hand, classically, it is known that the pectineal ligament lies from the pubic tubercle to the iliopubic eminence, attaches to the periosteum of the superior pubic ramus, and covers the pectineal line of the pubis while extending dorsally.…”

Section: Resultsmentioning

confidence: 87%

“…The pectineal ligament is one of the key anatomic structures in the pelvis, and is used in both abdominal and gynecologic surgeries. During procedures such as inguinal hernia repair, pelvic organ prolapse (POP), and stress urinary incontinence (SUI), the pectineal ligament is used as a surgical anchoring point (1) . Detailed anatomic knowledge of the pectineal ligament and relevant anatomic landmarks improves surgical anatomy practice and facilitates surgery.…”

Section: Introductionmentioning

confidence: 99%

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Surgical anatomy of the pectineal ligament during pectopexy surgery: The relevance to the major vascular structures

Pulatoğlu¹,

Doğan²,

Medisoğlu³

et al. 2020

tjod

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Objective: During pectopexy surgery, the prolapsed uterus or the vaginal apex is fixed to the pectineal ligament. The anatomic structures found in the lateral part of the prevesical and paravaginal space above the obturator fossa, raise the importance of the surgical steps required to prevent complications. This study was conducted to evaluate the proximity of vascular structures to the pectineal ligament. Materials and Methods: The distances between the surgical suturing area during pectopexy surgery and the external iliac vein, pubic anastomotic vessel (corona mortis) and obturator canal were measured bilaterally in seven fresh female cadavers. Results: The total length of the pectineal ligament was 5.9±0.76 cm on the left and 6.5±1.14 cm on the right side; the midpoint of the pectineal ligament was 2.8±0.52 cm on the left and 3.6±0.47 cm on the right side. From the midpoint of the left pectineal ligament, the mean distance to the left external iliac vein was 1.04±0.23 cm, to the left corona mortis it was 2.15±0.48 cm, and to the left obturator canal it was 3.12±0.95 cm. From the midpoint of the right pectineal ligament, the mean distance to the right external iliac vein was 1.25±0.43 cm, to the right corona mortis it was 2.37±0.63 cm, and to the right obturator canal it was 3.57±0.93 cm. Conclusion: The anatomic findings of the study confirmed that the pectineal ligament was in close association with main vessels. The external iliac vein was measured as the closest anatomic structure to the pectineal ligament. Surgeons must be careful to minimize life-threatening complications because of the proximity of the pectineal ligament to main vessels.

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“…Burch colposuspension is performed through laparotomy or laparoscopy [38]. the external iliac vessels and the pubic spine [43].They reported that during Burch colposuspension stitches should be located near to the iliac vessels and 4 cm lateral to the medial insertion of the ligament, where it has its greatest thickness [43]. According to other study, the medial part of pectineal ligament close to the pubic tubercle was the thickest section and it became thinner while extending laterally [44].…”

Section: Clinical Applications Of Aovs Acovs and Cmor In Gynecologymentioning

confidence: 99%

Corona mortis, aberrant obturator vessels, accessory obturator vessels: clinical applications in gynaecology

et al. 2021

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Corona mortis " (CMOR) is a heterogeneous and often dubious term that causes much confusion in medical literature, especially in regard to its modern day significance in pelvic surgery. Some authors define CMOR as any abnormal anastomotic vessel between the external iliac and obturator vessels, whereas others define it as any vessel coursing over the superior pubic branch, regardless whether it is a vascular anastomosis, an accessory obturator vessels, an obturator vessel related to the external iliac system or a terminal small vessel. There is no standard classification of CMOR and obturator vessels variations, although there are multitudes of classifications describing the diverse variations in the obturator foramen region. We define accessory obturator, aberrant obturator vessels and CMOR as different structures, as CMOR is an anatomical term that reflects a clinical situation rather than an anatomical structure. A new clinical classification for aberrant, accessory obturator vessels and CMOR is proposed regarding the anatomical variations, and the location of vessels to the deep femoral ring. The clinical significance of accessory obturator, aberrant vessels and CMOR is delineated in oncogynecological and urogynecological surgery.

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The pectineal ligament anatomical study and surgical applications

Cited by 13 publications

References 9 publications

Laparoscopic pectopexy: initial experience of single center with a new technique for apical prolapse surgery

Laparoscopic pectopexy: initial experience of single center with a new technique for apical prolapse surgery

Surgical anatomy of the pectineal ligament during pectopexy surgery: The relevance to the major vascular structures

Corona mortis, aberrant obturator vessels, accessory obturator vessels: clinical applications in gynaecology

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