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Pelvic nerves during radical trachelectomy
  1. Lei Li and
  2. Ming Wu
  1. Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
  1. Correspondence to Dr Lei Li, Peking Union Medical College Hospital, Beijing 100730, China; lileigh{at}163.com

https://doi.org/10.1136/ijgc-2020-001876

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    A 24-year-old patient accepted laparoscopic radical trachelectomy for stage IB1 cervical squamous cell carcinoma. During the surgery(Figure 1), after resection of the deep uterine vein (V) and its branches by the right parametrium, the parasympathetic pelvic visceral nerves originating from sacral nerves (in this case, S2 to S4) are evident. long the right ureter (U), sympathetic hypogastric nerves (H) and pelvic visceral nerves are tangled up and constituted an inferior hypogastric plexus (that is, pelvic plexus). We demonstrate a type C1 surgery of Querleu-Morrow classification. Identification of the anatomy is critical for nerve-sparing surgeries.

    Figure 1
    Figure 1

    Right-side pelvic visceral nerves.*Inferior hypogastric plexus. H, hypogastric nerves; S2 to S4, second to fourth sacral nerves; U, right ureter; V, deep uterine vein.

    Footnotes

    • Contributors LL and MW performed the surgery and obtained the consent for publication. LL contributed to drafts and reviewing of the paper. Both authors have approved the final version of the manuscript.

    • Funding This study was funded by Chinese Academy of Medical Sciences Initiative for Innovative Medicine; grand number (CAMS-2017-I2M-1-002).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Commissioned; internally peer reviewed.