Whiteside James L, Walters Mark D
The Cleveland Clinic Foundation, Department of Obstetrics and Gynecology, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2004 Jul-Aug;15(4):223-6. doi: 10.1007/s00192-004-1143-y.
Our objective was to determine the relationships between a trans-obturator sling and anatomic structures within the obturator region. The obturator regions of six cadavers were dissected and distances from the mid-point of the ischiopubic ramus to the muscles, nerves, and vessels of the region were measured. A trans-obturator sling was placed and distances from the device to the same anatomic structures were determined. Four additional cadavers were dissected to determine the device route of passage. The obturator canal is on average 4.4 cm from the midpoint of the ischiopubic rami. The trans-obturator sling passes on average 2.4 cm inferior-medial to the obturator canal. The anterior and posterior divisions of the obturator nerve are on average 3.4 and 2.8 cm, respectively, from a passed trans-obturator device. The device passed on average 1.1 cm from the most medial branch of the obturator vessels. Vascular and nerve structures are within 1-3 cm of the path of any device passed through the obturator foramen. A trans-obturator sling risks injury to these structures, although the small caliber of the vessels and the confined space in which they would bleed make the consequences of injury uncertain.
我们的目的是确定经闭孔吊带与闭孔区域内解剖结构之间的关系。对六具尸体的闭孔区域进行了解剖，并测量了从耻骨支中点到该区域肌肉、神经和血管的距离。放置了一条经闭孔吊带，并确定了该装置与相同解剖结构的距离。另外解剖了四具尸体以确定该装置的通过路径。闭孔管平均距离耻骨支中点4.4厘米。经闭孔吊带平均在闭孔管下内侧2.4厘米处通过。闭孔神经前支和后支距离已通过的经闭孔装置平均分别为3.4厘米和2.8厘米。该装置平均距离闭孔血管最内侧分支1.1厘米。血管和神经结构位于任何通过闭孔的装置路径的1 - 3厘米范围内。经闭孔吊带存在损伤这些结构的风险，尽管血管口径小且出血时的受限空间使得损伤后果不确定。
