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Step 1. Development of periureteral and lateral pelvic spaces K. Guru
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Step 1. Development of periureteral and lateral pelvic spaces
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Title:
Step 1. Development of periureteral and lateral pelvic spaces
Author:
Khurshid Guru
Date:
16-08-2016
Description
- Periureteral space: The dissection begins with an incision in theposterior peritoneum above the iliac vessels, followed by identification of the ureter. Inflammatory conditions associated with diverticular disease may render ureteral dissection more difficult on the left side. Thefourth arm can be used to retract the sigmoid colon to improve exposure. The ureter is dissected distally toward the ureterovesical junction, while maintaining adequate periureteral tissue to avoid ischemia to the distal ureter. The distal margin is cut using the cold scissors and sent for frozen section.
- Lateral pelvic space: An incision is made lateral to themedial umbilical ligament and extended towards theipsilateral ureter. Dissection continues till the endopelvic fascia is encountered and incised.
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