A novel technique for the management of the vesicouterine ligament during radical hysterectomy.
OBJECTIVE
To introduce a simple and safe method for the management of the vesicouterine ligament (VUL) during radical hysterectomy.


METHODS
From 2004 to 2006, 35 patients with the International Federation of Gynecology and Obstetrics (FIGO) stage IB1 (n=32) and IB2 (n=3) invasive cervical cancer underwent radical hysterectomy. Epinephrine, which was diluted 1:1,000,000 times with saline solution, was injected into the VUL. We investigated whether this hydrodissection technique is safe and simple to apply in the management of the VUL during radical hysterectomy.


RESULTS
The hydrodissection technique enabled us to easily identify cervicovesical vessels. As a result, none of the patients suffered ureteral injury during radical hysterectomy.


CONCLUSIONS
The injection of diluted epinephrine into the VUL is safe and simple to apply in the management of the VUL during radical hysterectomy.
Kobayashi
Eiji
E
Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone, Kita-ku, Sakai City, Osaka 591-8025, Japan. Electronic address: e_kobayashi@fkmc.or.jp.
Iwamiya
Tadashi
T
Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone, Kita-ku, Sakai City, Osaka 591-8025, Japan.
Isobe
Masanori
M
Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone, Kita-ku, Sakai City, Osaka 591-8025, Japan.
Miyake
Takahito
T
Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone, Kita-ku, Sakai City, Osaka 591-8025, Japan.
Shiki
Yasuhiko
Y
Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone, Kita-ku, Sakai City, Osaka 591-8025, Japan.
Yamasaki
Masato
M
Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone, Kita-ku, Sakai City, Osaka 591-8025, Japan.
D000328:Adult; D000368:Aged; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008022:Ligaments / Q000033:anatomy & histology / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014599:Uterus / Q000033:anatomy & histology / Q000098:blood supply / Q000601:surgery
D004837:Epinephrine