Abstract:
AIM:This technical note aims to suggest a safe introduction of ancillary trocars in gynaecological surgery, in order to prevent inferior epigastric artery damage. MATERIAL OF STUDY:We performed a narrative overview, synthesizing the findings of literature retrieved from searches of computerized databases. RESULTS:Among the different techniques, the identification of the "yellow island" as anatomical landmark seems to be a useful aid to avoid complication. This particular landmark is identified taking the lateral third of a line between the anterior superior iliac spine and the umbilicus as reference points, by a subperitoneal accumulation of adipose tissue located in that area. DISCUSSION:"Yellow island" could be considered a safe place for trocars introduction because epigastric artery never runs there, even in patients with particular anatomical variants. This technique is particularly useful in obese patients, in which "yellow island" appears to be more evident respect to lean ones. Furthermore, the use of "open" trocars insertion may reduce the possibility of epigastric artery lesions respect to "Verres needle technique". CONCLUSION:The identification of the "yellow island" anatomical landmark could be considered an useful aid for the safe introduction of ancillary trocars in gynaecological surgery. KEY WORDS:Gynaecology, Laparoscopic surgery, Trocars placement. SCOPO:Questa nota tecnica ha lo scopo di individuare un metodo di introduzione sicura dei trocars ancillari in chirurgia ginecologica, al fine di prevenire lesioni dell’arteria epigastrica inferiore. MATERIALE DELLO STUDIO:È stata eseguita una revisione narrativa, sintetizzando i dati della letteratura ottenuta dalla ricerca di database computerizzati. RISULTATI:Tra le varie tecniche, l’identificazione dell’ “isola gialla” come repere anatomico sembra essere di valido ausilio per evitare complicanze. Questo particolare repere è identificato da una zona di accumulo di tessuto adiposo subperitoneale sul terzo laterale di una linea che congiunge la spina iliaca anteriore superiore e l’ombelico. DISCUSSIONE:L’ “isola gialla” può essere considerata come una zona sicura per l’inserimento dei trocars, dal momento che l’arteria epigastrica non decorre in quell’area, neanche in pazienti con particolari varianti anatomiche. Questa tecnica è particolarmente utile nelle pazienti obese, in cui l’ “isola gialla” è maggiormente evidente rispetto alle pazienti magre. Inoltre l’utilizzo della tecnica “open” di inserzione dei trocars potrebbe ridurre il rischio di lesioni dell’arteria epigastrica inferiore rispetto alla tecnica di induzione del pneumoperitoneo con ago di Verres. CONCLUSIONE:L’identificazione dell’“isola gialla” può essere considerata un valido ausilio per l’introduzione sicura dei trocars ancillari in chirurgia ginecologica. SCOPO:Questa nota tecnica ha lo scopo di individuare un metodo di introduzione sicura dei trocars ancillari in chirurgia ginecologica, al fine di prevenire lesioni dell’arteria epigastrica inferiore. MATERIALE DELLO STUDIO:È stata eseguita una revisione narrativa, sintetizzando i dati della letteratura ottenuta dalla ricerca di database computerizzati. RISULTATI:Tra le varie tecniche, l’identificazione dell’ “isola gialla” come repere anatomico sembra essere di valido ausilio per evitare complicanze. Questo particolare repere è identificato da una zona di accumulo di tessuto adiposo subperitoneale sul terzo laterale di una linea che congiunge la spina iliaca anteriore superiore e l’ombelico. DISCUSSIONE:L’ “isola gialla” può essere considerata come una zona sicura per l’inserimento dei trocars, dal momento che l’arteria epigastrica non decorre in quell’area, neanche in pazienti con particolari varianti anatomiche. Questa tecnica è particolarmente utile nelle pazienti obese, in cui l’ “isola gialla” è maggiormente evidente rispetto alle pazienti magre. Inoltre l’utilizzo della tecnica “open” di inserzione dei trocars potrebbe ridurre il rischio di lesioni dell’arteria epigastrica inferiore rispetto alla tecnica di induzione del pneumoperitoneo con ago di Verres. CONCLUSIONE:L’identificazione dell’“isola gialla” può essere considerata un valido ausilio per l’introduzione sicura dei trocars ancillari in chirurgia ginecologica.
