Neurovascular and lymphatic vessels distribution in uterine ligaments based on a 3D reconstruction of histological study: to determine the optimal plane for nerve-sparing radical hysterectomy

• DOI: 10.1007/s00404-019-05108-w
• Publication Date: 2019-03-14T09:16:58Z
• Authors: Pengfei Li; Hui Duan; Jun Wang; Shipeng Gong; Guidong Su; Jianyi Li; Lei Tang; Yan Zhang; Huijian Fan; Ping Liu; Chunlin Chen
• Keywords: Ligaments; Dissection; Uterine Cervical Neoplasms; Autonomic Nervous System; Hysterectomy; Pelvis; 3. Good health; 03 medical and health sciences; Imaging, Three-Dimensional; 0302 clinical medicine; Adnexa Uteri; Carcinoma, Squamous Cell; Image Processing, Computer-Assisted; Humans; Female; Lymphatic Vessels

To present the distribution of neurovascular and lymphatic vessels in uterine ligaments using 3D models based on the pathological staining of serial 2D sections of postoperative specimens.Serial transverse sections of fresh uterine ligaments from a patient with stage IB1 cervical squamous cell carcinoma were studied using the computer-assisted anatomic dissection (CAAD) technique. The sections were stained with hematoxylin and eosin, Weigert elastic fibers, D2-40 and immunostainings (sheep anti-tyrosine hydroxylase and rabbit anti-vasoactive intestinal peptide). The sections were then digitalized, registered and reconstructed three-dimensionally. Then, the 3D models were analyzed and measured.The 3D models of the neurovascular and lymphatic vessels in uterine ligaments were created, depicting their precise location and distribution. The vessels were primarily located in the upper part of the ligaments model, while the pelvic autonomic nerves were primarily in the lower part; the lymphatic vessels were scattered in the uterine ligaments, without obvious regularity.CAAD is an effective anatomical method to study the precise distribution of neurovascular and lymphatic vessels in uterine ligaments. It can present detailed anatomical information about female pelvic autonomic innervation and the spatial relationship between nerves and vessels and may provide a better understanding of nerve-sparing radical hysterectomy.