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

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Abstract

Purpose

The incidence of inferior epigastric artery (IEA) injury is 0.2–2 %. The aim of this study was to trace the position and course of the inferior epigastric artery in the anterior abdominal wall above the inguinal ligament at three important landmarks, i.e., at the mid-inguinal point, Anterior Superior Iliac Spine (ASIS) and umbilicus in abdominal CT Angiograms. The study also correlates the relationship of body build and the position of the inferior epigastric artery.

Methods

In 50 CT Abdominal angiograms, the course of the inferior epigastric artery was traced and distance between the artery and midline was measured at the above landmarks using measurement tool on the picture archival and communication system. The measurements were analyzed using SPSS version 16 and expressed as mean and standard deviation. Mann–Whitney test was used to compare the mean values and ratios in males and females. Linear regression was done to derive formulas by which the position of the inferior epigastric artery could be found.

Results

The mean distance of the inferior epigastric artery from the midline was 5.17 ± 0.93 cm at the level of mid-inguinal point, 4.57 ± 1.05 cm at the level of ASIS and 5.27 ± 1.17 cm at the level of umbilicus. There was a definitive predictive pattern in the course of the artery as seen in correlation and regression analysis.

Conclusion

The security distance for safe trocar placement was 6 cm at the level of ASIS and 9 cm at the level of umbilicus. Preoperative IEA assessment is helpful in reducing injuries to IEA.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

The study was done after obtaining ethical committee clearance.

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Authors and Affiliations

  1. Department of Anatomy, All India Institute of Medical Sciences, Raipur, Chhattisgarh, 492099, India

    Praisy Joy

  2. Department of Radiology, Christian Medical College, Vellore, Tamilnadu, 632004, India

    Betty Simon

  3. Department of Anatomy, Christian Medical College, Vellore, Tamilnadu, 632002, India

    Ivan James Prithishkumar & Bina Isaac

Authors
  1. Praisy Joy
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  2. Betty Simon
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  3. Ivan James Prithishkumar
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  4. Bina Isaac
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Correspondence to Praisy Joy.

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Joy, P., Simon, B., Prithishkumar, I.J. et al. Topography of inferior epigastric artery relevant to laparoscopy: a CT angiographic study. Surg Radiol Anat 38, 279–283 (2016). https://doi.org/10.1007/s00276-015-1513-9

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  • DOI: https://doi.org/10.1007/s00276-015-1513-9

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