Anatomical Discoveries Research Articles

Human Adapted Prosomeric Model: A Future for Brainstem Tumor Classification

This study reevaluates the conventional understanding of midbrain anatomy and neuroanatomical nomenclature in the context of recent genetic and anatomical discoveries. The authors assert that the midbrain should be viewed as an integral part of the forebrain due to shared genetic determinants and evolutionary lineage. The isthmo-mesencephalic boundary is recognized as a significant organizer for both the caudal midbrain and the isthmo-cerebellar area. The article adopts the prosomeric model, redefining the whole brain as neuromeres, offering a more precise depiction of brain development, including processes like proliferation, neurogenesis, cell migration, and differentiation. This shift in understanding challenges traditional definitions of the midbrain based on external brain morphology. The study also delves into the historical context of neuroanatomical models, including the columnar model proposed by Herrick in 1910, which has influenced our understanding of brain structure. Furthermore, the study has clinical implications, affecting neuroanatomy, neurodevelopmental studies, and the diagnosis and treatment of brain disorders. It emphasizes the need to integrate molecular research into human neuroanatomical studies and advocates for updating neuroanatomical terminology to reflect modern genetic and molecular insights. The authors propose two key revisions. First, we suggest reclassifying the isthmo-cerebellar prepontine region as part of the hindbrain, due to its role in cerebellar development and distinct location caudal to the genetically-defined midbrain. Second, we recommend redefining the anterior boundary of the genetically-defined midbrain to align with genetic markers. In conclusion, the authors highlight the importance of harmonizing neuroanatomical nomenclature with current scientific knowledge, promoting a more precise and informed understanding of brain structure, which is crucial for both research and clinical applications related to the human brain.

To the 500th anniversary of the birth of Gabriele Falloppio (1523–1562)

The article is dedicated to the 500th anniversary of the birth of the greatest physician and scientist of the 16th century Gabriele Falloppio (Fallopius), a revolutionary morphologist who made an invaluable contribution to the development of science, and one of the founders of fundamental anatomy. Although Falloppio is primarily known as an anatomist who described the uterine (“fallopian”) tubes, his range of interests was much wider, and his contribution to anatomy was substantially more significant. Fallopius made many important discoveries in anatomy, and a number of anatomical structures bear his name. Also, Gabriele Falloppio was a talented teacher and a renowned medical practitioner, surgeon and pharmacist. It should be especially noted that Fallopius considered himself an apprentice of Andreas Vesalius. There is no data confirming the fact of their personal acquaintance, but there is documentary evidence of short-term correspondence between Fallopius and Vesalius. In his famous work “Anatomical observations” (“Observationes anatomicae”, 1561), Fallopius pointed out Vesalius’ mistakes and inaccuracies in anatomical descriptions, subjecting his “De humani corporis fabrica” to correct criticism. Vesalius’ reply with compliments to Fallopius as a scientist has been preserved. In any case, the undoubted fact is that Fallopius was an adherent of Vesalius’ methods in applied science and the teaching of anatomy, and consistently introduced them into practice throughout his life.

Skeletal reconstruction of fossil vertebrates as a process of hypothesis testing and a source of anatomical and palaeobiological inferences

Reconstructions of extinct animals play an important role in vertebrate palaeontology. Such reconstructions represent visual hypotheses regarding the original morphology of the vertebrates they depict, which are amenable to future testing as additional information comes to light through discoveries of new specimens and re-examination of specimens that have already been collected. In this contribution, we argue that the scientific value of reconstructing a fossil vertebrate extends beyond simple presentation of a visual hypothesis, because the process of creating a reconstruction is itself analytical and hypothetico-deductive. Successive drafts of the reconstruction represent provisional visual hypotheses that can be tested on the basis of their internal consistency and their congruence with empirical evidence about the extinct taxon that is the reconstruction’s subject. Iterative refinement of the reconstruction over successive rounds of testing and modification is likely to lead to discoveries about the subject’s anatomy, as certain anatomical possibilities are rejected and others found to be plausible. These anatomical discoveries, here termed first-order inferences, may in turn lead to second-order inferences about functional morphology or other aspects of palaeobiology. Three case studies from dinosaur palaeontology, respectively involving the skull of the hadrosaurid Edmontosaurus Lambe, 1917, the forelimb of the ceratopsid Pachyrhinosaurus Sternberg, 1950, and the hindlimb of an indeterminate ceratopsid, are provided to illustrate how the process of reconstruction can be a fertile source of discoveries.

