Related Experiment Video
Updated: Aug 8, 2026
Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Lateral ligaments of the rectum: an anatomical study
O M Jones1, N Smeulders, O Wiseman
1Department of Anatomy, University of Cambridge, Cambridge, UK.
Background:
The lateral ligaments of the rectum are surrounded by confusion and misconception. Their identification before 'hooking them on the finger', clamping and ligating is considered in many surgical texts to be an essential step in mobilization of the rectum. By contrast, it is the experience of many colorectal surgeons that the mesorectum can be dissected out either by diathermy or sharp dissection alone.
Methods:
Dissection in the mesorectal plane was performed on 28 cadaveric pelves.
Results:
In ten of the pelves, no connective tissue structure crossed from the pelvic side wall to the rectum. The remaining 18 had only very insubstantial connective tissue strands crossing this space. A total of 17 middle rectal arteries were found, all of them unilateral. Fourteen of these vessels crossed the mesorectum independent of any structure, while the remainder were part of a neurovascular bundle with a connective tissue element.
Conclusion:
It is proposed that the 'lateral ligaments' of the rectum do not exist and that the term should be dropped from surgical texts. When present, the middle rectal artery is a small vessel, close to the pelvic floor. The entire rectum may be mobilized by sharp dissection without the need for clamping or ligation of any significant structure.
Related Concept Videos
01:23Anatomy of the Intestines
Small Intestines
The small intestine is an ~7 meter-long tube with an inner diameter of just 2.5 cm. Since most nutrients are absorbed here, the inner lining of the small...
01:19Abdominal Regions and Quadrants
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four quadrants...
01:21Muscles of the Abdomen
Anterolateral Region
The anterolateral region comprises five paired muscles classified into the lateral and anterior...
01:09Large Intestine
The ileocecal sphincter, a mucous membrane fold, guards the opening from the ileum to the large intestine. This valve permits material from the small intestine to pass into the large intestine. Attached to the ileocecal valve is the cecum. This small pouch, approximately 6 cm long, has a twisted, coiled tube known as...
01:26Histology of the Large Intestine
The innermost mucosa layer comprises simple columnar epithelium, lamina propria, and muscularis mucosae. This layer is primarily populated with absorptive cells, tasked with water absorption, and goblet cells, responsible for secreting mucus to...
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...