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Corona mortis: anatomical data and clinical considerations
Alcestis Stavropoulou-Deli1, Sofia Anagnostopoulou
1Laboratory of Descriptive Anatomy, Department of Anatomy, University of Athens Medical School, Athens, Greece. alceste_delce@hotmail.com
Summary
Injury to the corona mortis during TVT-Secur™ procedures is a risk. This study details aberrant vessel anatomy, finding most veins and arteries lie further from the symphysis pubis than the device margin.
Area of Science:
- Anatomy
- Vascular Surgery
- Gynecology
Background:
- Minimally invasive procedures like TVT-Secur™ carry a risk of injury to the corona mortis.
- Vessel proximity to the insertion site (25-30 mm from symphysis pubis) contributes to potential injury during TVT-Secur™ insertion.
Purpose of the Study:
- To systematically describe aberrant corona mortis anatomy.
- To aid gynecologists in assessing peri- and postoperative complication risks associated with TVT-Secur™ and similar procedures.
Main Methods:
- Cadaveric dissection of the lesser pelvis in ten female subjects.
- Documentation of origin, diameter, and course of aberrant venous and arterial vessels.
- Measurement of vessel distance from the symphysis pubis.
Main Results:
- Arterial corona mortis (n=8) originated from the inferior epigastric artery, crossing superior pubic rami at an average of 52.4 mm from the symphysis pubis (average diameter 3 mm).
- Venous corona mortis (n=10) drained into external iliac or inferior epigastric arteries, crossing superior pubic rami at an average of 46.7 mm from the symphysis pubis (average diameter 3.13 mm).
Conclusions:
- Aberrant veins are typically at least 8 mm from the TVT-Secur™ margin, while arteries appear even further.
- Understanding aberrant vessel anatomy can help mitigate risks during urogynecological procedures.
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