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Summary
Arterial branches to the uterus and ovaries that pass through the mesosalpinx contribute significantly to the maintenance of the ovarian reserve. Especially arterial supply of the uterine tube is provided by a number of anastomoses between both the uterine and ovarian vessels. Knowledge on the morphologic peculiarities will allow to identify main contributors especially blood flow ultrasound examination for the purpose of ovary preserving surgery. This study aimed at identifying landmarks especially for so-called low-flow tubal vessels. Arteries of 17 female Thielembalmed bodies were studied along three preselected paramedian segments and measurements taken. A section was made through the center of the ovary perpendicular to uterine tube, then the mesosalpinx tissue distance was divided into 3 equivalent zones: upper, middle and lower thirds. The surface area of the mesosalpinx averaged 1088 ± 62 mm2. 47.7 ± 7.1 % of the mesosalpinx zones included macroscopically visible vessels. The lower third segment of mesosalpinx was the thickest averaging 2.4 ± 1.5 mm. One to three tubal branches were identified in the middle third of the mesosalpinx. Arterial anastomoses were found in the upper segment of the mesosalpinx, but no presence of a marginal vessel supplying the fallopian tube could be found. Statistically significant moderate positive correlations were established between the diameters of the mesosalpingeal arteries between the three zones. The mesosalpinx, uterine tube and the ovary form areas of segmental blood supply. Variants of tubal vessels appear to be a sparse source of blood supply.
Keywords
Uterine tube * Mesosalpinx * Ovarian reserve * Salpingectomy * Salpinx * Vascularization
Introduction
The mesosalpinx forms an anatomical structure presenting a duplication of the peritoneum and contains numerous vessels and adipose tissue [1-2]. The surgical approach to the uterine tube for its dissection, both complete or for partial removal, can be performed through it. A number of practical recommendations are known for approaching and performing operations on the uterine appendages. While performing salpingectomy, some amount of tissue with vessels near the ovarian gates should be left so as not to cause its blood supply disturbance in the surgical follow up [3-4]. A decrease in blood flow in the ovarian tissues is associated with a diminished ovarian reserve.
Preservation of the uterine artery has been of particular importance for...