PURPOSE: To analyze the complications of laparoscopy in different vascular structures using magnetic resonance imaging (MRI). MRI has become a key tool in laparoscopic surgery. During these procedures, pneumoperitoneum creation and placing the patient in the surgical position provoke different changes in the splachnic circulation. MATERIALS AND METHODS: Ten pigs were included in the study. MRI studies of the abdominal area were carried out in four different situations of abdominal pressure and body position. RESULTS: Changes in the area of the lumen of the portal vein and the abdominal aorta were analyzed in all situations. A significant reduction in the area of the abdominal aorta was observed after the pneumoperitoneum in supine and anti-Trendelemburg position. The lumen of the portal vein was significantly reduced in all analyzed situations except when placing the patient in anti-Trendelemburg without pneumoperitoneum, in which case the area was increased. CONCLUSION: The creation of pneumoperitoneum provokes morphological changes in the lumen of different abdominal vessels as a consequence of the increase of pressure. Furthermore, the combination of pneumoperitoneum together with the anti-Trendelemburg position results in a more significant reduction of the lumen of the portal vein and the abdominal aorta.
PURPOSE: To analyze the complications of laparoscopy in different vascular structures using magnetic resonance imaging (MRI). MRI has become a key tool in laparoscopic surgery. During these procedures, pneumoperitoneum creation and placing the patient in the surgical position provoke different changes in the splachnic circulation. MATERIALS AND METHODS: Ten pigs were included in the study. MRI studies of the abdominal area were carried out in four different situations of abdominal pressure and body position. RESULTS: Changes in the area of the lumen of the portal vein and the abdominal aorta were analyzed in all situations. A significant reduction in the area of the abdominal aorta was observed after the pneumoperitoneum in supine and anti-Trendelemburg position. The lumen of the portal vein was significantly reduced in all analyzed situations except when placing the patient in anti-Trendelemburg without pneumoperitoneum, in which case the area was increased. CONCLUSION: The creation of pneumoperitoneum provokes morphological changes in the lumen of different abdominal vessels as a consequence of the increase of pressure. Furthermore, the combination of pneumoperitoneum together with the anti-Trendelemburg position results in a more significant reduction of the lumen of the portal vein and the abdominal aorta.
Authors: Hannes G Kenngott; Felix Nickel; Anas A Preukschas; Martin Wagner; Shivalik Bihani; Emre Özmen; Philipp A Wise; Nadine Bellemann; Christof M Sommer; Tobias Norajitra; Bastian Graser; Christian Stock; Marco Nolden; Araineb Mehrabi; Beat P Müller-Stich Journal: Surg Endosc Date: 2021-01-04 Impact factor: 4.584