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Checklist for Surgical Anatomy by Laparoscopy

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This checklist is part of the Gynsurgery guidelines used in an educational setting for residents in Ob-Gyn. (The pdf form of this checklist for Gyn Surgical Anatomy may not contain the latest changes below)

  1. ___ anterior margin of bladder (possible site of perforation by suprapubic trochar)
  2. ___ peritoneal surface of bladder dome (site for endometriosis, site for supra pubic catheter insertion)
  3. ___ cervical margin of bladder ( incision site for bladder flap)
  4. ___ left round ligament (may be mistaken for tube during tubal ligation)
  5. ___ left inguinal ring (site for possible inguinal hernia)
  6. ___ left medial umbilical ligament and inferior epigastric vessels (possible perforation of vessels lateral to ligament)
  7. ___ right medial umbilical ligament and inferior epigastric vessels (possible perforation of vessels lateral to ligament)
  8. ___ right round ligament (may be mistaken for tube during tubal ligation)
  9. ___ right inguinal ring (site for possible inguinal hernia)
  10. ___ cul de sac (site for possible endometriosis)
  11. ___ posterior uterine wall (site for possible endometriosis)
  12. ___ left sigmoid peritoneal reflection (often mistaken for pelvic adhesions)
  13. ___ left fimbria ovarica (site for injection of pitressin solution in ectopic removal)
  14. ___ left fimbria (site of tubal occlusion in pelvic inflammatory disease)
  15. ___ left tubal ampula (most common site of tubal ectopic pregnancy)
  16. ___ left tubal isthmus (site for tubal ligation 2-3 cm from cornua)
  17. ___ left corneal tubal insertion and adjacent space between tube and round ligament (site for pitressin injection for ectopic pregnancy removal)
  18. ___ left infundibulopelvic ligament (site for ligation of ovarian blood supply and injury to proximal ureter)
  19. ___ left ovary anterior and posterior surface and hilum (hilum is site for compromise of ovarian blood supply in cystectomies)
  20. ___ left utero ovarian ligament (site to grasp to stabilize ovary for ovarian cystectomy)(may be mistaken for tube during tubal ligation)
  21. ___ left utero ovarian vein (may be mistaken for tube during tubal ligation)
  22. ___ left posterior leaf of broad ligament (site for endometriosis, ovarian adhesions and broad ligament windows)
  23. ___ left ureter coursing toward trigone under uterine artery/vein (site for ureter injury during hysterectomy)
  24. ___ left uterosacral ligament, cervical, intermediate and sacral portions (intermediate portion is site for resupport of prolapsed uterus or vaginal vault)
  25. ___ proximity of left ureter to uterosacral ligament (site for possible kinking of ureter with uterosacral vault suspension or culdoplasty)
  26. ___ insertion of left uterosacral ligament into cervix (site for reattachment of uterosacral ligaments for uterine suspension)
  27. ___ insertion of right uterosacral ligament into cervix (site for reattachment of uterosacral ligaments for uterine suspension)
  28. ___ right uterosacral ligament, cervical, intermediate and sacral portions (intermediate portion is site for resupport of prolapsed uterus or vaginal vault)
  29. ___ proximity of right ureter to uterosacral ligament (site for possible kinking of ureter with uterosacral vault suspension or culdoplasty)
  30. ___ right ureter coursing toward trigone under uterine artery/vein (site for ureter injury during hysterectomy)
  31. ___ right posterior leaf of broad ligament (site for endometriosis, ovarian adhesions and broad ligament windows)
  32. ___ right utero ovarian ligament (site to grasp to stabilize ovary for ovarian cystectomy)(may be mistaken for tube during tubal ligation)
  33. ___ right utero ovarian vein (may be mistaken for tube during tubal ligation)
  34. ___ right ovary anterior and posterior surface and hilum (hilum is site for compromise of ovarian blood supply in cystectomies)
  35. ___ right infundibulopelvic ligament (site for ligation of ovarian blood supply and injury to proximate ureter)
  36. ___ right corneal tubal insertion and adjacent space between tube and round ligament (site for pitressin injection for ectopic pregnancy removal)
  37. ___ right tubal isthmus (site for tubal ligation 2-3 cm from cornua)
  38. ___ right tubal ampula (most common site of tubal ectopic pregnancy)
  39. ___ right fimbria (site of tubal occlusion in pelvic inflammatory disease)
  40. ___ right fimbria ovarica
  41. ___ right internal iliac vein/artery (terminates as the uterine artery)
  42. ___ right external iliac vein/artery (terminates as the femoral vein/artery, can be injured by Verhess needle)
  43. ___ right ureter crossing external iliac vein (easiest location to visualize ureter descending into pelvis)
  44. ___ common iliac vein (can be injured by Verhees needle)
  45. ___ sacral promontory (landmark for opening presacral space for abdominosacral colpopexy or presacral neurectomy)
  46. ___ femoral nerve exiting psoas muscle (site for nerve injury from lateral retractor blades)
  47. ___ cecum and appendix if present (site of possible endometriosis, inflamed appendix)
  48. ___ right ascending colon peritoneal reflection (often mistaken for pelvic adhesions)
  49. ___ liver (site for adhesions due to pelvic inflammatory disease)
  50. ___ gall bladder
  51. ___ falciform ligament (can be mistaken for adhesions)
  52. ___ stomach (possible site for trochar injury if left upper quadrant insertion)

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