Internal Iliac Artery Ligation: Experience of Self-learning by Cadaveric Dissection
Author(s): Prashant Narhar Mukadam, Munjal Jayeshkumar Pandya, Chandni Joshi, Zeel Kandhla, Deep Joshi, Parth Shah
Abstract
Post-partum hemorrhage is one of the commonest causes of maternal morbidity as well as mortality in majority of the developing countries even today. Failure of intervention by medications requires surgical intervention. Ligation of anterior division of internal iliac artery is life saving, uterus preserving surgery, and expertise at it can reduce obstetric hysterectomies. To visualize anterior division of internal iliac artery in cadavers and to plan out further steps for training of post graduate students. Dissection was carried out in 5 cadavers, reaching internal iliac artery and passing silk suture beneath the same, before its bifurcation. The average time taken for reaching internal iliac artery from putting an incision on skin to the artery was 15 minutes. Ligation of anterior division of internal iliac artery is a life saving procedure, preserving fertility as well. Training post graduate students for the same would require cadaveric dissection as first step, which can be followed by assisting senior consultants while performing the procedure in emergencies. Cadaveric dissection for internal iliac artery is a skill enhancing, confidence enriching step as a part of the training, which can be further enhanced by assisting live surgeries, producing more competent obstetricians and surgeons, which in turn may reduce maternal morbidity and mortality.
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