The value of transthoracic echocardiography and chest X-ray in locating the tip of central venous catheter in dialysis patients: a comparative study with computed tomography imaging

To determine the tip position of the central venous catheter (CVC) in patients with dialysis, the guidelines recommend that it be determined using chest radiography (CXR) after catheterization, without fluoroscopy. However, some researchers have proposed that transthoracic echocardiography (TTE) can replace CXR, but this has not been widely adopted. This study aimed to determine which of the two aforementioned methods is more suitable for locating the tip position of the CVC. This prospective study included 160 patients who underwent hemodialysis at our hospital from March 2021 to December 2022. After inserting the CVC through the internal jugular vein, we used transthoracic echocardiography and CXR to determine the tip of the CVC and compared the results with those of computed tomography (CT). In the comparison between TTE and CXR for locating the CVC tip, we obtained three main findings. (1) TTE was associated with fewer misdiagnosed cases than CXR. (2) TTE provided higher sensitivity (similar sensitivity in position 2), specificity, positive/negative predictive values, and accuracy than CXR. (3) When comparing the receiver operating characteristic curves of TTE and CXR, the area under the curve (95% confidence interval) for the former was larger. Additionally, we made anatomical discoveries: the "hyperechoic triangle" recognized by TTE was equivalent to the entrance of the superior vena cava into the right atrium shown by transesophageal transthoracic echocardiography. TTE is more suitable than CXR as the first examination for CVC tip localization, as it improves diagnostic accuracy and reduces X-ray radiation damage.

The unknown and misunderstood life of Ruggero Oddi, the pioneer of biliary system physiology.

Ruggero Oddi was a talented scientist who initiated the modern era of biliary system physiology, not only with the anatomical discovery of the hepatopancreatic sphincter, but also with the detailed description of its spinal center and nerve regulation. However, his personal and scientific life were determined by an incredible series of unfortunate circumstances. Until now most of these events have been unknown, while the few known have produced biographies distorted by fake interpretations. The purpose of this article is to document Oddi's biography and scientific production in detail, comprehensively framing the scientific environment in which his discoveries occurred. It clears many misinterpretations about events in Oddi's life and academic career, bringing to a new light his figure as scientist in gastroenterological field.

Jean Pecquet (1622–1674). To the 400th anniversary of the birth

The article is dedicated to the 400th anniversary of the birth of the outstanding French anatomist, physician and philosopher Jean Pecquet (1622–1674). Pecquet’s biography is connected with the city of Dieppe, where the future scientist was born and got his primary education, and with Paris, where he made his main discoveries in anatomy. Throughout his life, Pecquet collaborated with many prominent scientists of that time (Jacques Mentel, Louis Gayant, Jean Riolan (the Younger)), including not only physicians and anatomists, but also physicists such as Blaise Pascal, Edme Mariotte, Marin Mersenne and Evangelista Torricelli. Pecquet’s most famous discovery is the chyle cictern, or cisterna chyli. The structure was named after of the scientist – “Pecquet’s reservoir (cistern)”. But more revolutionary discovery made by Pecquet is revealing and proving the fact that the lymphatic ducts flow into the superior vena cava indirectly through the venous angles and refuting the conventional opinion on the drainage of lymph into the liver. An important help in Pecquet’s anatomical research and experiments was his passion for the physical and mathematical sciences. In collaboration with Edme Marriott, Pecquet studied the structure of the eyeball and turned out to be more foresighted, because, unlike Marriott, he correctly understood the role of the retina in the functioning of the eye as an organ of vision. Pecquet was one of William Harvey’s supporters regarding his concept of blood circulation. He introduced cutting-edge at that moment technologies into the anatomy methodology, including animal experiments in vivo, and made a fateful contribution to the progress of anatomical science.

Sorting sex, controlling sex: Masui Kiyoshi's chicken research and experimental system, 1915-1950.

