Retroperitoneal dissection in gynecologic surgery for benign disease.

In this study, the pelvic retroperitoneal anatomy was dissected during 140 consecutive exploratory laparotomies for benign gynecologic disease. In addition, 110 bilateral hypogastric artery ligations were done both to teach the technique and to attempt to determine whether such a procedure reduces blood loss in elective abdominal hysterectomy. Fifty-eight hysterectomies with hypogastric artery ligation were compared to an equal number done without bilateral hypogastric ligation. The data indicate that prophylactic hypogastric artery ligation during hysterectomy did decrease blood loss, though other variables may account for this, and that teaching retroperitoneal dissection to residents is paramount, teaching them a potentially life-saving procedure essential to gynecologic and obstetric training. Only one complication occurred in this series.