Suspensory Ligament of Ovary

The suspensory ligament of the ovary, also known as the infundibulopelvic ligament, is a fold of peritoneum that extends from the ovary to the lateral wall of the pelvis. It conveys the ovarian vessels, lymphatics, and autonomic nerves between the abdomen and the ovary. Although called a ligament, it primarily functions as a conduit for these vital structures. It plays a critical role in surgical procedures such as oophorectomy and is distinct from the ovarian ligament, which connects the ovary to the uterus.

Structure

The suspensory ligament is a thickened fold of peritoneum containing the ovarian artery, ovarian vein, lymphatic vessels, and autonomic nerves. It is not a true ligament in the mechanical sense, but rather a mesenteric structure that supports and transmits neurovascular components to and from the ovary.

• Contents: Ovarian artery, ovarian vein, lymphatics, and sympathetic nerve fibers
• Tissue type: Double layer of peritoneum with embedded vessels and connective tissue
• Shape: Elongated, narrow, and somewhat fan-shaped

Location

The suspensory ligament stretches from the lateral aspect of the ovary (at the superior pole) to the lateral pelvic wall. It passes anterior to the ureter and is continuous with the posterior layer of the broad ligament. It lies superior and lateral to the ovarian ligament and is oriented vertically within the pelvis.

Function

• Vascular Conduit: Transmits the ovarian artery and vein between the abdominal aorta/IVC and the ovary
• Lymphatic Drainage: Provides a pathway for lymphatic vessels to para-aortic lymph nodes
• Neural Supply: Carries sympathetic nerve fibers that regulate ovarian function
• Surgical Landmark: Important in gynecologic surgery for clamping ovarian vasculature

Blood Supply

• Ovarian artery: Branch of abdominal aorta; runs within the ligament to the ovary
• Ovarian vein: Drains via suspensory ligament to IVC (right) or left renal vein (left)

Lymphatic Drainage

• Via vessels in the suspensory ligament to para-aortic (lumbar) lymph nodes at L1–L2 level

Innervation

• Sympathetic fibers from the ovarian plexus (via aortic plexus)

Embryological Development

• Derived from the upper portion of the embryonic gubernaculum and associated mesonephric structures
• Becomes continuous with the mesovarium and part of the broad ligament

Clinical Significance

• Oophorectomy: The suspensory ligament must be carefully ligated to control ovarian vessels during ovary removal
• Ovarian Torsion: Twisting of this ligament can obstruct ovarian blood flow, leading to ischemia
• Pelvic Mass Surgery: The ligament is manipulated during procedures involving the adnexa
• Ureteral Injury Risk: Due to close relation of ureter, improper clamping can result in ureteral damage during surgery