Anatomical distances among pelvic structures related to surgical techniques through the obturator foramen

Objective: To describe distances between the major bony, vascular, neurologic and visceral structures of importance when guiding trocar needles through the obturator foramen. Material and methods: Six embalmed female hemipelvises from voluntary donors were dissected at the Department of Anatomy of the Universitat Autònoma de Barcelona (UAB) School of Medicine. Special attention was paid to the obturator foramen and its neighboring bony, aponeurotic and muscular structures, and neurovascular bundles. Results: Several distances were collected. Distances in relation to the ischiopubic ramus, the ischial spine and the arcus tendineus of levator ani seemed to be particularly important, as they are the main landmarks for surgery. Conclusion: A good knowledge of anatomy illuminates the passage of trocar needles inserted through the obturator foramen as a route to enter the pelvic space. This knowledge improves safety, understanding of potential risks and how to avoid them, as well as the management of perioperative complications.