Masui Kiyoshi (1887-1981), a prominent Japanese geneticist, is best known for inventing the sex-sorting method of chicks and his contributions to experimental genetics in Japan. Masui drew inspiration from Goldschmidt's sex determination theory and used chickens, transplantation techniques, and his own "chick sexing" methods in his scientific work. This paper examines the intersection of genetics and industrial breeding by tracing the evolution of Masui's experimental systems. During the early 20th century, poultry farming emerged as a significant industry in Japan, resulting in the development of standardized organisms and techniques for chicken farming. Masui, a professor at Tokyo Imperial University, collaborated with the Imperial Zootechnical Experimental Station to use these organisms as models for sex determination theory while exploring their further industrial possibilities. First, the paper show how Masui viewed chickens as epistemological objects and transformed his anatomical discoveries into standardized industrial practices. Next, it describes how Masui's collaboration with German geneticist Richard Goldschmidt led to new academic questions about sex determination mechanisms and how he integrated his knowledge of chicken physiology into his research on "experimental gynandromorphs" to elaborate the theories. Lastly, the paper discusses the biotechnological ideals that Masui aimed to achieve and how they were co-constructed with his mass-production method of intersex chickens from the early 1930s. The trajectory of Masui's experimental systems highlights the dynamic relationship between agroindustry and genetics in the early twentieth century and demonstrates the 'biology of history' in which the biological processes of organisms intertwine with their epistemological history.

Human cochlear microstructures at risk of electrode insertion trauma, elucidated in 3D with contrast-enhanced microCT

Cochlear implant restores hearing loss through electrical stimulation of the hearing nerve from within the cochlea. Unfortunately, surgical implantation of this neuroprosthesis often traumatizes delicate intracochlear structures, resulting in loss of residual hearing and compromising hearing in noisy environments and appreciation of music. To avoid cochlear trauma, insertion techniques and devices have to be adjusted to the cochlear microanatomy. However, existing techniques were unable to achieve a representative visualization of the human cochlea: classical histology damages the tissues and lacks 3D perspective; standard microCT fails to resolve the cochlear soft tissues; and previously used X-ray contrast-enhancing staining agents are destructive. In this study, we overcame these limitations by performing contrast-enhanced microCT imaging (CECT) with a novel polyoxometalate staining agent Hf-WD POM. With Hf-WD POM-based CECT, we achieved nondestructive, high-resolution, simultaneous, 3D visualization of the mineralized and soft microstructures in fresh-frozen human cochleae. This enabled quantitative analysis of the true intracochlear dimensions and led to anatomical discoveries, concerning surgically-relevant microstructures: the round window membrane, the Rosenthal’s canal and the secondary spiral lamina. Furthermore, we demonstrated that Hf-WD POM-based CECT enables quantitative assessment of these structures as well as their trauma.

Description and nomenclature of organ subdivisions in the Terminologia Anatomica and in anatomical education: Comparison with cancer classifications.

Terminology is the basis for communication among medical professionals. For anatomists, their daily work is based on the Terminologia Anatomica (TA), while pathologists cite the Tumor Node Metastasis (TNM) classification when referring to the anatomical boundaries and regions of malignant tumors. Terminologia Anatomica and clinical-based classifications, including the TMN classification of tumors, use a world-wide standardized nomenclature, which has been revised regularly to incorporate new anatomical discoveries and clinically relevant structures. In medical education, students are familiarized with medical nomenclatures in anatomy textbooks and online learning platforms. Sometime, descriptions and illustrations in anatomy teaching materials put a different focus on the importance of anatomical subdivisions and their borders than is found in cancer classifications. This discrepancy contrasts with the efforts of medical societies to define and implement clinically relevant anatomical structures, including organ subdivisions and their boundaries, in daily clinical practice. Here, we illustrate this problem using the larynx and pancreas as examples. Anatomy education should coordinate teaching content with the requirements of the clinical disciplines.

The brain-immune ecosystem: Implications for immunotherapy in defeating neurodegenerative diseases

Recent functional and anatomical discoveries of brain-immune relationships have overturned previous beliefs regarding the brain's immune privilege. Here, we propose that the brain and immune cells at its borders operate as an "ecosystem" to support the brain's robustness and resilience. Modulation of this ecosystem can be harnessed in the clinic.

Discovery of a trans-sellar vascular supply for the pituitary gland.

