Anatomy Surrounding the Uterosacral Ligament

Knowledge of the anatomy surrounding the uterosacral ligament is paramount to safety when performing vault suspension procedures involving the ligament. Figure 4-2.11 illustrates the close proximity of the ureter and vasculature to the uterosacral ligament. The ureter is closest to the uterosacral ligament at its distal end - approximately 1 cm. The ureter diverges laterally as the uterosacral ligament is traced toward the sacrum. At the level of the spine, the

Figure 4-2.10. Surgical correlates - ureter anatomy in relation to the uterus and vaginal apex at total vaginal hysterectomy. Upward traction on the bladder during vaginal hysterectomy increases the distance of the ureter away from the area of clamp placement. (Reprinted with the permission of The Cleveland Clinic Foundation.)

Figure 4-2.10. Surgical correlates - ureter anatomy in relation to the uterus and vaginal apex at total vaginal hysterectomy. Upward traction on the bladder during vaginal hysterectomy increases the distance of the ureter away from the area of clamp placement. (Reprinted with the permission of The Cleveland Clinic Foundation.)

Figure 4-2.11. Surgical correlates - anatomy surrounding the uterosacral ligament when an Allis clamp is applied at the time of vaginal vault suspension. (Reprinted with the permission of The Cleveland Clinic Foundation.)

ureter is approximately 2.3 cm lateral to the uterosacral ligament.8 Note the location of the middle rectal and superior gluteal vessels beneath the uterosacral ligament. When using the uterosacral ligament for suspension procedures, the surgeon should understand the course and proximity of these adjacent structures.

Herbal Remedies For Acid Reflux

Herbal Remedies For Acid Reflux

Gastroesophageal reflux disease is the medical term for what we know as acid reflux. Acid reflux occurs when the stomach releases its liquid back into the esophagus, causing inflammation and damage to the esophageal lining. The regurgitated acid most often consists of a few compoundsbr acid, bile, and pepsin.

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