Mapping Inferior Epigastric Artery Relative to Abdominal Landmarks: Defining Surgical Safe Zones and Risks
คำสำคัญ:
Inferior epigastric artery, Laparoscopic surgery, Trocar placement, Cadaverบทคัดย่อ
Abstact
The inferior epigastric artery (IEA) is a critical landmark during laparoscopic surgery. While IEA injuries occur in only up to 2% of procedures, they can lead to serious complications such as port-site hematomas or life-threatening hemorrhage. This systematic review aims to clarify the IEA’s anatomical course relative to key abdominal landmarks to define surgical safe zones. We synthesized data from cadaveric dissections, radiologic imaging (CT and ultrasound), and surgical anatomy reviews. The IEA consistently courses within a paramedian "danger zone," typically located 4-8 cm lateral to the midline. Variations exist based on population and side; for instance, some studies show the vessel as close as 2 cm or as far as 10 cm from the midline. Higher BMI also tends to push the IEA slightly more lateral. To minimize injury risk, trocars should be placed in identified "safe zones": the avascular midline (linea alba) or areas >8 cm lateral to the midline. Given the current lack of Thai-specific anatomical data, local cadaveric studies are essential to refine these safety guidelines for regional populations.
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