دورية أكاديمية
أعرض في EDS

The Importance of Lumbar Lordosis During Laparoscopic Trocar Entry.

التفاصيل البيبلوغرافية
العنوان: The Importance of Lumbar Lordosis During Laparoscopic Trocar Entry.
المؤلفون: Bektaş O; Department of Obstetrics and Gynecology, Gynecologic Oncology (Onur Bektaş), Ruhr University Bochum, Herford Clinic, Herford, Germany. Electronic address: o.b@outlook.com., Çelik H; Department of Obstetrics and Gynecology, Gynecologic Oncology, (Hüsnü Çelik), Başkent University, Adana, Turkey.
المصدر: Journal of minimally invasive gynecology [J Minim Invasive Gynecol] 2024 Jun; Vol. 31 (6), pp. 511-517. Date of Electronic Publication: 2024 Mar 23.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101235322 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1553-4669 (Electronic) Linking ISSN: 15534650 NLM ISO Abbreviation: J Minim Invasive Gynecol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : Elsevier, c2005-
مواضيع طبية MeSH: Lordosis* , Laparoscopy*/adverse effects , Laparoscopy*/methods , Abdominal Wall* , Gynecologic Surgical Procedures*/adverse effects , Gynecologic Surgical Procedures*/methods, Retrospective Studies ; Humans ; Surgical Instruments ; Blood Vessels/injuries ; Peritoneal Cavity/blood supply ; Female
مستخلص: Study Objective: Investigating the effect of lumbar lordosis on the relationship between abdominal trocar entry points and major vascular structures.
Design: Retrospective cohort.
Setting: Tertiary referral center.
Patients: Distances between the skin and the aorta and inferior vena cava at the trocar entry points, both at the umbilicus and 3 cm and 5 cm superior to the umbilicus, were measured at entry angles of 90 and 45 degrees in 101 abdominal computer tomography images.
Interventions: The relationship of these values with lumbar lordosis was investigated concerning menopausal status, body mass index (BMI), and parity differences. To assess the isolated effect of lumbar lordosis, a simulated 30-degree increase in the lordosis angle was applied to the patients' computed tomography images. The impact of this increased lumbar lordosis angle on the distances between the skin and major vessels was then evaluated at both the umbilical and supraumbilical trocar entry sites.
Measurements and Main Results: In the tomographic images of all patients, the distances from the skin to vascular structures were measured at a 90-degree entry angle, resulting in measurements of 8.97 cm ± 2.81 at the umbilicus, 10.89 cm ± 3.02 at 3 cm above the umbilicus, and 11.36 cm ± 2.88 at 5 cm above the umbilicus. These distances exhibited significant differences between patients with BMI <30 and BMI ≥30, as well as between premenopausal and postmenopausal patients. However, at a 45-degree entry angle, vascular structures were observed in only a few patients during trocar projection, and no measurable values were determined. In the simulation, it was found that a 1-degree increase in lumbar lordosis angle resulted in a decrease of 0.272 mm ± 0.018 in the distance between the skin and vascular structures at the umbilicus, 0.425 mm ± 0.024 at 3 cm above the umbilicus, and 0.428 mm ± 0.024 at 5 cm above the umbilicus.
Conclusion: An increase in the degree of lumbar lordosis reduces the distance between trocar entry points and major vascular structures. Along with other factors during Veress and trocar entry, lumbar lordosis should be carefully considered.
(Copyright © 2024 AAGL. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Aorta; Major vascular structures; Minimal invasive surgery; Vena cava inferior; Veress needle
تواريخ الأحداث: Date Created: 20240325 Date Completed: 20240607 Latest Revision: 20240627
رمز التحديث: 20240627
DOI: 10.1016/j.jmig.2024.03.012
PMID: 38527703
قاعدة البيانات: MEDLINE
الوصف
تدمد:1553-4669
DOI:10.1016/j.jmig.2024.03.012