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See: chain, nexus
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This is located within the lateral part of the Retzius space anterior to the cardinal ligament, bilaterally.
Full term ANOC Anococcygeal raphe B Bladder CCM Coccygeus muscle CL Cardinal ligament Cx Coccyx EAS External anal sphincter ICM Iliococcygeus muscle Obt Obturator internus muscle Pb Perineal body PCM Pubococcygeus muscle Pm Perineal membrane PRM Puborectalis muscle Ps Pubic symphysis PUL Pubourethral ligament R Rectum U Urethra Umb Umbilical ligament USL Uterosacral ligament Ut Uterus V Vagina Table 2: Biomechanical properties of endopelvic fascia constituents.
This space is bordered by the ureter medially, the by-pogastric or internal iliac artery laterally, and the base of the cardinal ligament anteriorly, with the levator ani muscle as the floor.
The common sites of injury are ovarian vascular pedicle at infundibulo-pelvic ligament, the ureteric relation with the uterine artery, where it crosses under the artery, cardinal ligament tunnel, dorsal to the infundibulo-pelvic ligament near or at the pelvic brim, vaginal fornices and lateral rectal pedicles.
The clamp should now include the superior portion of the cardinal ligament with the uterine vessels and paracolpium immediately above the lateral vaginal fornix.
We place the loop after we've carried our dissection down to the middle of the cardinal ligament. The loop is placed at the level of the internal os.
The pararectal space is bordered laterally by the pelvic sidewall, anterolaterally by the cardinal ligament, and medially by the rectal pillars.