Topography of inferior epigastric artery relevant to laparoscopy: a CT angiographic study

Joy, Praisy; Simon, Betty; Prithishkumar, Ivan James; Isaac, Bina

doi:10.1007/s00276-015-1513-9

Cited by 10 publications

(11 citation statements)

References 10 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A number of studies have challenged the 8-cm boundary suggested by Saber et al [7]. A more recent CT imaging study suggested that a 9-cm margin at the umbilicus is necessary to avoid deep epigastric vessel injury [16]. Similarly, Epstein et al [5] examined cadavers and found the inferior epigastric artery as far lateral as 9 cm at the ASIS and 9.5 cm at the level of the umbilicus; however, the embalmed nature of the cadavers and advanced age raise concerns about generalizability to surgical patients.…”

Section: Discussionmentioning

confidence: 98%

“…Various studies have been completed to map the deep epigastric vessel location to avoid injury while placing laparoscopic accessory trocars [7,8,[12][13][14][15][16]. Although the distance from the midline varies somewhat among studies, the deep epigastric vessels were consistently found within 9 cm from the midline, above the level of the pubic symphysis (PS).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Location of the Deep Epigastric Vessels in the Resting and Insufflated Abdomen

Burnett

Garza-Cavazos

Groesch

et al. 2016

Journal of Minimally Invasive Gynecology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

Location of the Deep Epigastric Vessels in the Resting and Insufflated Abdomen

Burnett

Garza-Cavazos

Groesch

et al. 2016

Journal of Minimally Invasive Gynecology

View full text Add to dashboard Cite

“…There was a definitive predictive pattern in the course of the artery as seen in correlation and regression analysis. [6] Epstein et al . in their study of 30 cadavers (18 female and 12 male) found that the IEA ran vertically throughout its course in the anterior abdominal wall.…”

Section: Discussionmentioning

confidence: 99%

Clinical anatomy of the inferior epigastric artery with special relevance to invasive procedures of the anterior abdominal wall

2017

Self Cite

View full text Add to dashboard Cite

INTRODUCTION:Injury to the inferior epigastric artery (IEA) has been reported following lower abdominal wall surgical incisions, abdominal peritoneocentesis and trocar placements at laparoscopic port sites, resulting in the formation of abdominal wall haematomas that may expand considerably due to lack of tissue resistance. The aim of this study was to localise its course in relation to standard anatomic landmarks and suggest safe areas for performance of invasive procedures.MATERIALS AND METHODS:Sixty IEAs of 30 adult cadavers (male = 19; female = 11) were dissected and the course of the IEA noted in relation to the mid-inguinal point, anterior superior iliac spine (ASIS) and umbilicus.RESULTS:The mean distance of the IEA from the midline was 4.45 ± 1.42 cm at the level of the mid-inguinal point, 4.10 ± 1.15 cm at the level of ASIS and 4.49 ± 1.15 cm at the level of umbilicus. There was an average of 3.3 branches per IEA with more branches arising from its lateral aspect. The IEA was situated within one-third (32%) of the distance between the midline and the sagittal plane through ASIS at all levels.CONCLUSION:To avoid injury to IEA, trocars can be safely inserted 5.5 cm [mean + 1 standard deviation (SD)] away from the midline (or) slightly more than one-third of the distance between the midline and a sagittal plane running through ASIS. These findings may be useful not only for laparoscopic procedures but also for image-guided biopsy, abdominal paracentesis, and placement of abdominal drains.

show abstract

“…In man, the reported incidence of abdominal wall vessel injury during laparoscopic surgery is between 0.2% and 2% . Complications reported in human literature from abdominal wall vessel injury are similar to those in the veterinary literature, with the addition of necrosis of the rectus abdominis muscle, aortoiliac disease, and death . Abdominal wall vessel injuries in patients during laparoscopic procedures, paracentesis, and abdominal drain placement have led to numerous studies attempting to define the course, variations, and relation of body mass to the location of the epigastric vessels.…”

Section: Introductionmentioning

confidence: 92%

“…These studies determined the course of the epigastric vessels with cadaveric studies, computed tomography, and Doppler ultrasound. Current clinical methods for avoiding the abdominal vessels during laparoscopic portal placement in human surgery include the use of external anatomical landmarks, direct laparoscopic visualization, transillumination, computed tomography, and Doppler ultrasound …”

Section: Introductionmentioning

confidence: 99%

Ex vivo radiocontrast description of the caudal epigastric arteries in horses

et al. 2018

View full text Add to dashboard Cite

Objective: To determine the location of the deep and superficial caudal epigastric arteries in relation to 3 midline positions and the relationship between the location of these arteries, body circumference, and body condition score. Study design: Descriptive anatomical study. Sample population: Nine horses, aged 1-28 years (mean 10.61 ± 8.89 SD). Methods: Body condition score and body circumference were measured prior to euthanasia. Angiographic studies of the deep and superficial caudal epigastric arteries were performed on resected abdominal walls. The distances between the deep and the superficial caudal epigastric arteries and 3 midline positions were measured. Correlations among these distances, body circumference, and body condition score were analyzed. Results: The location of the deep caudal epigastric artery correlated with body circumference and body condition score at the umbilicus (r = 0.53 and 0.68, respectively), midpoint landmark (r = 0.79 and 0.83, respectively), and prepubic tendon attachment (r = 0.69 and 0.78, respectively). The course of this artery could be estimated by multiplying body circumference by 0.04 ± 0.02 at the umbilicus, 0.07 ± 0.01 at the midpoint landmark, and 0.03 ± 0.015 at the prepubic tendon attachment. The course of the superficial caudal epigastric artery did not correlate with anatomic landmarks. Conclusion: The course of the deep caudal epigastric artery could be estimated at 3 midline landmarks on the basis of body circumference and body condition score in equine cadavers. Clinical significance: Predicting the course of the caudal epigastric arteries in the equine abdomen based on correlation among location, body circumference, and body condition score may prevent iatrogenic damage during creation of laparoscopic portals.

show abstract

Topography of inferior epigastric artery relevant to laparoscopy: a CT angiographic study

Abstract: The security distance for safe trocar placement was 6 cm at the level of ASIS and 9 cm at the level of umbilicus. Preoperative IEA assessment is helpful in reducing injuries to IEA.

Cited by 10 publications

References 10 publications

Location of the Deep Epigastric Vessels in the Resting and Insufflated Abdomen

Location of the Deep Epigastric Vessels in the Resting and Insufflated Abdomen

Clinical anatomy of the inferior epigastric artery with special relevance to invasive procedures of the anterior abdominal wall

Ex vivo radiocontrast description of the caudal epigastric arteries in horses

Contact Info

Product

Resources

About