Primary Internal Iliac Artery Ligation – An Effective Technique For Surgical Hemostasis In Wertheim’s Hysterectomy
Primary Internal Iliac Artery Ligation
Keywords:
Carcinoma cervix, Wertheim’s Hysterectomy, Bilateral internal iliac artery ligation, lessening intra-operative blood lossAbstract
Objective: Lessening intra-operative blood loss by the technique of bilateral internal iliac artery ligation as 1st step in Wertheim’s Hysterectomy. Methods: 20 cases of early Stage Cancer Cervix, who underwent Wertheim’s hysterectomy over period June 09 to Dec 12 in CRG Hospital, Ujjain and Base Hospital Delhi Cantonment, were studied. The demographic data, hemoglobin before and after surgery, and requirement of intra-operative blood transfusion, were studied. Results : 80% patients had less than 200ml intra-operative blood loss. Conclusion : Alleviating troublesome bleeding during dissection of lymph nodes and ureteric tunnel by primary ligation of internal iliac artery is a statistically proven optimum technique of Wertheim’s Hysterectomy. [Roy P K et al NJIRM 2013; 4(6) : 145-147]
References
2. Epedemiology of Cervical Cancer, Wikipedia, The free encyclopedia.
3. Te Linde’s Operative Gynaecology (Tenth Edition), 2008
4. Kelly H. Ligation of both internal iliac arteries for hemorrhage in hysterectomy for carcinoma uteri. Bull John Hopkins Hosp 1894;5:53
5. Reich WJ, Nechtow MJ, Keith L. Supplementary report on hypogastric artery ligation in the prophylactic and active treatment of hemorrhage in pelvic surgery. Int Surg 1965;44:1
6. Shafiroff BGP, Grillo EB, Baron H. Bilateral ligation of hypogastric arteries. Am J Surg 1959;98:34
7. Burchell RC, Mengert WF. Internal iliac artery ligation: a series of 200 patients. J Int Fed Obstet Gynecol 1969;7:85.
8. Burchell RC. Hemodynamics of the internal iliac artery ligation. Presented at the 1964 Clinical Congress of the American College of Obstetricians and Gynaecologists
9. Burchell RC. Internal iliac artery ligation: hemodynamics. Obstet Gynecol 1964;24:737
10. Paraskevaides E, Noelke L, Afrisibi M. Internal iliac ligation (IIAL) in obstetrics and gynecology.Eur J. Obstet Report Biol, 1993; 52:71-75.
