SciCombinator

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Concept: Extraperitoneal space

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Corona mortis is a highly variable vascular connection between the obturator and external iliac or inferior epigastric arteries or veins located behind the superior pubic ramus in the retropubic space (space of Retzius). Due to the significant variation in this collateral circulation, detailed anatomical knowledge of the corona mortis is vital to enhance the prevention of possible iatrogenic errors in hernia repair and other pubic surgical procedures. The aim of our meta-analysis was to provide comprehensive data on the prevalence, anatomical characteristics, and ethnic variations of the corona mortis vessel.

Concepts: External iliac artery, Extraperitoneal space, Retropubic space, Blood vessel, Anders Retzius, Hernia, Surgery, Pelvis

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Placement of an inflatable penile prosthesis (IPP) is the most effective treatment modality for men with ED refractory to medical management. We have previously demonstrated a protocol for IPP reservoir placement within the abdominal wall musculature, which was shown to be a safer location than traditional placement in the retropubic space of Retzius. The aim of this study was to review our complications with IPP reservoir entry into the peritoneum after abdominal wall placement of the reservoir. We retrospectively reviewed our two patients with peritoneal entry of the reservoir after posterior to transversalis fascia and anterior to transversalis fascia placement during virgin and compromised IPP cases, respectively. Our goal was to assess common inherent patient and surgical factors that resulted in this complication in order to develop a management algorithm to prevent future occurrence during alternative reservoir placement. Peritoneal reservoir entry was identified in two patients. These patients were both noted to be thin (mean body mass index (BMI) 18.5 kg/m(2)), current or former smokers. Peritoneal entry was identified early after reservoir placement. Neither of the patients suffered bowel injury and both subsequently underwent successful reservoir removal and IPP replacement. Both are currently doing well with functional IPPs on follow-up. Peritoneal entry of the reservoir occurs very rarely and, in our series, occurred in a cohort of patients with low BMI and tobacco use history. We recommend early identification of similar patients and subsequent reservoir placement anterior to transversalis fascia with caution to prevent peritoneal entry.International Journal of Impotence Research advance online publication, 29 June 2017; doi:10.1038/ijir.2017.26.

Concepts: Stomach, Extraperitoneal space, Transversalis fascia, Peritoneum, Abdomen, Abdominal wall, Anders Retzius, Body mass index

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Dedifferentiated liposarcoma is an uncommon variant of liposarcoma, with poor prognosis and higher preponderance to local recurrence. Only nine cases of dedifferentiated liposarcoma of small bowel mesentery have been reported till now. This is a case of giant dedifferentiated liposarcoma of the small bowel mesentery, weighing nearly 9 kg (19.8 lbs), with synchronous lesions in the extraperitoneal space, which is the first such case to be reported.

Concepts: Small intestine, Retropubic space, Large intestine, Bowel obstruction, Digestive system, Report, Extraperitoneal space, Case

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Water-filled laparoendoscopic surgery (WaFLES) has been proposed as a novel surgical system achieving a wide surgical field in the intra- and extraperitoneal space with continuous irrigation of isotonic fluid into the field. Despite its technical feasibility and advantages, the safety of the technique, particularly with respect to physiological functions, has not been evaluated.

Concepts: Extraperitoneal space, Polynomial, ASA physical status classification system, Al-Andalus, Mathematics, Anesthesia, Surgery

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Midurethral tension-free vaginal tapes (TVT), placed through the retropubic space or through the obturator foramina, are widely used for the surgical treatment of female stress urinary incontinence. Some complications are associated with retropubic tapes owing to the passage of the tape through the space of Retzius. One of the most frequent complications is bleeding, and if injury to major vessels is involved, this may be life-threatening. In 2010, the Gynecare TVT-Exact® Continence System was introduced onto the market, with a rigid trocar shaft measuring 3.0 mm in diameter. We have no clinical data regarding the complication rate, especially concerning bleeding, connected with this device; all data are related to the original size of the TVT inserter. The cases presented demonstrate that bleeding complications can occur with the TVT-Exact procedure.

Concepts: Radical retropubic prostatectomy, Tape, Incontinence, The Passage, Extraperitoneal space, Retropubic space, Urinary incontinence, Anders Retzius

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Inflatable penile prosthesis (IPP) surgery is a successful therapeutic option for men with erectile dysfunction. Traditional placement of the reservoir in the retropubic space of Retzius is associated with the rare occurrence of significant complications including bladder, bowel, and vascular injury. An alternative site, posterior to the abdominal wall musculature, has been identified as a potentially safer location for reservoir placement.

Concepts: Prosthetics, Penis, Penile prosthesis, Amputation, Extraperitoneal space, Retropubic space, Anders Retzius, Erectile dysfunction

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The prevesical space is the largest potential space within the pelvic extraperitoneal space. Located anterosuperior to the bladder, it has complex communications with the adjacent pelvic extraperitoneal spaces, rectus sheath, and retroperitoneum. The prevesical space is also the site of various pathological processes, and can act as a conduit for the spread of these conditions. Therefore, awareness of the detailed anatomy and potential routes of communication may help radiologists in making accurate diagnoses of pathological conditions involving the prevesical space.

Concepts: Pelvic floor, Human anatomy, Medical school, Biology, Kidney, Retropubic space, Extraperitoneal space, Anatomy