Ultrasonic detection of viscera slide as an indicator of abdominal wall adhesions

Kodama, Issei; Loiacono, Laurie A.; Sigel, Bernard; Machi, Junji; Golub, Robert M.; Parsons, Richard E.; Justin, Jeffery; Zaren, Howard A.; Sachdeva, Ajit K.

doi:10.1002/jcu.1870200603

Cited by 52 publications

(52 citation statements)

References 3 publications

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“…Relying on open techniques for trocar placement can reduce the chance of visceral injury [3], but if bowel is present at the operative site, injury to the viscera can still occur. The use of real-time ultrasonography to visualize viscera slide, as a means to identify intraabdominal adhesions, has been proposed by Kodama to avoid visceral injury during initial needle or trocar placement for laparoscopy [7]. Kodama's initial results were very encouraging since no adhesions were found in patients with a normal viscera slide.…”

mentioning

confidence: 53%

The ultrasonic localization of abdominal wall adhesions

et al. 1995

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Laparoscopic candidates with abdominal scars may have adhesions that result in visceral injury during trocar insertion. The purpose of this study was to evaluate the use of preoperative ultrasound mapping of abdominal wall adhesions, to provide safe initial laparoscopic access, and to guide the placement of subsequent trocars, facilitating adhesolysis when necessary. Thirty consecutive patients with previous abdominal surgery who were scheduled for laparoscopy underwent a preoperative ultrasonic examination of the abdominal wall using a 7-MHz linear ultrasound probe. Spontaneous viscera slide was measured during longitudinal scanning (normal = 2-5 cm) and induced viscera slide was evaluated during longitudinal and transverse scanning (normal = 1 cm or more) over the existing abdominal scar, the peri-umbilical region, and the remaining abdominal quadrants. Sixteen (53%) of 30 patients had adhesions under their scar and only four patients (25%) had umbilical adhesions. The 12 patients without umbilical adhesions all had successful closed cannulation while open cannulation at alternate sites was successful in the four individuals with umbilical adhesions. Blind umbilical needle cannulation was successfully done in all of the remaining 14 patients (47%) without visceral injury, including three patients (21%) with upper abdominal scars who were adhesion-free elsewhere. No adhesions were encountered that had not been preoperatively predicted by ultrasound. We conclude that examination of the abdominal wall with spontaneous and induced viscera slide, using ultrasound scanning, can reliably detect intraabdominal adhesions. The examination is best done on a highly selective basis by the operating surgeon to guide the location for initial trocar insertion

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mentioning

confidence: 53%

The ultrasonic localization of abdominal wall adhesions

et al. 1995

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“…Hence, viscera slide ultrasound may help identify the safest place for the initial incision and entry into the peritoneal cavity or placement of the laparoscopic trocars. Alternatively, at sites at which adhesions are shown to be absent, ultrasonography could obviate the need for more extensive laparoscopic access procedures [124, 125, 126, 127]. …”

Section: Further Researchmentioning

confidence: 99%

“…Normal sliding motion was termed ‘viscera slide’ and occurred either spontaneously, during respiratory movements, or was induced by manual palpation of the abdomen. Restricted viscera slide was shown as an accurate indication of intra-abdominal adhesions [125]. Viscera slide ultrasound is a promising noninvasive diagnostic technique that may be useful in identifying and mapping abdominal wall adhesions prior to laparascopic or open surgical procedures.…”

Section: Further Researchmentioning

confidence: 99%

Peritoneal Adhesions: Etiology, Pathophysiology, and Clinical Significance

et al. 2001

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Aim: To summarize the most common etiologic factors and describe the pathophysiology in the formation of peritoneal adhesions, to outline their clinical significance and consequences, and to evaluate the pharmacologic, mechanical, and surgical adjuvant strategies to minimize peritoneal adhesion formation. Methods: We performed an extensive MEDLINE search of the internationally published English literature of all medical and epidemiological journal articles, textbooks, scientific reports, and scientific journals from 1940 to 1997. We also reviewed reference lists in all the articles retrieved in the search as well as those of major texts regarding intraperitoneal postsurgical adhesion formation. All sources identified were reviewed with particular attention to risk factors, pathophysiology, clinical manifestations, various methods, and innovative techniques for effectively and safely reducing the formation of postsurgical adhesions. Results: The formation of postoperative peritoneal adhesions is an important complication following gynecological and general abdominal surgery, leading to clinical and significant economical consequences. Adhesion occur in more than 90% of the patients following major abdominal surgery and in 55–100% of the women undergoing pelvic surgery. Small-bowel obstruction, infertility, chronic abdominal and pelvic pain, and difficult reoperative surgery are the most common consequences of peritoneal adhesions. Despite elaborate efforts to develop effective strategies to reduce or prevent adhesions, their formation remains a frequent occurrence after abdominal surgery. Conclusions: Until additional information and findings from future clinical investigations exist, only a meticulous surgical technique can be advocated in order to reduce unnecessary morbidity and mortality rates from these untoward effects of surgery.

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“…If those injuries remain unrecognized at the time of the initial laparoscopy, a delayed diagnosis of bowel injury may cause severe complications [2] . Sigel and coworkers had proposed a technique by sliding motion of the abdominal contents for detection of the intra-abdominal adhesion preoperatively to prevent injury during laparoscopic operation [3] . In the present study, we modifi ed the visceral sliding technique and prospectively used it for detection of intra-abdominal adhesions in patients scheduled for laparoscopic surgery.…”

Section: Introductionmentioning

confidence: 99%

Visceral Sliding Technique Is Useful for Detecting Abdominal Adhesion and Preventing Laparoscopic Surgical Complications

Hsu¹,

Chang²,

Huang³

et al. 2006

Gynecol Obstet Invest

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Study Objective: Introduce a non-invasive method preoperatively to prevent bowel injury by the Veres needle and trocar during laparoscopy. Design: Case-controlled study. Setting: A hospital-based study. Patients: Five hundred and twelve patients who underwent laparoscopic surgery were prospectively enrolled. Intervention: A simple and non-invasive method to detect bowel adhesions preoperatively. Results: A total of 512 patients who underwent operative laparoscopy were prospectively enrolled for ultrasonographic visceral sliding evaluation. They were subdivided into two groups as follows: group I, 332 patients without previous abdominal surgery; group II, 180 patients with previous abdominal surgery. No bowel adhesion to the umbilicus was present in group I. In group II, only two cases with bowel adhered to the periumbilical area were found by visceral sliding technique. No patients suffered any bowel injury. Conclusion: The proposed technique is useful and highly effective in guiding the insertion of the Veres needle and trocar to prevent bowel injury in laparoscopy.

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Ultrasonic detection of viscera slide as an indicator of abdominal wall adhesions

Cited by 52 publications

References 3 publications

The ultrasonic localization of abdominal wall adhesions

The ultrasonic localization of abdominal wall adhesions

Peritoneal Adhesions: Etiology, Pathophysiology, and Clinical Significance

Visceral Sliding Technique Is Useful for Detecting Abdominal Adhesion and Preventing Laparoscopic Surgical Complications

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