Department of Obstetrics and Gynecology, Uludag University Hospital, Bursa (Drs. Orhan, Ozerkan, Kasapoglu, and Uncu); Department of Obstetrics and Gynecology, Koc University School of Medicine, Istanbul (Drs. Taskiran and Vatansever); Department of Anatomy, Uludag University School of Medicine, Bursa (Dr. Sendemir), Turkey..
Department of Obstetrics and Gynecology, Uludag University Hospital, Bursa (Drs. Orhan, Ozerkan, Kasapoglu, and Uncu); Department of Obstetrics and Gynecology, Koc University School of Medicine, Istanbul (Drs. Taskiran and Vatansever); Department of Anatomy, Uludag University School of Medicine, Bursa (Dr. Sendemir), Turkey.
J Minim Invasive Gynecol. 2020 Jul-Aug;27(5):1081-1086. doi: 10.1016/j.jmig.2019.07.031. Epub 2020 Apr 12.
To determine and categorize the anatomic variations of the uterine artery (UA) as observed during laparoscopic hysterectomy with retroperitoneal dissection for benign conditions.
A prospective, observational study.
A hospital department of obstetrics and gynecology, Uludag University Hospital, Bursa, Turkey.
A total of 378 female patients who presented with indications for laparoscopic hysterectomy for benign disease.
Laparoscopic hysterectomy with retroperitoneal dissection was performed bilaterally in all patients between March 2014 and October 2018. The vascular anatomy beginning at the bifurcation of the common iliac artery down to the crossing of the UA with the ureter was exposed and subsequently studied. The UA was identified, and its variable branching patterns were recorded. The patterns were then categorized into groups adapted from classic vascular anatomy studies.
Retroperitoneal dissections of 756 UAs were performed in 378 female patients. The UA was the first anterior branch of the internal iliac artery in 80.9% of the cases (Model 1; Main Model). Three additional models adequately described other variations of the UA as follows: Model 2 (Cross Model), 3.7%; Model 3 (Trifurcation Model), 3.1%; and Model 4 (Inverted-Y Model), 7.4%. The origin of the UA could not be determined in 7.4% of the cases.
The UA is the first anterior branch of the internal iliac artery in more than 80% of females. Surgeons should be aware of the anatomic variations of the UA to perform safe and efficient procedures.
在腹腔镜下经腹膜后解剖治疗良性疾病的子宫动脉（UA）解剖变异的确定和分类。
前瞻性观察研究。
土耳其布尔萨乌鲁达大学医院妇产科医院。
共有 378 名因良性疾病需要腹腔镜子宫切除术的女性患者。
2014 年 3 月至 2018 年 10 月，所有患者均行双侧腹腔镜下经腹膜后解剖子宫切除术。暴露并随后研究起始于髂总动脉分叉至 UA 与输尿管交叉处的血管解剖。识别 UA，并记录其可变的分支模式。然后将这些模式分类为源自经典血管解剖研究的组。
在 378 名女性患者中进行了 756 例 UA 的腹膜后解剖。UA 在 80.9%的病例中是髂内动脉的第一个前支（模型 1；主要模型）。另外三个模型充分描述了 UA 的其他变异，如下所示：模型 2（交叉模型），3.7%；模型 3（三分叉模型），3.1%；和模型 4（倒 Y 模型），7.4%。UA 的起源在 7.4%的病例中无法确定。
UA 是超过 80%女性的髂内动脉的第一个前支。外科医生应了解 UA 的解剖变异，以进行安全有效的手术。
