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Radical hysterectomy. A. Exposure of the inferior epigastric vessels before transection of the rectus muscles. B. Ligation of the inferior epigastric vessels
before transection of the rectus muscles. C. Ligation and division of the round ligaments opens the pelvic retroperitoneum. D. First peritoneal incision
lateral to the ovarian vessels and across the vesicouterine fold. E. Narrow malleable retractors (Indiana retractors) are placed into the paravesical and
pararectal spaces to provide excellent access to the lateral pelvic sidewall and pelvic lymph nodes. F. Pelvic lymphadenectomy (external and internal iliac
vessels). G. Pelvic lymphadenectomy (obturator fossa). H. Development of the uterine and superior vesical arteries. I. The uterine artery has been clipped
and divided near its origin. J. The proper ovarian ligament and proximal fallopian tube are clamped and divided if the ovary is to be preserved. K. The
Source: Gynecology, Schwartz's Principles of Surgery, 10e
ureters have been detached from the posterior peritoneum of the broad ligament and are retracted laterally. The rectovaginal space is developed using
Citation: Brunicardi
F, Andersen
Billiar TR,
Dunn DL,M.Hunter
JG,are
Matthews
Pollock
RE.
Schwartz's
of Surgery,
blunt finger dissection.
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ligaments.
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placed JB,
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Available
at:
http://mhmedical.com/
Accessed:
May
06,
2017
upper vagina.
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