The vasculature of the pituitary gland is discussed briefly and the details of an anatomical discovery of the vessels supplying the pituitary gland provided. Twenty latex injected cadaveric heads were dissected. Any vessels that were found to penetrate the sella turcica and travel to the pituitary gland were documented and measured. Additionally, 25 adult skulls were evaluated for the presence, size, and sites of bony foramina in the floor of sella turcica. Trans-sellar vessels were identified in 65% of specimens. There was a mean of 1.5 vessels per specimen consisting usually of a mixture of veins and arteries. The mean diameter of these vessels was 0.3 mm and the mean length from the sella turcica to the pituitary gland was 2.3 mm. These vessels were concentrated in the most concave part of the sella turcica. In bony specimens, the mean number of trans-sellar foramina was four. The diameter of these foramina ranged from 0.3 to 0.6 mm in size. The trans-sellar foramina were concentrated near the center part of the sella turcica and had no regular pattern. The pituitary gland receives at least some blood supply and drainage via vessels traveling along the septum of the sphenoidal sinuses and through the sella turcica. Knowledge of such vessels might lead to a better understanding of the vascular supply and drainage of the pituitary gland and would be useful during skull base approaches such as trans-nasal approaches to the pituitary gland.

Cartography and Topographic Mapping: The Historical Basis for the Standardization of Anatomical Analysis and Surgical Mark-Making to Improve Outcomes in Body Contouring.

Maps have been used for thousands of years to guide and advance mankind's interests. Recently, cartography has grown exponentially into standardized, densely layered systems, facilitating countless functions that use complex algorithms and multifactorial data. Surgeons have successfully addressed bodily concerns for centuries, aided by consistency of human anatomy, physiologic responses to disease, and patterns of disease. However, body contouring techniques alter the much more inconsistent surface anatomy of stretched or aged skin and highly variable subcutaneous fullness. To date, no consistent strategy has been proposed to analyze, map, and alter human shape in a standardized fashion; however, well-established cartographic methods for topographic mapping can be logically adapted to meet surgical needs. Quantification of results, valid and meaningful comparison of techniques, and anatomical discovery could all be achieved by adopting cartographic methods. As anatomists and scientists, surgeons constantly seek logical and reproducible methods to improve patient outcomes. In this article, the authors present a technique derived from topographic mapping, applied directly to the surface of the human body, reflecting the actual underlying anatomy, to guide both elective and reconstructive procedures. The method provides logical and quantifiable methods for (1) the analysis of anatomy, (2) data-driven planning of surgical care, and (3) a consistent operative implementation-so that each patient can receive individualized, anatomically based procedures. Use of well-established mapping strategies would also promote interdisciplinary collaboration, permit adaptation of software to analyze volume and shape, and improve patient outcomes through quantification of change and meaningful comparisons of procedural options.

Remembering Our Past: Teaching the History of Anatomy at Indiana University

Most students pursuing careers in anatomy or related disciplines have a limited understanding of how, over the centuries, the intricate structure of the human body came to be known. To provide students with the relevant historical perspective, we developed a team‐taught survey course in the history of anatomical sciences—including gross anatomy, histology, neuroanatomy, and embryology—from antiquity to the present. Taught entirely via Zoom during the Spring semester of 2021, History of Anatomy (2 semester hours credit) met once per week for approximately 2 hours. Enrollment consisted of 5 undergraduate students majoring in Biology (2), Human Biology (2), or Anthropology (1), as well as 3 graduate students pursuing either a master’s degree in Clinical Anatomy (1) or a Ph.D. in Anatomy Education (2). Three of the students had no prior coursework in anatomy. Through assigned readings, lectures, and discussions, the class explored the work of the great anatomists and their discoveries. A particular emphasis was placed on the evolution of anatomy as a discipline and the cultural influences, scientific controversies, and ethical dilemmas facing its practitioners. Syllabus topics included critical appraisals of the role of gender, race, and ethnicity in anatomical discovery. A key feature of the course was the opportunity for students to engage in robust discussions about such controversial issues as: Eurocentric biases in our understanding of human anatomy and the untold story of Muslim contributions to anatomical knowledge well before Vesalius; Competing claims of priority for who “discovered” the pulmonary circulation; The underappreciated role of women in the history of anatomy and medicine; The ethical quandary of teaching anatomy from archival fetal specimens obtained before the era of informed consent; Accusations that famed anatomist William Hunter used the bodies of murdered pregnant women to create his anatomical atlas of the gravid uterus; Complicity of Eduard Pernkopf and other Nazi‐era anatomists in the unethical use of executed victims to obtain images for a renowned anatomical atlas. All students were assessed through weekly homework (written responses to study questions), a mid‐term writing assignment, and a term paper about an historical topic of the student’s choosing. Graduate students had the additional requirement of a class presentation about their term paper topic. The end‐of‐course evaluation suggested that the course was well‐received by the students (mean Likert score = 4.63 on a 5‐point scale; n = 6). Based on this positive reception, we plan to offer History of Anatomy again on a recurring basis. We believe that by knowing our history, both the good and the bad, future practitioners of anatomy and related disciplines will be less likely to perpetuate the biases and ethical transgressions of earlier eras.

