Surg Endosc

Gynecologic Oncology and Minimally-Invasive Pelvic Surgery Unit, International School of Surgical Anatomy, Sacred Heart Hospital, Ospedale Sacro Cuore-Don Calabria, Via Don A. Sempreboni No. 5, 37024, Negrar, Verona, Italy,
Results: The anatomic entity commonly termed the "posterior parametrium" can be identified as the conjunction of three important anatomic structures (ligaments): the cranial structure (uterosacral ligaments), the caudad structure (rectovaginal ligaments), and the laterocaudad structure (lateral rectal ligaments). Identification of these structures (containing autonomic innervations for pelvic viscera) may allow an accurate nerve-sparing surgical approach in many radical pelvic operations.

Conclusions: The incidences of urinary, rectal, and sexual morbidity after radical pelvic surgical procedures for oncologic diseases (rectal/ovarian cancer, advanced endometrial/cervical cancer, posterior pelvic recurrences) and deep severe endometriosis can be reduced by better knowing and dissecting the right embryo-anatomic planes of the so-called "posterior parametrium."