Retraction of External Iliac Vessels and Obturator Nerve With the Vas Deferens During Extended Pelvic Lymph Node Dissection in Robot-assisted Radical Prostatectomy

Topographical relationships between the obturator nerve, artery, and vein in the lateral pelvic wall

INTRODUCTION AND HYPOTHESIS

The aims of this study were to determine the topographical relationships between the obturator nerve (ON), artery (OA), and vein (OV) in the lateral pelvic wall.

METHODS

One hundred and fifty hemipelvises of 84 Korean cadavers were dissected.

RESULTS

The ON, OA, and OV ran in that order (from upper to lower) within the lateral pelvic wall in 46.7 % of specimens. In 32 % of cases, the three structures were separated at the posterior portion of the wall and then converged toward the obturator canal (OC). In 10 %, the OA and OV were in contact with each other and separate from the ON; in 2 %, the ON was contiguous with the OA and separate from the OV; in 2.7 %, all three structures were in contact with each another. Alternately, the order of ON, OA, and OV was altered in the lateral pelvic wall in 41.3 % of specimens. Finally, in 12 % specimens, either the OA or OV or both were absent from the lateral pelvic wall.

CONCLUSIONS

The possibility of the presence of either the OA or OV being between the ON and the external iliac vein, and the potential contact between the ON and either the OA or OV in the lateral pelvic wall, should be borne in mind during pelvic procedures.