1. Cadaver Demonstration: Seven times at risk ESO-ESSO Masterclass in Colorectal Cancer Surgery February 13, 2011 Caiscais, Portugal Klaas Havenga University Medical Center Groningen

2. Department of Surgery, University Medical Center Groningen Ureter Hypogastric Nerve Splanchnic nerves Inferior Hypogastric Plexus Havenga 1 2 3 4 5 6 7

3. 1 Inferior mesenteric plexus

5. 2 Superior hypogastric plexus

7. Superior hypogastric plexus Willem Hans Steup

8. 3 Hypogastric nerve

9. Hypogastric nerves Cees Maas / De Ruiter

17. Hypogastric nerves Department of Surgery, University Medical Center Groningen

18. 4 Inferior hypogastric plexus

19. Inferior hypogastric plexus Department of Surgery, University Medical Center Groningen

21. 5 Pelvic Splanchnic nerves

22. Pelvic Splanchnic Nerves Department of Surgery, University Medical Center Groningen

23. Rectosacral fascia divided Parasympathetic Nerves shine through

24. Another angle Levator Ani Muscle Piriformis Muscle Sacral Foramen ± 3 cm. laterally Parasympathetic nerves covered by parietal fascia

25. Parasympathetic Nerves Branches of Medial Rectal Vessels Medial part of mesorectum removed Cranially to the nerve Covered by Parietal fascia

27. Medial Rectalis Vein Cranially to nerves Parasympathetic branch towards rectum

28. 6 Urogenital bundle, level of seminal vesicles

29. Urogenital bundle level seminal vesicles Department of Surgery, University Medical Center Groningen

30. Urogenital bundle level seminal vesicles Department of Surgery, University Medical Center Groningen P=prostate R=rectum SV=seminal vesicle DVF=green Nerves=red

31. Urogenital bundle level seminal vesicles Department of Surgery, University Medical Center Groningen P=prostate R=rectum SV=seminal vesicle DVF=green Nerves=red

33. 7 Urogenital bundle, level of prostate (laterodorsal)