Anterior abdominal wall nerve and vessel anatomy: clinical implications for gynecologic surgery

Injury of epigastric vessels at laparoscopy: diagnosis and management

“…In a recent study which dissected the ilioinguinal and iliohypogastric nerves and the inferior epigastric vessels in 11 unembalmed female cadavers, the inferior epigastric vessels were 3.7 cm (2.6-5.5 cm) from the midline at the level of the anterior superior iliac spine and always lateral to the rectus muscles at a level 2 cm superior to the pubic symphysis [14].…”

“…Where it is not possible to visualise the vessels, for example in obese patients, methods of transillumination and surface landmarks are often relied on. Recent data suggest that the risk of nerve and vessel injury may be minimised when lateral trocars are placed superior to the anterior superior iliac spines and >6 cm from the midline [14]. Handheld Dopplers have been used in difficult cases to effectively identify the inferior epigastric arteries [15].…”

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

“…They found that the IEA was 3.7 cm from the midline at the plane of ASIS. They suggested that placement of trocars should A distance between the midline to lateral border of rectus abdominis at the level of mid-inguinal point, B distance between the midline to lateral border of rectus abdominis at the level of ASIS, C distance between the midline to lateral border of rectus abdominis at the level of umbilicus, D distance between the midline to the inferior epigastric artery at the level of mid-inguinal point, E distance between the midline to the inferior epigastric artery at the level of ASIS, F distance between the midline to the inferior epigastric artery at the level of umbilicus, G distance between the midline to ASIS [7]. In overweight individuals, the IEAs may be situated further laterally from the midline and hence trocars should be placed more laterally than in a normal weight individual [4].…”

Facteurs influençant la durée opératoire de la kystectomie ovarienne par accès endoscopique unique

“…Il s'agit de plaies du pédicule épigastrique inférieur [31], plaies nerveuses [32,33], plaies vésicales ainsi que le risque d'hernie sur orifice de trocart selon le diamètre utilisé [34].…”