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Left upper quadrant laparoscopic placement: effects of insertion angle and body mass index on distance to posterior peritoneum by magnetic resonance imaging.

Publication ,  Journal Article
Giannios, NM; Gulani, V; Rohlck, K; Flyckt, RL; Weil, SJ; Hurd, WW
Published in: Am J Obstet Gynecol
November 2009

OBJECTIVE: To determine the ideal angle for insertion of laparoscopic instruments at Palmer's point. STUDY DESIGN: Abdominal magnetic resonance images were reviewed for 75 women between ages 18 and 50 years old. The distance from the skin to the retroperitoneal structures were determined perpendicular to the spine and angled 45 degrees caudally. RESULTS: When instruments are inserted perpendicular to the skin in the axial plane and peritoneum perpendicular to the spine, the distance from skin to posterior was 10.0 +/- 0.2 cm and to the aorta was 11.3 +/- 0.2 cm. If instruments are inserted at an angle 45 degrees caudally, this distance increased to 16.6 +/- 0.2 cm. CONCLUSION: When inserting laparoscopic instruments at Palmer's point, insertion perpendicular to the skin in the axial plane and angled 45 degrees caudally in relation to the spine offers an increased margin of safety compared with insertion perpendicular to the spine, particularly in thin women.

Duke Scholars

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

November 2009

Volume

201

Issue

5

Start / End Page

522.e1 / 522.e5

Location

United States

Related Subject Headings

  • Young Adult
  • Peritoneum
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Magnetic Resonance Imaging
  • Laparoscopy
  • Humans
  • Female
  • Body Mass Index
  • Adult
 

Citation

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Giannios, N. M., Gulani, V., Rohlck, K., Flyckt, R. L., Weil, S. J., & Hurd, W. W. (2009). Left upper quadrant laparoscopic placement: effects of insertion angle and body mass index on distance to posterior peritoneum by magnetic resonance imaging. Am J Obstet Gynecol, 201(5), 522.e1-522.e5. https://doi.org/10.1016/j.ajog.2009.07.017
Giannios, Nichole M., Vikas Gulani, Kelsey Rohlck, Rebecca L. Flyckt, Stacie J. Weil, and William W. Hurd. “Left upper quadrant laparoscopic placement: effects of insertion angle and body mass index on distance to posterior peritoneum by magnetic resonance imaging.Am J Obstet Gynecol 201, no. 5 (November 2009): 522.e1-522.e5. https://doi.org/10.1016/j.ajog.2009.07.017.
Giannios NM, Gulani V, Rohlck K, Flyckt RL, Weil SJ, Hurd WW. Left upper quadrant laparoscopic placement: effects of insertion angle and body mass index on distance to posterior peritoneum by magnetic resonance imaging. Am J Obstet Gynecol. 2009 Nov;201(5):522.e1-522.e5.
Giannios, Nichole M., et al. “Left upper quadrant laparoscopic placement: effects of insertion angle and body mass index on distance to posterior peritoneum by magnetic resonance imaging.Am J Obstet Gynecol, vol. 201, no. 5, Nov. 2009, pp. 522.e1-522.e5. Pubmed, doi:10.1016/j.ajog.2009.07.017.
Giannios NM, Gulani V, Rohlck K, Flyckt RL, Weil SJ, Hurd WW. Left upper quadrant laparoscopic placement: effects of insertion angle and body mass index on distance to posterior peritoneum by magnetic resonance imaging. Am J Obstet Gynecol. 2009 Nov;201(5):522.e1-522.e5.
Journal cover image

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

November 2009

Volume

201

Issue

5

Start / End Page

522.e1 / 522.e5

Location

United States

Related Subject Headings

  • Young Adult
  • Peritoneum
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Magnetic Resonance Imaging
  • Laparoscopy
  • Humans
  • Female
  • Body Mass Index
  • Adult