journal_name
Ann Ital Chirjournal_title
Annali italiani di chirurgiaauthors
Vitale SG,Gasbarro N,Lagana AS,Sapia F,Rapisarda AMC,Valenti G,Trovato MA,Rossetti D,Chiofalo B,Barrasso G,Tinelli A,Corrado Fsubject
Has Abstractpub_date
2016-01-01 00:00:00pages
608-611eissn
0003-469Xissn
2239-253Xpii
S0003469X16026142journal_volume
87pub_type
杂志文章abstract::Curative surgical treatment of esophageal cancer involves the complete macroscopic and microscopic removal of the tumor (R0-resection). Only by these means the prognosis can be improved. The treatment of choice for squamous cell cancer is transthoracic en-bloc esophagectomy. Preoperative risk analysis of the patient a...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:1992-01-01 00:00:00
abstract::Elastofibroma is a benign slow-growing neoplasm of soft tissues, originally defined Elastofibroma dorsi because of the typical localization in the connective tissue placed between the bottom corner of the scapula and the chest wall. From 1990 to 2013 at our center, 115 patients underwent elestofibroma surgical removal...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2014-03-20 00:00:00
abstract:BACKGROUND AND AIMS:vertical banded gastroplasty (GPV) is the most frequently performed restrictive procedure for morbid obesity, but long-term follow-up is almost nonexistent. A poor outcome after GPV and a low quality of life has been reported. The aim of the study was to determine long-term outcome after 5 years fol...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2003-11-01 00:00:00
abstract::Meckel's diverticulum (MD ) is the most common congenital anomaly of the gastrointestinal tract. We revalued clinical records of patients discharged from Unit of Urgent and General Surgery of Highly Specialized Hospital "A.O.R.N. Antonio Cardarelli" of Naples with diagnosis of acute pathology associated to complicated...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2014-03-01 00:00:00
abstract::After radical surgery for colo-rectal cancer, the prevention of local recurrence and/or distant metastasis, represents the key factor of the active measures adopted by surgeons and oncologists. Recent trends of the research in this field, show that an effective chemotherapy is the goal to achieve. Our review of the li...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:1993-03-01 00:00:00
abstract::Intracranial epidermoid cysts are estimated to constitute 0.2 to 1.8% of brain tumours (4) and they can be divided into four categories describing their anatomic origin and frequent primary location: retro-sellar-cerebellopontine angle, parasellar-sylvian fissure, suprasellar-chiasmatic and basilar-posterior fossa. We...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2008-11-01 00:00:00
abstract:INTRODUCTION:The recent Sars-CoV2 pandemic has dramatically slowed patients' access to our clinic for vascular pathology when the contagion curve peaked. The need to restore the assistance activity has led us to adopt new individual prophylaxis and hygiene measures. METHODS:Doctors and staff must wear dedicated clothe...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2020-01-01 00:00:00
abstract:AIM OF THE STUDY:To define the characteristics of Crohn's disease in the elderly, basing on our own and other Authors' experience. CASISTIC: During last 10 years, 46 patients affected by Crohn's disease were observed at Emergency Surgery Unit of "Vittorio Emanuele" Hospital in Catania (Italy). Of these patients, 4 (8,6...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2006-05-01 00:00:00
abstract::Gas within the wall of the stomach (emphysematous gastritis) is a rare condition associated with systemic toxicity and very often mortal end. The etiology includes firstly infections with gas-foaming organisms, other predisposing causes are the ingestion of corrosive substances, alcohol abuse and immunosuppression. Bu...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:Carcinoma of the rectal colon begins as a small neoplastic polyp which gradually increases in size and, after passing through various degrees of dysplasia, develops into an overtly malignant carcinoma. Clinical experience suggests that patients may be divided into subgroups based on the aggressivity of the tu...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2001-05-01 00:00:00
abstract::Venous aneurysms are rare lesions and of little significance in every day clinical practice. While in many cases asymptomatic they can be the cause of great morbidity due to thrombosis and subsequent possibility of pulmonary embolism. Venous aneurysms are classified in deep and superficial according to affected vein. ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2016-10-14 00:00:00
abstract::Elastofibroma is a rare benign lesion that typically arises on the posterior chest wall beneath the scapula. The etiopathogenesis is still unclear and the knowledge about its diagnosis and management mainly comes from small case series. We collected all the data related to 11 Elastofibroma Dorsi treated at our institu...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2014-12-29 00:00:00
abstract::In the last years the therapeutic behaviour with regard to gastrinomas, has deeply changed becoming more and more aggressive. Nowadays, almost all authors recommend, after a serious treatment of the hypersecretion with omeprazole, an explorative laparatomy in all patients affected by gastrinoma even without a preopera...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract::Head and neck surgery presents a high operating risk of infectious complications. We agree upon the fact that 60% of the so-called infected operations would be complicated by secondary infections if they are not treated by antibiotic therapy. Such a premise justifies the more and more used application of a chemoprophy...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::The surgery of the thyroid pathologies in Day and/or One-Day-Surgery requires a thorough choice former of the surgery of the patients and the availability of the team specialist that could guarantee an adequate nursing after surgery. The authors describe the advantages and the limits of the short confined to stay in h...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract:AIM:Primary mesenteric fibromatosis is a rare, locally invasive, non-metastasizing type of intra-abdominal fibromatoses with a very high rate of recurrence. In this study, we aimed to present our surgical approach, tumor characteristics, clinical presentation and long-term follow-up results in cases of primary mesenter...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2020-01-01 00:00:00
