Article Text

other Versions

Download PDFPDF

Repeated intravenous indocyanine green application to prove uterine perfusion during uterus transposition
  1. Christhardt Kohler1,
  2. Pirkko Kettner1,
  3. Dirk Arnold2,
  4. Gero Puhl3,
  5. Simone Marnitz4 and
  6. Andrea Plaikner1
  1. 1Department of Special Operative and Oncologic Gynecology, Asklepios Kliniken Hamburg GmbH - Asklepios Altona, Hamburg, Germany
  2. 2Department of Oncology, Asklepios Kliniken Hamburg GmbH - Asklepios Altona, Hamburg, Germany
  3. 3Department of Surgery, Asklepios Kliniken Hamburg GmbH - Asklepios Altona, Hamburg, Germany
  4. 4Department of Radio-oncology, Medical Faculty of the University of Cologne, Cologne, Nordrhein-Westfalen, Germany
  1. Correspondence to Dr Andrea Plaikner, Department of Special Operative and Oncologic Gynecology, Asklepios Klinik Altona, 22763 Hamburg, Germany; an.plaikner{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Deep rectal or anal cancer in women younger than 40 years is a rare event. Pelvic chemoradiation is the standard of care for these entities. However, due to the high radiosensitivity of ovaries and endometrium, pelvic radiation stands in contrast to fertility preservation and must be discussed with the patient.1 We present the case of a young patient with deep rectal cancer in whom uterine transposition was performed. As first described by Ribeiro et al, 2017,2 3 the uterus can be released from vaginal and parametrial attachments (including transection of uterine arteries) if sufficient blood supply to the uterus is provided by anastomosis between the uterine and ovarian arteries. Due to the preservation of infundibulopelvic ligaments, a mobile uterus together with both adnexae can be fixed onto the anterior abdominal wall, and finally, the cervix uteri will be sutured to an umbilical fascia window to ensure menstruation and cervical secretion. Uterine necrosis is a major concern during this procedure, although it seems to be a rare event.2 With repeated intravenous indocyanine green injections it is possible to check in real time the uterine perfusion during the surgery before and after transection of the uterine vessels to minimize the risk of uterine necrosis post-operatively.

Video 1

Disclaimer: this video summarises a scientific article published by BMJ Publishing Group Limited (BMJ). The content of this video has not been peer-reviewed and does not constitute medical advice. Any opinions expressed are solely those of the contributors. Viewers should be aware that professionals in the field may have different opinions. BMJ does not endorse any opinions expressed or recommendations discussed. Viewers should not use the content of the video as the basis for any medical treatment. BMJ disclaims all liability and responsibility arising from any reliance placed on the content.

Data availability statement

There are no data in this work.

Ethics statements

Patient consent for publication



  • Contributors All authors have contributed to this submission. AP acts as the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.