微创腹膜透析置管术中超声多普勒测量腹直肌宽度及腹壁下动脉定位

IF 0.1 Q4 SURGERY Surgical Techniques Development Pub Date : 2023-06-09 DOI:10.3390/std12020009
J. Janež, J. Grosek
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引用次数: 0

摘要

腹腔镜腹膜透析导管插入是腹膜透析导管放置的一种既定方法。该手术的一个关键方面是直肌鞘隧道。腹膜透析导管在腹壁内的适当结合对于减少鞘管渗漏和腹膜透析功能的正确发挥非常重要。特别是,内套在直肌鞘内的准确定位对于防止潜在的透析液泄漏至关重要。在本报告中,我们描述了术中超声作为一种有价值的工具的应用,它可以确定内套的理想位置,并评估直肌鞘穿通过程中上腹部下动脉的走向。该技术旨在优化内套的位置,最大限度地减少血管损伤和鞘管周围渗漏等并发症。此外,我们证明,导管插入后,超声成像为评估内套、外皮下套的适当位置和腹壁内潜在出血提供了有价值的见解。
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Minimally Invasive Peritoneal Dialysis Catheter Insertion with Intraoperative Ultrasound-Doppler Measurement of Rectus Muscle Width and Inferior Epigastric Artery Localization
Laparoscopic peritoneal dialysis catheter insertion is an established method for peritoneal dialysis catheter placement. One critical aspect of this procedure is rectus sheath tunneling. Proper peritoneal dialysis catheter incorporation within the abdominal wall is important for reducing pericatheter leaks and for proper peritoneal dialysis functioning. Particularly, accurate positioning of the internal cuff within the rectus muscle sheath is crucial to prevent potential dialysate fluid leakage. In the present report, we describe the utilization of intraoperative ultrasound as a valuable tool for determining the ideal location of the internal cuff and assessing the course of the inferior epigastric artery during rectus sheath tunneling. This technique aims to optimize the position of the internal cuff and minimize complications such as vessel injury and pericatheter leaks. Furthermore, we demonstrate that post-catheter insertion, ultrasound imaging offers valuable insights into evaluating the appropriate placement of the internal cuff, external subcutaneous cuff, and potential bleeding within the abdominal wall.
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