Internal iliac artery ligation-a contemporary simplified approach

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Hemorrhage Control

Background:

• Severe pelvic hemorrhage is a life-threatening condition often requiring urgent intervention.
• Classical internal iliac artery ligation involves extensive dissection, posing risks of injury to adjacent iliac veins.
• A safer, less invasive surgical technique is needed for effective pelvic hemorrhage management.

Purpose of the Study:

• To present a contemporary, minimally invasive technique for bilateral ligation of the anterior division of the internal iliac arteries.
• To reduce surgical risks associated with traditional internal iliac artery ligation.
• To provide surgeons with an alternative, safer approach for managing severe pelvic hemorrhage.

Main Methods:

• A novel technique involving limited dissection of the anterior division of the internal iliac artery.
• Utilizing right-angle forceps to create minimal space around the vessel.
• Occluding the artery with two large vascular clips, avoiding circumferential dissection.

Main Results:

• The proposed technique requires significantly less retroperitoneal dissection compared to the classical method.
• Reduced risk of inadvertent injury to the internal iliac vein and external iliac vein.
• Facilitates easier and potentially faster surgical occlusion of the internal iliac artery.

Conclusions:

• This contemporary technique for internal iliac artery ligation is a safer alternative for controlling severe pelvic hemorrhage.
• Minimally invasive ligation reduces the risk of vascular injury, enhancing patient safety.
• The described approach empowers surgeons with an effective and less hazardous option for a lifesaving procedure.