Laparoscopically visualizing anatomic relationships

I recently observed a laparoscopic sigmoidectomy, the removal of the sigmoid colon. The patient's uterus figured prominently in the center of the screen. As the surgeons followed the left descending colon into the sigmoid colon and rectum, I noted that the large bowel tracked posterior to the uterus.


Flashback to a little less than a year ago when as a second-year medical student, lacking any meaningful clinical experience, I was taught how to perform a pelvic exam with a standardized patient. I remember being surprised at the time that a complete pelvic exam includes inserting a finger in the patient's rectum, the purpose of which is to check for cysts or fibroids on the posterior aspect of the uterus.

Afterward, I looked in Netter's to better understand the anatomical relationship between the uterus and rectum. I got it then, but it wasn't until this past week when I saw the actual anatomy directly from inside the abdominal cavity that I really got it.