This chapter provides an introduction to the laparoscopic anatomy of the female pelvis and uses several simple procedures to illustrate that anatomy. Obviously, a single chapter cannot do full justice to an entire subspecialty, but basic information about these procedures and the relevant laparoscopic anatomy will be useful to the general surgeon. References at the end give further technical details of more advanced procedures.

The laparoscopic view of the pelvis (see the orientation figure) is similar to that obtained with the uterus elevated and retracted for transabdominal hysterectomy (see also Fig. 85.2). The round ligaments arch up and laterally to exit through the internal (deep) inguinal rings. The uterus lies between bladder (anterior) and rectosigmoid colon (posterior). The white color of the ovaries contrasts sharply with the pink color of the encircling fallopian tubes. Crossing the pelvic brim, the ureters, gonadal vessels, and round ligament (from posterior to anterior) are found. The right ureter is generally visible under the pelvic peritoneum as it crosses over the iliac vessels, and will vermiculate if touched. The left is generally hidden by overlying sigmoid colon and mesentery.