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. 2009;64(9):897-901.
doi: 10.1590/S1807-59322009000900011.

Variability in the origin of the obturator artery

Mangala M Pai  1 , Ashwin Krishnamurthy, Latha V Prabhu, Manohar V Pai, Senthil A Kumar, Gavishiddappa A Hadimani
Affiliations

Variability in the origin of the obturator artery

Mangala M Pai et al. Clinics (Sao Paulo). 2009.

Abstract

Introduction: General surgeons dealing with laparoscopic herniorrhaphy should be aware of the aberrant obturator artery that crosses the superior pubic ramus and is susceptible to injuries during dissection of the Bogros space and mesh stapling onto Cooper's ligament. The obturator artery is usually described as a branch of the anterior division of the internal iliac artery, although variations have been reported.

Materials and methods: The present study was conducted on 98 pelvic halves of embalmed cadavers, and the origin and course of the obturator artery were traced and noted.

Results: In 79% of the specimens, the obturator artery was a branch of the internal iliac artery. It branched off at different levels either from the anterior division or posterior division, individually or with other named branches. In 19% of the cases, the obturator artery branched off from the external iliac artery as a separate branch or with the inferior epigastric artery. However, in the remaining 2% of the specimens, both the internal and the external iliac arteries branched to form an anastomotic structure within the pelvic cavity.

Conclusion: The data obtained in this study show that it is more common to find an abnormal obturator artery than was reported previously, and this observation has implications for pelvic surgeons and is of academic interest to anatomists. Surgeons dealing with direct, indirect, femoral, or obturator hernias need to be aware of these variations and their close proximity to the femoral ring.

Keywords: External iliac artery; Inferior epigastric artery; Internal iliac artery; Obturator artery; Variations.

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Figures

Figure 1
Figure 1
Right side of a pelvis showing the origin of the obturator artery (OA) from the posterior division (PD) of the internal iliac artery (IIA). AD- anterior division, EIA- External iliac artery, ON- obturator nerve, OV- obturator vein
Figure 2
Figure 2
Right side of a pelvis showing the origin of the OA from the PD of the IIA with the iliolumbar artery (ILA). The red arrow indicates the common trunk. EIA- external iliac artery, ON- obturator nerve, OV- obturator vein
Figure 3
Figure 3
Right side of a pelvis showing the origin of the OA from the posterior division of the IIA with the superior gluteal artery (SGA). EIA- external iliac artery, ON- obturator nerve
Figure 4
Figure 4
Right side of a pelvis showing the origin of the OA from the external iliac artery (EIA). IIA- Internal iliac artery, ON- obturator nerve, OV- obturator vein
Figure 5
Figure 5
Left side of a pelvis showing the origin of the OA from the EIA with the inferior epigastric artery (IEA). IIA- Internal iliac artery, ON- obturator nerve.
Figure 6
Figure 6
Right side of a pelvis showing the dual origin of the OA from both the EIA (OA1) and IIA (OA2), and forming an anastomotic structure (arrows). IEA- Inferior epigastric artery, ON- obturator nerve, OV- obturator vein
Figure 7
Figure 7
Left side of a pelvis showing the OA arising from the EIA and advancing posterior to the external iliac vein (EIV) to reach the pelvic cavity. ON- obturator nerve, OV- obturator vein
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