The Location and Contents of the Lateral Ligaments of the Rectum: A Study in Human Soft Cadavers

PURPOSE: This study was designed to identify the location of the lateral ligaments of the rectum and to reveal its contents. METHODS: From 18 human soft cadavers (9 males), 18 pelves were sagittally sectioned into 36 hemipelvic specimens affording good anatomic view of the lateral aspect of the rectum. All of them were dissected and mobilized by using sharp technique under direct vision by one surgeon to avoid confounding factor. The lateral ligaments of the rectum were identified and the distances from the center of its pelvic attachment to the promontory of sacrum and coccyx were measured. After measurement, they were transected and brought for histologic examination. RESULTS: In 36 hemipelvic specimens, 18 lateral ligaments of the rectum were found on the right side of the rectum and 18 were found on the left side. One cadaver had no lateral ligament on the right side and another had two lateral ligaments on the right side 3-cm apart. The location of the lateral ligaments was posterolateral to the rectum. The distance from the lateral ligament to sacral promontory on right side was 8.14 +/- 1.82 cm (mean +/- standard deviation) and 8.14 +/- 1.22 cm on left side. The distances from the lateral ligament to coccyx on the right and left sides were 5.12 +/- 1.4 cm and 4.88 +/- 1.29 cm, respectively. The content of the lateral ligaments of the rectum consisted of loose connective tissue with cluster of small nerves. No artery was detected in all specimens. The small arterioles and venules were discovered in only four specimens. CONCLUSIONS: The lateral ligaments of the rectum were located at posterolateral side of the rectum. They were closer to the coccyx than to the sacral promontory. Its component was loose connective tissue containing multiple small nerves. There was no artery found in any lateral ligaments by histologic study. Small arterioles and venules were detected 11 percent.