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Left upper quadrant called safe alternative for umbilicus entry.(Gynecology)
SAN FRANCISCO -- The ninth intercostal space in the left upper quadrant provides a safe alternative to umbilicus entry for laparoscopy when the patient has adhesions, Neena Agarwala, M.D., reported in a poster presentation during the annual meeting of the American Association of Gynecologic Laparoscopists.
In a large retrospective study, Dr. Agarwala of the University of Nebraska Medical Center, Omaha, studied all 918 laparoscopies performed over a 6-year period on patients with surgical scars at a university hospital and a community hospital. Of those 918 laparoscopies, 504 (55%) of the patients had umbilical adhesions.
Using the alternate entry position in the left upper quadrant resulted in no trocar-related injuries and only two Veress needle-related injuries.
One was a needle puncture to the left lung margin resulting ...
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...sheath, to scan the surgical area using the following standardized sequence: right upper quadrant, right lower quadrant, left lower quadrant, left upper quadrant, and then midline. The time from when the wand device was given to the surgeon...
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...considered as the region where pyloric sphincter was. Pylorus was located in the right upper quadrant, on the median plane and in the left upper quadrant. There was a significant relation between the thickness of the muscular coat in the stomach...
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...established to a pressure of 12-15 mm Hg. Next, 12-mm umbilical, 5-mm right upper quadrant, 5-mm left lower quadrant, and 15-mm left upper quadrant trocars were placed. A purse-string suture was placed on the anterior wall of the...
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- Magazine article from: OB GYN News Demott, Kathryn June 1, 2002 700+ words
...a hernia laparoscopically, entry can be in the left-upper quadrant for an umbilical hernia or at the umbilicus for a lateral hernia. If entering from the left-upper quadrant, however, the stomach must be decompressed.
Source: HighBeam Research, Left upper quadrant called safe alternative for umbilicus...