The mesovarium is the fold of peritoneum within the posterior layer of the broad ligament that attaches the ovary to the broad ligament and transmits the ovarian blood supply from the hilum. The mesosalpinx is the peritoneal fold within the broad ligament that suspends the fallopian tube, transmitting the tubal blood supply. Together they constitute the two peritoneal leaves of the superior broad ligament, with the parametrium (cardinal ligament) forming the base.
The mesovarium and mesosalpinx suspend the ovary and tube within the broad ligament, transmit their blood supplies, and form the peritoneal coverings that contain the adnexal structures.
The mesosalpinx contains the tubal blood supply and must be individually ligated during salpingectomy for ectopic pregnancy or prophylactic salpingectomy. In salpingo-oophorectomy, the mesovarium and mesosalpinx are excised together. Paratubal cysts arise from Wolffian duct remnants in the mesosalpinx and may be large enough to cause symptoms or torsion. The mesovarium vascularity is important in fertility-sparing cystectomy for ovarian cysts, where the cleavage plane between the cyst and ovarian parenchyma is developed while preserving the mesovarian blood supply.
Ruptured ectopic pregnancy from the fallopian tube bleeds from the mesosalpinx vasculature, producing haemoperitoneum that may be massive; laparoscopic salpingectomy with sequential ligation of the mesosalpinx from the fimbrial end to the cornual end controls haemorrhage while sparing the ovary.