Highlights of neuroanatomical discoveries of the mammalian gonadotropin-releasing hormone system.

The anatomy and morphology of gonadotropin‐releasing hormone (GnRH) neurons makes them both a joy and a challenge to investigate. They are a highly unique population of neurons given their developmental migration into the brain from the olfactory placode, their relatively small number, their largely scattered distribution within the rostral forebrain, and, in some species, their highly varied individual anatomical characteristics. These unique features have posed technological hurdles to overcome and promoted fertile ground for the establishment and use of creative approaches. Historical and more contemporary discoveries defining GnRH neuron anatomy remain critical in shaping and challenging our views of GnRH neuron function in the regulation of reproductive function. We begin this review with a historical overview of anatomical discoveries and developing methodologies that have shaped our understanding of the reproductive axis. We then highlight significant discoveries across specific groups of mammalian species to address some of the important comparative aspects of GnRH neuroanatomy. Lastly, we touch on unresolved questions and opportunities for future neuroanatomical research on this fascinating and important population of neurons.

The coronoid insertion of the human masseter muscle was well described in the 18th century

IntroductionA recent paper in Annals of Anatomy (The human masseter muscle revisited: First description of its coronoid part) claimed to have discovered a previously unrecognized anatomical component of the deep layer of the masseter muscle. The goal of this study is to emphasize the importance of undertaking comprehensive exploration of the historical literature before asserting primacy of an anatomical discovery. MethodsA search was conducted of historical texts describing the anatomical structure of the masseter muscle, spanning the 18th, 19th, and early 20th centuries. Historical sources were obtained via Google Books, the Internet Archive, and the digital collections of Stanford Lane Library Medical History Center, Paris University Numerical library Medica (France), and the State Library of Bavaria (Germany). Contemporary anatomical studies were identified via PUBMED search ResultsRather than a “first description” of newly discovered anatomical feature, the paper we comment upon has added important anatomical details of the length, width, thickness, and fiber orientation of coronoid portion of the deep layer of the masseter. As early as the 18th century, anatomists had described the masseter as possessing a three rather than two-layer structure with a deep layer which inserts on the coronoid process. DiscussionAssertions of primacy (ie. “first description”) of an anatomical structure in the 21st century necessitates a diligent search of literature, including sources which were published during the era when anatomical studies reigned supreme at the forefront of medical science. Systematic scanning of historical medical material has made older texts widely and freely available and digital translation tools have helped to remove language barriers. It is important to study original articles as secondary citations of historical material are less reliable. Without rigorous historical investigation, assertions of primacy cannot be made with confidence.

A Cyclops, a Stone, and a Four-Breasted Woman: Drawing Anatomical Knowledge

Drawings have a long history communicating new ideas, and in the early modern period, they were mobilized by a new form of institution—the scientific society—which emerged as a permanent structure to facilitate novel modes of pursuing and producing anatomical knowledge. This collaborative approach engendered new techniques for communicating and circulating knowledge among investigators, including innovative visual and material practices. Institutions such as the Royal Society of London and the Académie royale des sciences in Paris produced hundreds of drawings, by both artists and philosophers, in the course of their pursuits to understand the functions, structures, and diseases of the body. From depictions of bladder stones to monstrous births, drawings not only recorded anatomical investigations but often stood in for anatomical objects themselves. This essay explores how these early scientific societies created and used drawings as an important tool in their work, particularly in the study of human anatomy. From drawn accounts of dissected cadavers to recording anatomical anomalies, drawings circulated in society meetings, were debated by members, and were recorded in the institution’s minutes. This essay focuses on the materiality of drawings and their ability to preserve and perpetuate anatomical knowledge in ways that ephemeral specimens were not able to match. Based on unstudied archival drawings, this essay contends that image-making was a central component to the study of human anatomy in early scientific societies and that these drawings were a crucial tool in the process of anatomical discovery and knowledge production during their early years.

