Broad LigamentEdit
The broad ligament, or ligamentum latum uteri, is a large, bilaminar fold of peritoneum that drapes across the female pelvis. It extends from the lateral aspects of the uterus to the lateral pelvic walls, effectively forming a double layer that helps organize the arrangement of pelvic organs within the peritoneal cavity. Because it is a peritoneal fold, the broad ligament is less a stout, discrete ligament and more of a conduit and stabilizing sheet that carries vessels, nerves, and lymphatics to the uterus, fallopian tubes, and ovaries. In clinical anatomy, it is often described as comprising three mesenteries— the Mesometrium, the Mesovarium, and the Mesosalpinx—each contributing to attachments and passageways for the reproductive structures it encloses.
The broad ligament is not primarily a muscular support structure, but it participates in spatial organization within the pelvis. Its three constituent mesenteries attach the uterus, ovaries, and fallopian tubes to the pelvic walls and show how the reproductive tract is invested by the peritoneum. The anterior and posterior surfaces of the broad ligament frame the vesicouterine and rectouterine spaces, and its edges lie near important vascular and neural tracks that supply the pelvic organs. The ureter runs inferior to the uterine artery near the cervix, a relationship that surgeons must respect during procedures in the region and that has given rise to the adage about the “water under the bridge.” The uterine arteries and their branches travel within the base of the broad ligament as they ascend to the uterus, and lymphatic channels within the same region accompany these vessels to regional nodes.
Anatomy
Mesometrium
The mesometrium is the largest portion of the broad ligament and forms the connection between the body of the uterus and the lateral pelvic wall. It provides a corridor for the uterine vessels and adjacent nerves and lymphatics, and it helps stabilize the uterus within the pelvic cavity. In surgical terms, the mesometrium is a key landmark during procedures such as hysterectomy or other operations involving the uterus and cervix. The relationship between the uterine artery, the ureter, and the surrounding connective tissue in this region is a central consideration for operating clinicians. Uterine artery and Ureter are commonly discussed in relation to the broad ligament.
Mesovarium
The mesovarium attaches the ovary to the posterior aspect of the broad ligament and carries vessels and nerves that supply the ovary and the distal portions of the reproductive tract. Within the mesovarium, the ovarian vessels traverse on their way to the ovary, and the region helps orient the ovary in relation to the uterus and fallopian tube. The ovary itself is represented by the Ovary in anatomical descriptions.
Mesosalpinx
The mesosalpinx surrounds and supports the Fallopian tube (salpinx) along its course between the ovary and the uterus. This portion of the broad ligament helps maintain the spatial relationship of the tube to the ovary and uterus, and it contains vessels and nerves that serve the tube and adjacent structures.
Contents and relationships
Within the layers of the broad ligament lie vascular and neural elements that supply the reproductive organs. The major arterial supply to the uterus comes from the Uterine artery, a branch of the internal iliac system, and branches along the base of the broad ligament feed the uterus, cervix, and adjacent tissues. The ureter, which courses under the uterine artery in this region, is a critical consideration during pelvic surgery due to the risk of iatrogenic injury. The broad ligament also contains lymphatic channels that drain the uterus and related structures to regional nodes. Pathologies can involve the broad ligament—such as endometriosis implants or rare broad ligament masses—which underscores its role as a conduit for disease as well as a stabilizing sheet. See discussions of Endometriosis and rare Leiomyomas in relation to broad ligament involvement.
Development and variation
During embryonic development, the peritoneum forms folds that envelop the developing pelvic organs and create the broad ligament as a sheet surrounding the uterus, ovaries, and tubes. Its extent and thickness vary among individuals and can change with age, pregnancy, and hormonal influences, though its basic three-part organization—mesometrium, mesovarium, and mesosalpinx—remains a useful framework for anatomical description. It is important to recognize that, while the broad ligament provides a recognizable scaffold, the pelvis gains most of its mechanical support from other structures such as the pelvic floor and supporting ligaments, with the broad ligament primarily serving a connective and conduit function.
Clinical significance
The broad ligament is a key anatomical corridor in pelvic surgery. Understanding its relationships helps surgeons avoid injury to the ureter and to the uterine arteries during procedures such as hysterectomy, oophorectomy, or tubal ligation. Pathologies may involve the broad ligament itself or extend into it from adjacent organs; endometriosis can affect the broad ligament, and rare broad ligament masses or cysts can occur. Imaging studies in the pelvis—whether ultrasound or cross-sectional modalities like MRI—often describe findings in the region of the broad ligament when evaluating adnexal or uterine conditions. The broad ligament’s position adjacent to important pelvic compartments means it is a frequent reference point for describing the spread of disease and planning operative approaches.