Surface anatomy of the inferior epigastric artery in relation to laparoscopic injury
Surface anatomy of the inferior epigastric artery in relation to laparoscopic injury
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DOI：
10.1002/ca.10192
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发表时间：
2004-07-01
期刊：
影响因子：
2.4
通讯作者：
Ellis, H
中科院分区：
文献类型：
--
作者：
Epstein, J;Arora, A;Ellis, H
腹壁下动脉（IEA）在腹腔镜手术中有损伤的风险。当前IEA过程的描述不提供对外科医生有用的表面标志。本研究旨在定义表面关系并提出更安全的穿刺器放置指南。对30具保存尸体的前腹壁后表面进行了解剖。明确了60个IEA及其分支的表面解剖。在髂前上级棘（ASIS）水平，从中线到ASIS的IEA为38% +/- 18%（95%置信区间[CI]）。在腹股沟中点，该关系为40% +/- 17%，在脐部为40% +/-22%。树枝的样式变化很大。尽管提供穿刺器插入指南可能是危险的，但我们发现以下内容是有价值的：1）中线是无血管的; 2）如果穿刺器沿a插入超过沿着a插入距离的三分之二，则可避开IEA的主干。3）IEA分支最不常见于动脉外侧腹部的最低部分。(C)2004 Wiley-Liss，Inc.
The inferior epigastric artery (IEA) is at risk of injury in laparoscopic surgery. Current descriptions of the course of the IEA do not provide surface landmarks useful to the surgeon. This study aimed to define surface relations and propose guidelines for safer trocar placement. The posterior surfaces of the anterior abdominal walls of 30 preserved cadavers were dissected. The surface anatomy of 60 IEAs and their branches were defined. At the level of the anterior superior iliac spine (ASIS), the IEA is 38% +/- 18% (95% confidence interval [CI]) from the midline to the ASIS. At the mid-inguinal point the relation is 40% +/- 17% and at the umbilicus 40% +/- 22%. The pattern of branches is highly variable. Although giving guidelines for trocar insertion can be treacherous, we found the following to be of value: 1) the midline is avascular; 2) the main stem of the IEA will be avoided if trocars are inserted more than two-thirds of the distance along a. horizontal line between the midline and the ASIS; and 3) IEA branches are least frequently found in the lowest part of the abdomen lateral to the artery. (C) 2004 Wiley-Liss, Inc.