ГАСПАРЕ АЗЕЛЛИ (1581-1626) И ЕГО ВКЛАД В ИЗУЧЕНИЕ ЛИМФАТИЧЕСКОЙ СИСТЕМЫ

In the article the basic moments of life and scientific activity of the Italian anatomist Gaspare Aselli (1581-1626), one of discoverers of the lymphatic system are described. Scientists engaging in the study of the vascular system are enumerated, modern interpretation of the lymphatic system anatomy and its value in physiological processes is presented. A brief biography about professor Aselli is presented, the circumstances of the anatomic discovery accom- plished by him are described, an estimation of inlay a scientist in morphological researches is given. Text is illustrated by pictures from Aselli’s scientific publications.

Marinus of Alexandria: Galen's anatomical forefather, or: How do you solve a problem like Marinus?

Marinus of Alexandria is—with the exception of Hippocrates—the most commended ancient anatomist in the Galenic corpus, and the man to whom Galen attributes the resurgence of anatomy itself. Working in the first century C.E., he dramatically influenced the course of the history of medicine in two main ways: firstly, he made great strides in anatomical discovery, expounded in an extensive anatomical textbook that attracted much contemporary praise; secondly, he produced considerable expertise around the ancient world through teaching and didactic enterprise. Marinus generated significant renown and respect from these endeavours, which greatly benefitted future generations of medical scholars, including the infamous Galen himself, who even openly admits as such.However, despite Marinus' enormous influence on Galenic anatomy, a body of scientific knowledge that reigned supreme and untouchable for more than a millennium, he today fails to command a level of recognition befitting his epochal achievements. This article explores the factors contributing to his underrated reputation amidst incredibly mixed scholarly opinion, in contrast to the available evidence of the discoveries and innovations of a man who proved so inspirational to the most famous of ancient authors.

Bygone theatres of events: A history of human anatomy and dissection.

Over the last four millennia, the discipline of anatomy and its relationships with medicine and society have evolved dramatically. Human dissection, the perennial tool for anatomical discovery and education, has both guided this evolution and matured alongside it. Soon after the first cadaveric dissections recorded in ancient Greece, China, India, and Persia, clear endorsements of its practice fell largely silent in the anatomical record for 1,500 years before reappearing in Europe at the dawn of the Renaissance. Between the 13th and 18th centuries CE, the performance of anatomical dissection became a popular form of education and public entertainment, and the demand for human cadavers steadily increased among European anatomical schools while supply remained limited by legal statute. This gave rise to an informal group of amateur and professional body snatchers called the Resurrectionists and, later, inspired the Anatomy Act of 1832 CE. In the 20th and 21st centuries CE, voluntary body bequeathal programs have enabled the practice of human dissection to continue in academic centers as a cornerstone of anatomical education, now with a newfound focus on the development of affective skills. This article provides an abridged account of anatomy's development, highlighting key moments in its growth, the valuable contributions of many different societies to the discipline, and the important roles of several luminary anatomists of antiquity. Within the broader context of this history, it offers an overview of anatomical dissection's evocative past, spanning from its inception to its present-day practice.

Pelvic membrane anatomy and surgery with network preservation of autonomic nervous system for rectal cancer

The principle of total mesorectal excision (TME) standardizes the resection range and surgical dissection plane in radical rectal cancer surgery, reduces the local recurrence rate and improves the long-term survival. TME is the "gold standard" in radical rectal cancer surgery. However, with the progress of laparoscopic surgical instruments and techniques in recent years, further understanding of pelvic membrane anatomy and autonomic nervous system has been gained, which makes the surgical plane of TME more accurate and the autonomic nervous system better preserved. According to anatomical discovery and histological confirmation, there is a fascia between the mesorectal fascia and pelvic parietal fascia, called pre-hypogastric nerve sheath, in which autonomic nervous system courses, including the superior hypogastric plexus, left and right hypogastric nerves, pelvic plexus and the neurovascular bundles, from the abdominal to the pelvic cavity behind the mesorectal fascia. It fuses with the end of the mesorectum at the superior border of musculi puborectalis, and goes around the mesorectum to join with Denonvillier fascia. On the basis of anatomical studies and empirical anatomical observations, we put forward the concept of network preservation of the autonomic nervous system: the main trunk as well as the nerve branches of the pelvic autonomic nervous system and accompanying blood vessels should be preserved to ensure the integrity of the nerve reflex arc. The concept allows the radical resection of rectal cancer to follow the principle of TME, and meanwhile, protect patient's urination function and sexual function to the greatest extent, improving the quality of life of patients after surgery.