BILATERAL   VARIATION   IN   THE   ORIGIN   OF   OBTURATOR   ARTERY,   ITS   DIMENSIONS,   PHYLOGENY   AND   CLINICAL   SIGNIFICANCE:   A CADAVERIC STUDY AND REVIEW Amar Singh L* 1 , Lakshmikanta B M 2 . *1 Associate professor, Department of Anatomy, International Medical School, MSU, Bangalore Campus, Karnataka, India 2 Associate professor, Department of Anatomy, DM Wayanad Institute of Medical Sciences, Kerala, India Corresponding   Author   Address:   Dr   Amar   Singh   L,   Associate   Professor,   Department   of   Anatomy,   International   Medical   School,   MSU,   Bangalore   campus, New BEL road, MSRIT post, Bangalore-560054, Karnataka, India. Cell: 09901042452 E-Mail:  drmjamar34@gmail.com ABSTRACT: Introduction:    Obturator   artery   usually   arises   from   anterior   division   of   internal   iliac   artery.   Variations   in   its   origin   and   course   can   lead   to   unnecessary   exploratory   surgery and complications during laparoscopic herniorrhaphy procedures. Aim:  The aim of the present study is to observe the variations in the origin and course of Obturator artery. Material   and   methods:    Forty   (40)   adult   human   pelvic   halves   of   known   sexes   were   studied   to   note   down   the   variations   in   the   origin,   course   and   dimensions   of   Obturator artery. Results:   In   39   (97.5%)   of   the   specimens   Obturator   artery   was   found   to   be   arising   normally   from   the   anterior   division   of   internal   iliac   artery,   were   as   in   one   (2.5%)   of   the specimen it was found to be arising bilaterally from the posterior division of internal iliac artery. Conclusions:   A   good   knowledge   about   the   normal   anatomy   and   the   variation   in   the   origin   and   dimensions   of   the   Obturator   artery   is   essential   as   it   reduces   the   surgical complications during pelvic surgeries. KEY WORDS: Obturator artery, variations, posterior division of internal iliac artery, clinical significance. References 1 . Williams   PL,   Bannister   LH,   Berry   MM,   Collins,   Dyson   M,   Dussek   JE,   Ferguson   MWJ,   Gray’s   Anatomy.   The   anatomical   basis   of   medicine   and   surgery.38th   Ed.   Churchill Livingstone, Edinburgh, 1995;1560. 2 . Snell’s RS. Clinical anatomy for students.6th Ed. Lippincot, Williams and Wilkins, Philadelphia, 2000;292-293. 3 . Sinnatamby CS, Last’s anatomy. Regional and applied.10th Ed. Churchill Livingstone, Edinburgh, 2000;291. 4 . Hollinshead HW. Blood vessels in the pelvis in anatomy for surgeons. Hoeber-Harper II, 1958;681-686. 5 . Arey LB. the development of peripheral blood vessels. Orbison JL, Smith DE. The peripheral blood vessels. Williams and Wilkins, Baltimore, 1963;1-16. 6 . Bergman   RA,   Thompson   SA,   Afifi   AK   and   Saadeh   FA.   Compendium   of   human   anatomic   variation:   catlog,   atlas   and   world   literature.   Urban   and   schwazenberg,   Baltimore and Munich, 1988; 40-41. 7 . Kumar D, Rath G. Anomalous origin of Obturator artery from the internal iliac artery. Int J morphol. 2007;25(3):639-641. 8 . Prabhu LV, Pillay M and Kumar A. Observation on the variations in origin of the principal branches of internal iliac artery. Anat Karnataka.2001; 1: 1-10. 9 . Chandler FA, Seidler F. Intrapelvic Extraperitoneal resection of the Obturator nerve. Surg.Gyn.obs.1939;100-102. 1 0 . Lau   H,   Lee   F.   A   prospective   endoscopic   study   of   Retropubic   vascular   anatomy   in   121   patients   undergoing   endoscopic   Extraperitoneal   inguinal   hernioplasty.   Surg Endosc.2003;17:1376-1379. 1 1 . Standring s. Cardiovascular system in Gray’s anatomy, Edinburg, London, 2005; 1316. 1 2 . Sinnatamby CS. Last’s anatomy regional and applied. Edinburgh, London, Newyork, Oxford, Philadelphia, Toronto, 2006;320. 1 3 . Anson   BJ.   The   cardiovascular   system   in   Morris   human   anatomy.   A   complete   systematic   treatise.   The   Blakiston   division   McGraw   Hill   book   company,   Newyork,   Sydney, London, 1966;752-766. 1 4 . Sarikeioglu L, Sindel M. Multiple vessel variations in the Retropubic region. Folia morphol(warsz). 2002;61(1):43-45. 1 5 . Braithwaite JL. Variations in origin of peripheral branches of internal iliac artery. J Anat. 1952;86(4):423-430. 1 6 . Iwasaki   Y,   Shoumura   S,   Ishizaki   N,   Emura   S,   Yamahira   T,   Ito   M,   Irono   H.   The   anatomical   study   on   the   branches   of   internal   iliac   artery-comparisiosn   of   the   findings   with Adachi’s classification. 1987;62(6):640-645. 1 7 . Pick JW, Anson B, Ashley FL. The origin of Obturator artery, a study of 640 body halves. Am J Anat. 1942;70:317-343. 1 8 . Roberts WH, Krishinger GL. Comparitive study of human internal iliac artery based on Adachi’s classification. Anat Rec. 1967;158(2):191-196. 1 9 . Maneesha sharma, Tripta sharma, Richhpal singh, Antarpreet kaur. Variation of Obturator artery in man. Anat physiol. 2012;2(3):1-4. 2 0 . Fitzerald MJT. Human embryology, New york, Harper international, 1978:38-56. 2 1 . Sanduno   JR,   Roig   M,   Rodriguez   A,   Ferreira   B,   Domenech   JM.   Rare   origin   of   Obturator   artery,   inferior   epigastric   and   femoral   arteries   from   a   common   trunk.   J.   Anat. 1993;183: 161-163. 2 2 . Dinesh kumar and Gayatri rath. Anomalous origin of Obturator artery from the internal iliac artery. Intl.J.Morphol.2007;25:939-41. 2 3 . Bleich   AT,   Rahn   DD,   Wieslander   CK,   Wai   CY,   Roshanravan   SM,   Corton   MM.   Posterior   division   of   the   internal   iliac   artery:Anatomic   variations   and   clinical   applications.Am   J Obstet Gynecol. 2007;197(6): 658.e1-5. 2 4 . Kelly HA. Ligaation of both internal iliac artery for hemorrhage in hysterectomy for carcinoma uteri. Bull Hopkins Hosp, 1894;53-54. 2 5 . Das Bn, Biswas AK. Ligation of internal iliac arterires in pelvic hemorrhage. J Obstet Gynaecol Res. 1998; 24(4):251-254. 2 6 . Papp Z, Toth-pal, Papp C, Sziller T, Gavai M, Silhavy M, Hupuczi P. Hypogastric artery ligation for intractable pelvic hemorrhage. Intl J Gynaecol Obstet. 2006; 92(1):27-31. 2 7 . Ilipoulos JI, Howanitz PE, Pierce GE, Kueshkerian SM, Thomas JH, Hermreck AS. The critical hypogastric circulation. AM J Surg. 1987;154(6):671-675.