Surgical Anatomy of the Retroperitoneal and Pelvic Extraperitoneal Space

Abstract

The retroperitoneal space (retroperitoneum) is a potential space in the posterior peritoneal cavity that lies between the parietal peritoneum internally and the fascia of posterior abdominal wall externally. The space extends from the diaphragm superiorly to the sacral promontory and to the arcuate line inferiorly, which communicates with the pelvic extraperitoneal space inferiorly, with mediastinal connective tissue superiorly through the lumbocostal triangles, as well as with extraperitoneal fat bilaterally. Therefore, a primary tumor located in the retroperitoneal space may spread or invade to the posterior mediastinum, lateral abdominal wall, or pelvic extraperitoneal space. The retroperitoneal space can be divided into left lumbar region (left flank), right lumbar region (right flank), prevertebral region, left iliac fossa (RIF), and right iliac fossa (LIF) areas.