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SURGICAL ANATOMY OF THE SUPERIOR EPIGASTRIC ARTERY | ||
| IRAQI JOURNAL OF MEDICAL SCIENCES | ||
| Article 1, Volume 5, Issue 1, 2007, Pages 3-7 | ||
| Authors | ||
| Hassan A. Hassan; Akram A. Jaffar; Hayder H. Abdul-Ameer | ||
| Abstract | ||
| Background: The superior epigastric artery and its preservation during surgical procedures are now gaining more importance. Anatomical studies regarding variations in the epigastric vessels have not been conclusively reported. More emphasis was directed towards the inferior epigastric artery on the expense of its superior counterpart. Objective: To illustrate the gross anatomy of the superior epigastric artery with special emphasis on laparoscopic cholecystectomy entry sites in order to map a safety zone. Method: Fifteen embalmed cadavers were dissected. Complications pertaining to the superior epigastric artery were reviewed in 90 patients who underwent laparoscopic cholecystectomy. Results: Gross arterial communication between the superior and inferior epigastric arteries was observed in (33%) of the cadavers where it was located above the umbilicus. In the epigastric region, the main stem of the superior epigastric artery was located within a longitude not extending laterally away from 5 cm off the midline. The inferior epigastric artery was commonly larger than the superior. In only one cadaver (7%) the caliber of the superior epigastric artery was comparable to that of the inferior. In (4.4%) of the cholecystectomy cases, bleeding occurred when the laparoscopic port was extended laterally beyond the 10-12mm wide incision at the point 5cm inferior to the xiphisternum. Conclusion: A variably large superior epigastric artery should be kept in mind during surgical interventions; the absence of accompanying arterial anomalies indicated that the large size of the artery is a normal anatomical variation. In the epigastric region, a safety zone could be determined lateral to 5cm off the midline. In laparoscopic cholecystectomy, the port incision in the epigastric region should not be extended laterally beyond 12mm off the midline. If circumstances dictate then the port should be enlarged using a dilator. Key words: Superior epigastric artery, anatomical variation, laparoscopic cholecystectomy | ||
| Keywords | ||
| Superior epigastric artery; anatomical variation; laparoscopic cholecystectomy | ||
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