 Hi, today we will be discussing about the pelvic anatomy, basically the arterial supply and the relations of the ureter and the spaces of the pelvis. The first step is to identify the conadal vessels, that is the ovarian vessels that run in the infundibular pelvic ligament. And we should always remember that this part of the anatomy is always persistent and constant that the ureter lies always and always medial to the infundibular pelvic ligament or medial to the conadal vessels. So the first incision that we made was in the pelvic peritoneum that was just medial to the infundibular pelvic ligament. Just underneath the pelvic peritoneum was the ureter which now we are dissecting layer by layer. So the outer layer of the pelvic peritoneum was cut and all the misentry of the ureter, the fat covering the ureter was displaced laterally. This is called as the lateralization of the ureter. You can clearly see the peristalsis of the ureter and the ureter going down into the pelvis all medial to the infundibular pelvic or the ovarian vessel. Below the ureter was the internal iliac artery which we will be seeing in detail. The first step is to lateralize the ureter and the second step is to medialize the ureter. Now what we are performing is medialization of the ureter. The dissection is being done by blunt dissection with the help of suction just to tell you that this part of the dissection is completely avascular if you are in the right plane. You have to separate the ureter from all the fibro fatty attachments with the peritoneum, keep going down deep into the pelvis, mobilize the ureter from both sides that is lateralize the ureter and medialize the ureter. The traction with the left hand is very very important. In our previous video we had done most of the surgery with monopolar forceps. Now we will be showing you a safe dissection with the help of ligature or a vessel sealer. The same dissection can even be equally performed well with the use of harmonic scalpel. We are going right over the ureter, we are medializing the ureter as well as lateralizing it and going on top of it making sure that we are away from causing any thermal injury onto the ureter. In doing so we are encountering the internal iliac artery, the anterior division of the internal iliac artery which is also called as the obliterated umbilical artery. We will be seeing these arteries and their branches in detail in some time. Now the posterior leaf of the broad ligament is cut all along the obliterated umbilical artery. Now we come back on to the ovarian vessels, the infundibulopelvic ligament, dissected of the soas muscle which can be seen below and the external iliac artery. This is an almost unedited video of pelvic anatomy. The last video that we had put up was an edited video. Now we have isolated the infundibulopelvic ligament right up to the pelvic brim, you are going to dissect it from medial and the lateral side and isolate the infundibulopelvic ligament. The attraction from the assistant surgeon is very important so as to open the space for a good pelvic dissection. This is a case of c-endometrium and a type 2 radical hysterectomy was being performed. We will be showing only the part of the pelvic dissection. The anterior leaf of the broad ligament is cut. Now you can see the ureter and lateral to the ureter is the internal iliac artery. Between the external iliac artery and the ureter is the internal iliac artery and all the branches of the internal iliac artery are being isolated. The uterine artery is seen from lateral to medial coursing horizontally from origin at the internal iliac artery anterior division and coursing above the ureters. This is the point where the water runs under the bridge that is the ureter runs under the horizontally placed uterine artery. Above the uterine artery is the paravacycle space. It's an avascular space as you can see that the blunt dissection is being performed by the operating surgeon both hands and you go right up to the levator and eye muscle. You can see the levator and eye muscle coming up and all this part of the dissection is completely avascular can be performed with any instrument. Below the ureters lies the uterine vein. So above the ureter runs the uterine artery and below the ureter sometimes runs the uterine vein. Below the uterine artery is the pararectal space which continues with the paravacycle space above the uterine artery. Over the left hand forceps is the horizontally placed uterine artery and now we are dissecting the uterine vein underneath. So both the spaces are almost joined and we are going to see the origin of the uterine artery from the internal iliac artery. This is the internal iliac artery which divides into the anterior division and the posterior division. The anterior division runs up and gives off the obliterated umbilical artery and the first division onto the medial side is the uterine artery. What we are dissecting now is nothing but the inferior gluteal artery which is the division of the anterior division of the internal iliac artery. Sometimes the inferior gluteal artery also gets originated from the posterior division and this inferior gluteal artery can also be mistaken as the posterior division of the internal iliac artery. The posterior division of the internal iliac artery usually dips vertically down. Now what we are performing is the lateralization of the ureter in its terminal half where the ureter is being pushed laterally and the dissection of the ureter anterior or superior to it underneath the uterine artery as well as separation of the ureter from the utrosacral line medial. The ureters always run lateral to the utrosacral and you can clearly see the uterine vein. This is the uterine vein running horizontally, above it is the uterine artery. The inferior gluteal artery can be seen behind or below the uterine vein. The uterine vein runs inferior to the ureters, the uterine artery runs superior to the ureters. So that is the internal iliac artery dividing into the anterior and the division, the inferior umbilical ligament and the uterine artery and the ureter's course. This was the whole anatomy of the pelvis and inherited video. Thank you very much.