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Corona mortis exposition during laparoscopic procedure for gynecological malignancies

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Corona mortis (CMOR) is an anastomotic branch between the external iliac or inferior epigastric vessels and the obturator artery or vein, or any vascular connection between the obturator and the external iliac systems in general with high anatomic variability. The aim of this study was to evaluate the type of anastomosis, if arterial, venous or both and the other subtypes of CMOR. Twenty-five laparoscopic procedures of bilateral pelvic lymphadenectomy for gynecological oncologic procedures (50 half pelvises) were performed. CMOR was located in 15 half pelvises on the right side (60 %), in 7 half pelvises on the left side (28 %), in 3 patients it was evidenced bilaterally. CMOR was dissected in 26/50 (52 %) half pelvises. Venous anastomosis was more frequently (46 %) followed by both venous and arterial vessels; in only 8 % (2/26) an arterial communication was observed. 83 % of venous anastomosis were single communications. One isolated arterial anastomosis was evidenced in two patients. In the cases of both arterial and venous anastomosis, one venous and one arterial vessel in 5/6 (83 %) were detected, and one type of anastomosis with one arterial and two venous vessels. Our data suggest that venous CMOR is usually present in higher frequency than the arterial one, followed by the combined type with arterial and venous connections. The isolated venous anastomosis resulted the frequent subtype.

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Fig. 1

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Corona mortis


External iliac artery


External iliac vein


Obturator vein


Obturator muscle


Obturator nerve


Inferior epigastric artery


Inferior epigastric vein


Pubic branch


Body mass index


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Correspondence to Gianluca Raffaello Damiani.

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All authors contributed substantially to this article and are in agreement with its content. The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.

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Pellegrino, A., Damiani, G.R., Marco, S. et al. Corona mortis exposition during laparoscopic procedure for gynecological malignancies. Updates Surg 66, 65–68 (2014).

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