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Variability in the origin of the obturator artery
Mangala M Pai1, Ashwin Krishnamurthy, Latha V Prabhu
1Department of Anatomy, Kasturba Medical College, Manipal University, Bejai, Mangalore, Karnataka, India. drmmpai@gmail.com
Insights
Aberrant obturator artery variations are more common than previously thought, occurring in 21% of cases. Awareness of these anatomical variations is crucial for pelvic surgeons to prevent surgical complications during hernia repair.
Area of Science:
- Anatomy
- Surgical Anatomy
- Vascular Anatomy
Background:
- The obturator artery is typically a branch of the internal iliac artery.
- Variations in its origin and course can lead to surgical complications, particularly during laparoscopic herniorrhaphy.
- Awareness of aberrant obturator artery anatomy is essential for general surgeons performing pelvic procedures.
Purpose of the Study:
- To investigate the prevalence and variations of the obturator artery.
- To provide anatomical data relevant to pelvic surgery.
- To enhance surgical safety in procedures involving the femoral ring.
Main Methods:
- Examination of 98 pelvic halves from embalmed cadavers.
- Detailed tracing and documentation of the obturator artery's origin and course.
- Statistical analysis of observed variations.
Main Results:
- The obturator artery originated from the internal iliac artery in 79% of specimens.
- Significant variations were observed in 21% of cases, including origin from the external iliac artery (19%) or dual origins (2%).
- These variations demonstrate a higher prevalence than previously reported.
Conclusions:
- Aberrant obturator artery anatomy is more common than previously understood.
- These findings have significant implications for pelvic surgeons, especially those performing hernia repairs.
- Understanding these vascular variations is critical for preventing iatrogenic injuries and improving patient outcomes.
Introduction:
General surgeons dealing with laparoscopic herniorrhaphy should be aware of the aberrant obturator artery that crosses the superior pubic ramus and is susceptible to injuries during dissection of the Bogros space and mesh stapling onto Cooper's ligament. The obturator artery is usually described as a branch of the anterior division of the internal iliac artery, although variations have been reported.
Materials And Methods:
The present study was conducted on 98 pelvic halves of embalmed cadavers, and the origin and course of the obturator artery were traced and noted.
Results:
In 79% of the specimens, the obturator artery was a branch of the internal iliac artery. It branched off at different levels either from the anterior division or posterior division, individually or with other named branches. In 19% of the cases, the obturator artery branched off from the external iliac artery as a separate branch or with the inferior epigastric artery. However, in the remaining 2% of the specimens, both the internal and the external iliac arteries branched to form an anastomotic structure within the pelvic cavity.
Conclusion:
The data obtained in this study show that it is more common to find an abnormal obturator artery than was reported previously, and this observation has implications for pelvic surgeons and is of academic interest to anatomists. Surgeons dealing with direct, indirect, femoral, or obturator hernias need to be aware of these variations and their close proximity to the femoral ring.
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