title: A novel technique for the management of the vesicouterine ligament during radical hysterectomy.
abstract: 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.
authors: 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.
authors: Eiji
authors: E
authors: Kobayashi
authors: Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone, Kita-ku, Sakai City, Osaka 591-8025, Japan.
authors: Tadashi
authors: T
authors: Iwamiya
authors: Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone, Kita-ku, Sakai City, Osaka 591-8025, Japan.
authors: Masanori
authors: M
authors: Isobe
authors: Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone, Kita-ku, Sakai City, Osaka 591-8025, Japan.
authors: Takahito
authors: T
authors: Miyake
authors: Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone, Kita-ku, Sakai City, Osaka 591-8025, Japan.
authors: Yasuhiko
authors: Y
authors: Shiki
authors: Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone, Kita-ku, Sakai City, Osaka 591-8025, Japan.
authors: Masato
authors: M
authors: Yamasaki
mesh_terms: 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
chemical_list: D004837:Epinephrine