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Surgical and Radiologic Anatomy

, Volume 36, Issue 1, pp 71–78 | Cite as

Biomechanical origin of the Denonvilliers’ fascia

  • M. M. Bertrand
  • B. Alsaid
  • S. Droupy
  • G. Benoit
  • M. Prudhomme
Original Article

Abstract

Introduction

Since 1836 and the first description of the recto-genital fascia by Charles Denonvilliers, many anatomists have shown interest in this subject. Recently, pelvic surgeons have in turn shown similar interest, for they consider that perfect knowledge of this anatomical domain is crucial for optimal nerve conservation during surgery. Thanks to new anatomical description techniques, fascia location and relationships with pelvic nerves now appear clearer.

Objectives

To describe and represent Denonvilliers’ fascia and its relationships in the female foetus at different stages of gestation and in three-dimensional space (3D).

Materiel/patients and methods

Computer-assisted anatomical dissection technique was used. Serial histological sections were made from four human female foetuses. Sections were treated with conventional staining, as well as with nerve and smooth muscle immunostaining. Finally, the sections were digitalized and reconstructed in 3D.

Results

Denonvilliers’ fascia was clearly located and visualized in three dimensions. It was present in the female foetus, being distinct from the fascia propria of the rectum. It appeared to be composed of multiple parallel layers situated between the vagina and the rectum. From a lateral view, it had an asymmetrical “Y-shaped” aspect that seemed to play the role of a protective sheet for the neurovascular bundles.

Conclusion

This study betters our comprehension of the Denonvilliers’ fascia in the female foetus and of its connections with pelvic nerves. It also provides a better understanding of safe planes during pelvic dissection. These findings also suggest a biomechanical theory for embryological origin of the Denonvilliers’ fascia.

Keywords

Denonvilliers’ fascia Embryology Neurovascular bundles Anatomy 3D reconstruction 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  • M. M. Bertrand
    • 1
  • B. Alsaid
    • 2
  • S. Droupy
    • 3
  • G. Benoit
    • 4
  • M. Prudhomme
    • 1
    • 5
  1. 1.Laboratory of Experimental Anatomy, Faculty of Medicine Montpellier-NîmesUniversity Montpellier IMontpellierFrance
  2. 2.Laboratory of Anatomy, Faculty of MedicineUniversity of DamascusDamascusSyria
  3. 3.Urology-Andrology DepartmentCHU de Nimes, University Montpellier 1NimesFrance
  4. 4.Laboratory of Experimental Surgery, EA 4122, Faculty of MedicineBicêtre-Paris 11 UniversityLe Kremlin-BicêtreFrance
  5. 5.Digestive surgery DepartmentCHU de Nîmes, University Montpellier 1NimesFrance

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