TY - JOUR
T1 - Control of inferior vena cava injury during laparoscopic surgery using a double balloon-equipped central venous catheter
T2 - proof of concept in a live porcine model
AU - Iwashita, Yukio
AU - Uchida, Hiroki
AU - Takayama, Hiroomi
AU - Ichimanda, Michihiro
AU - Taniguchi, Katsuya
AU - Kiguchi, Hideki
AU - Sakaguchi, Tetsumi
AU - Fujishima, Hajime
AU - Saga, Kunihiro
AU - Tada, Kazuhiro
AU - Hara, Takao
AU - Watanabe, Kiminori
AU - Hirashita, Teijiro
AU - Endo, Yuichi
AU - Ohta, Masayuki
AU - Inomata, Masafumi
N1 - Publisher Copyright:
© 2017, The Author(s).
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Background: Iatrogenic inferior vena cava (IVC) injury is a rare but potentially life-threatening complication during laparoscopic surgery. This experimental study aimed to assess the hemostatic ability of a new device, double balloon-equipped central venous (DB-CV) catheter, for IVC injury. Methods: The DB-CV catheter comprises a triple-lumen sphincterotome combined with two dilating balloons having a diameter of 25 mm. The experimental procedures were performed in five pigs. The DB-CV catheter was inserted via the right femoral vein. For the IVC occlusion test, correct placement of the balloons was confirmed by indocyanine green fluorescence imaging, and hemodynamic data were recorded. For the IVC injury test, a 3- to 4-mm circumferential incision was created in IVC, and hemostasis was initiated using balloon inflation 5 s after the injury. Results: Hemodynamic changes were minimal, with a 20 mmHg reduction in the mean arterial pressure because of IVC occlusion. All bleeding from IVC injuries was successfully temporarily stopped by direct balloon compression, with a mean time to hemostasis of 69 s and mean blood loss of 32 ml. Subsequently, the positioning of IVC injuries between two balloons made it possible to suture the injured IVC. Conclusions: Balloon occlusion using the DB-CV catheter provides a rapid temporal hemostatic effect and can overcome the serious condition of massive hemorrhage from IVC injuries.
AB - Background: Iatrogenic inferior vena cava (IVC) injury is a rare but potentially life-threatening complication during laparoscopic surgery. This experimental study aimed to assess the hemostatic ability of a new device, double balloon-equipped central venous (DB-CV) catheter, for IVC injury. Methods: The DB-CV catheter comprises a triple-lumen sphincterotome combined with two dilating balloons having a diameter of 25 mm. The experimental procedures were performed in five pigs. The DB-CV catheter was inserted via the right femoral vein. For the IVC occlusion test, correct placement of the balloons was confirmed by indocyanine green fluorescence imaging, and hemodynamic data were recorded. For the IVC injury test, a 3- to 4-mm circumferential incision was created in IVC, and hemostasis was initiated using balloon inflation 5 s after the injury. Results: Hemodynamic changes were minimal, with a 20 mmHg reduction in the mean arterial pressure because of IVC occlusion. All bleeding from IVC injuries was successfully temporarily stopped by direct balloon compression, with a mean time to hemostasis of 69 s and mean blood loss of 32 ml. Subsequently, the positioning of IVC injuries between two balloons made it possible to suture the injured IVC. Conclusions: Balloon occlusion using the DB-CV catheter provides a rapid temporal hemostatic effect and can overcome the serious condition of massive hemorrhage from IVC injuries.
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U2 - 10.1007/s00464-017-5938-6
DO - 10.1007/s00464-017-5938-6
M3 - Article
C2 - 29101571
AN - SCOPUS:85032790119
SN - 0930-2794
VL - 32
SP - 2397
EP - 2401
JO - Surgical endoscopy
JF - Surgical endoscopy
IS - 5
ER -