Artificial Displacement of Kidneys, Spleen, and Colon by Injection of Physiologic Saline and CO2 as an Aid to Percutaneous Procedures: Experimental Results

CT-Guided Drainage of Abdominal Abscesses: Hydrodissection to Create Access Routes for Percutaneous Drainage

“…Variations of this technique have been described to displace structures away from renal tumors targeted for radiofrequency ablation [10,11,13]. The results of this clinical study extend the experimental observations of Langen et al [14], who used a cadaveric model to show that the kidneys, spleen, and colon could be displaced by injection of physiologic saline into the retroperitoneum. Langen et al [8] also used a similar technique to displace mediastinal structures to create access routes for mediastinal biopsy.…”

Minimizing Diaphragmatic Injury During Radiofrequency Ablation: Efficacy of Intraabdominal Carbon Dioxide Insufflation

“…In previous work [11] and in this study, all superficial lesions (those with centers within 1 cm of liver surface) in the control group caused significant liver capsular and transdiaphragmatic injuries. Although these injuries are usually clinically silent and not life-threatening, thermal injury to the diaphragm during radiofrequency ablation can result in a significant level of primary and referred pain [1,[4][5][6][7].…”

“…Because this study was a variation of a previously published study [11], the control group consisted of two subgroups: historic controls and current controls. In the historic subgroup, we used seven lesions from the control group (six animals) of our prior study because all other factors (animal breed, animal weight, radiofrequency equipment, and radiofrequency technique) were similar.…”

“…Recently, several diaphragmatic and thoracic complications due to ablation of subcapsular diaphragmatic lesions have been reported [9]. Percutaneous manipulation of intraabdominal structures has been described with a variety of techniques to facilitate percutaneous imaging-guided intervention [10][11][12].…”

CT–guided Transvenous or Transcaval Needle Biopsy of Pancreatic and Peripancreatic Lesions

“…In a series of 269 pancreatic biopsies, Brandt et al (3) showed that the gastrointestinal tract can be traversed safely, although only seven passes were made through the colon. Other authors (7,9,10) developed methods to displace colon or solid organs from the chosen biopsy route. In the same study, a transhepatic approach was necessary in 10% and a transgastric approach was used in 15%.…”