abstract:INTRODUCTION:In this study we retrospectively reviewed data on 311 consecutive elective cholecystectomies, performed for benign disease (cholelithiasis, cholecystitis) in our institution in the last six years, in order to determine the frequency of unexpected gallbladder pre-neoplastic and neoplastic lesions and analys...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2013-05-01 00:00:00
abstract::In the period 1992-1997, 211 cases of acute pancreatitis were observed: 81 grave cases; 130 slight cases. The ERCP and endoscopic sphincterotomy were performed in 84 cases. From the critical revision 2 groups of patients emerged, homogeneous for etiology and clinical classification, the first submitted to ERCP within ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract:AIM:The success rates of free flaps in patients undergoing head and neck cancer (HNC) surgery are very high (95%- 97%) but the development of a surgical site infection (SSI) can put flap viability at risk. The aim of our study is to identify the risk factors for SSI in patients undergo free flaps reconstruction after h...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Merkel cell carcinoma (MCC) is a neuroendocrine malignant neoplasm that usually has its primary location on the skin. It often metastasizes to lymph nodes, liver, lungs, bones and brain. Actually there have been few cases of MCC of the retroperitoneal region without a primary skin lesion. CASE PRESENTATION:...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2014-03-01 00:00:00
abstract::The author intends to particularly analyse the origin of Surgery as regards its deterministic factors and contexts, resounding the essence and the meaning of Surgery itself. The primary core of the surgical practice dates back to Prehistoric Times, when, driven by his self-preservation instinct, the cave man, when suf...
journal_title:Annali italiani di chirurgia
pub_type: 社论,历史文章
doi:
更新日期:2001-07-01 00:00:00
abstract::Cavernous hemangioma is the most common benign tumor of the liver. Most patients are asymptomatic and the tumor is discovered incidentally during diagnostics procedures, at laparotomy or at autopsy. Only 10% of hepatic hemangiomas reach dimensions that need surgical treatment. The role of surgical excision in their tr...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
abstract:AIM:Retrospective review of aorto-iliac infections in a single vascular surgery center. METHODS:From a retrospective review of their experience in the last 20 years, the Authors analyze a series of 12 cases of aorto-iliac infection. Prognostic factors, surgical options and results are discussed and compared with the l...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2011-11-01 00:00:00
abstract::Primary torsion of the greater omentum is an uncommon cause of acute abdomen and frequently it is misunderstood. In fact, from the analysis of the literature the authors can evict that the preoperative diagnosis is generally wrong. The authors write about the subject and they describe four cases come to their observat...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:The authors report their experience about the treatment of two cases of gastric bezoar, treated in curative mode, the first endoscopically and the second with surgical intervention. SETTING:Operative Unit of General and Thoracic Surgery, Department of General and Emergency Surgery, Organ Transplantation, Pol...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2004-07-01 00:00:00
abstract:AIM:The aim of our study was to determine how many and what subtypes of breast cancer could be treated with breast-conserving surgery after NACT. Another outcome was to determine the applicability of MD Anderson Cancer Center nomogram to predict it. MATERIAL OF STUDY:We reviewed the histological examinations of 86 per...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2018-01-01 00:00:00
abstract::Agenesis of the gallbladder is a rare anomaly that is usually asymptomatic, but sometimes the patients may have symptoms compatible with a biliary disorder like cholelithiasis. Its preoperative diagnosis is often difficult, especially if dysplastic cyst is associated and simulates the gallbladder. When the diagnosis i...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract::The authors report their results of a prospective study on 1182 patients who underwent surgical operation relatively on postoperative infections. Studied variables were: structural and anamnestic: sex, age, smoking, drinking; clinical: evidence of functional changes in various organs, as assessed upon clinical basis a...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1992-03-01 00:00:00
abstract::Although skin burns at the site of grounding pad are a known risk of surgery, their exact incidence is unknown. We first report the case of a patient who presented a deep gluteal burn at the site of the grounding pad after an abdominal aortic aneurism repair, the etiology and the challenging treatment required to over...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2015-06-24 00:00:00
abstract::In this study the authors examined the influence of 71, beta-estradiol on cutaneous fibroblasts taken off either from healthy patients with no family history for cancer, or from patients with breast cancer. Fibroblasts were taken from the subcutaneous tissue of the mammary gland by a biopsy carried out in each patient...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1994-11-01 00:00:00