Which of the following arteries is most commonly injured during placement of a laparoscopic port in the left lower quadrant?
The most commonly injured vessels in laparoscopic procedures are the epigastric arteries, both the superficial and deeper vessels [2, 3].
What does the inferior epigastric artery do?
The inferior epigastric vessels give off several branches that supply the skin and muscles of the anterior abdominal wall, the deep structures of the abdominal wall and the spermatic cord. It terminates at the level of the umbilicus by anastomosing with the superior epigastric artery.
What is a trocar injury?
A trocar is a surgical instrument that is often used for withdrawing fluid and is inserted in the abdomen during laparoscopic surgery. Trocar injuries are commonly the result of people’s internal organs being too close to the point of trocar insertion or the trocar penetrating too far into the abdominal cavity.
What does inferior epigastric artery supply?
The inferior epigastric artery (IEA) is a major blood vessel that supplies the anterior abdominal wall. The aim of the current study was to provide clinicians, surgeons, and obstetricians with sufficient anatomical data on the inferior epigastric artery, such as its origin and branching pattern.
How do you identify an inferior epigastric artery?
Using anterior abdominal wall landmarks, the inferior epigastric artery can be identified midway between the anterior superior iliac spine and the pubic symphysis as it travels toward the umbilicus.
Where is inferior epigastric artery?
The inferior epigastric artery arises just above the inguinal ligament from the medial side of the external iliac artery and then runs upwards and medially along the medial side of the deep inguinal ring to the deep surface of the rectus abdominis.
What does inferior epigastric arise from?
The inferior epigastric artery arises from the external iliac artery and is an important artery supplying the anterior abdominal wall. If a superficial inferior epigastric artery is present, as seen in about two-thirds of cases, then the inferior epigastric artery is referred to as the deep inferior epigastric artery.
How do you place trocars?
The anterior abdominal wall must be adequately elevated by hand, and the trocar is inserted directly into the cavity, aiming toward the pelvic hollow. As an alternative, the abdominal wall is elevated by pulling on two towel clips placed 3 cm on both sides of the umbilicus, and the trocar is inserted at a 90° angle.
What is a saline drop test?
Saline drop test: saline solution was poured into the needle. Liquid flow was observed. This test was considered positive when the liquid disappeared immediately (IV-A), and negative when the liquid remained inside the needle (IV-B)
What does inferior epigastric artery come from?
Where is inferior epigastric artery located?
What causes damage to the inferior epigastric artery?
The majority are due to trauma to inferior epigastric artery (IEA) during trocar insertion. Bipolar diathermy via opposite accessory port is tempting but in cases of complete transectional injury of IEA, the ends of the vessel can retract preventing adequate hemostasis.
How often are epigastric vessels injured during laparoscopy?
Injury to the inferior epigastric vessels is relatively uncommon but may occur in up to 2% of operative laparoscopic procedures during insertion of lateral trocars [ 1 ].
How are sutures placed on inferior epigastric vessels?
Intramural sutures to proximal and distal ends of the inferior epigastric vessels can be placed through a laparoscopic approach.
Where are the epigastric vessels located in the abdomen?
The superficial epigastric vessels originate from the femoral artery just below the inguinal ligament. They pass through the saphenous opening in the fascia lata and ascend onto the abdomen in the superficial fascia covering the external oblique muscle. The vessels ascend almost to the level of the umbilicus .