Can general surgeons evaluate visceral slide with transabdominal ultrasound to predict safe sites for primary laparoscopic port placement? A prospective study of sonographically naïve operators at a tertiary center - 05/05/15
Abstract |
Background |
Port placement injuries are a potentially devastating complication of laparoscopic surgery. Ultrasound assessment for visceral slide has the ability to preoperatively determine adhesion-free areas. The utility of this technique has not been studied when performed by surgeons.
Methods |
Surgeons without expertise in ultrasound were taught the visceral slide technique. Patients with a history of abdominal surgery were then assessed for adhesion-free areas on the abdominal wall. Ultrasound assessments were validated against intraoperative visualization.
Results |
Nine surgeons using the visceral slide technique assessed 145 patients for the presence of adhesions immediately before surgery. Surgeon who performed ultrasound demonstrated a sensitivity of 69.6%, specificity of 98.7%, and positive predictive value of 99.5% for detection of areas free from critical adhesions. The median time to perform the examination was 2 minutes.
Conclusion |
The visceral slide technique was easily learned, was rapid to perform, and reliably identified adhesion-free areas of the abdominal wall.
Le texte complet de cet article est disponible en PDF.Keywords : Laparoscopic surgery, Trocar injuries, Intra-abdominal adhesions, Patient safety, Bowel injury, Surgical complications
Plan
| None of the authors have potential conflicts of interest, including financial interests, activities, relationships, or affiliations to disclose. |
Vol 209 - N° 5
P. 804-809 - mai 2015 Retour au numéro
Article précédent
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