Surgical Anatomy of Gynecologic Malignancies

Abstract

Surgical anatomy is quite different from natural, textbook anatomy or systemic anatomy because the configuration of the organs becomes rearranged during the surgical process. It is important to know the original, precise topology of the organs and how the landscape changes during surgery, step by step. For example, knowledge of the uterine vessels is important for preservation of the uterus. Understanding the configuration of the nerves around the uterus, ureter, and bladder is important for preservation of bladder function. It is also crucial to know the configuration of vessels and nerves during lymphadenectomy or removal of recurrent tumors. When removing disseminated peritoneal tumors under the diaphragm, knowing the thickness of the diaphragm is useful. The anatomy described in this chapter is mainly based on cadaveric dissection. It must be noted that, in the dorsal field, organs such as vessels and nerves—the view of which is usually obscured during conventional surgery—may be exposed in a cadaver.