Laboratory of Biological Anthropology and Anatomy, Integrative Centers for Science and Medicine, Martinsville, Virginia 24112-2922, USA.
Clin Anat. 2011 Jan;24(1):62-9. doi: 10.1002/ca.21057. Epub 2010 Oct 14.
The plica vesicalis transversa or transverse vesical fold (TVF) is a peritoneal fold extending from the lateral side of the bladder to the side of the lesser pelvis near the deep inguinal ring. It is an important landmark in laparoscopic surgery of the pelvis but is variably observed in the embalmed cadaver. We investigated the gross anatomy of this structure in the cadaver and confirmed that its medial portion corresponds to the location of the superior vesical artery(ies), thus supporting the idea that the TVF is "mesovesical." However, no large vessels were observed grossly in the lateral portion of the TVF. The hypothesis that the lateral TVF has a suspensory function was tested histologically by comparison with the suspensory ligament of the duodenum and the phrenicocolic ligament, both of which have smooth muscle contributing to their inferred suspensory function. Microscopic examination of prepared samples from 20 cadavers shows that the TVF evinces no smooth muscle in either its lateral or medial segments. The TVF is demonstrated to be a mesentery-like reflection of peritoneum raised by branches of the superior vesical artery which provides no demonstrable structural support for the bladder. Implications of these findings include avoidance of sectioning of medial TVF during laparoscopic surgery because of its vascular nature, and inadvisability of utilizing any portion of theTVF for an anchor in reconstruction of the anterior pelvic floor within the paravesical fossae.
膀胱横褶（TVF）是从膀胱侧面延伸到靠近腹股沟深环的小骨盆侧面的腹膜褶。它是骨盆腹腔镜手术中的一个重要标志，但在防腐尸体中观察到的情况各不相同。我们在尸体中研究了该结构的大体解剖结构，并证实其内侧部分对应于膀胱上动脉（ies）的位置，从而支持 TVF 是“系膜”的观点。然而，在 TVF 的外侧部分没有观察到大血管。通过与十二指肠悬韧带和膈结肠韧带的比较，对 TVF 的外侧部分具有悬吊功能的假设进行了组织学测试，这两个韧带都具有平滑肌，有助于推测其悬吊功能。对 20 具尸体的标本进行的显微镜检查显示，TVF 的外侧和内侧段均没有平滑肌。研究表明，TVF 是由膀胱上动脉分支提起的腹膜系膜样反射，它不能为膀胱提供可证明的结构支撑。这些发现的意义包括避免在腹腔镜手术中切开 TVF 的内侧部分，因为其具有血管性质，以及不建议在膀胱前盆腔重建的矢状旁窝中使用 TVF 的任何部分作为锚点。
