Prophylactic internal iliac artery ligation in gynecologic pelvic surgery

Abstract

Ligation of the internal iliac artery was first w x performed by Howard Kelly in 1893 1 . It has been used extensively in the control of pelvic hemorrhage in both obstetrics and gynecology in w x emergency situations 2]4 . However, its elective use to reduce operative blood loss has been scantily reported. In most developing countries, and especially in this environment, medical facilities are poor. In addition there are inadequate blood banks and blood transfusion services. Hemorrhage contributes significantly to operative morbidity and mortality. This fact prompted the authors to carry out prophylactic bilateral internal Ž . iliac artery ligation BIIAL during pelvic surgery. Fourteen patients that needed radical pelvic surgery at the gynecological unit of the University Ž . of Benin Teaching Hospital UBTH between September 1992 and August 1997 were offered an elective internal iliac artery ligation at the onset of surgery. The normal routines for any patient undergoing major surgery at the UBTH theater