Evidence map›Paper›PMID 33481111›Full record

ArticleSurgical endoscopy2022

Preperitoneal insufflation pressure of the abdominal wall in a porcine model.

Riley E Reynolds, Benjamin P Wankum, Sean J Crimmins, Mark A Carlson, Benjamin S Terry

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Riley E Reynolds *Department of Mechanical Engineering, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA.ORCID 0000-0001-9022-5382
Benjamin P Wankum *Department of Mechanical Engineering, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA. bwankum2@unl.edu.ORCID 0000-0002-3534-4327
Sean J CrimminsDepartment of Mechanical Engineering, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA.ORCID 0000-0002-4619-976X
Mark A CarlsonDepartment of Surgery, University of Nebraska Medical Center, Omaha, NE, 68198, USA.ORCID 0000-0002-8113-9199
Benjamin S TerryDepartment of Mechanical Engineering, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA.ORCID 0000-0001-7067-6434

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMost complications and adverse events during laparoscopic surgery occur during initial entry into the peritoneal cavity. Among them, preperitoneal insufflation occurs when the insufflation needle is incorrectly placed, and the abdominal wall is insufflated. The objective of this study was to find a range for static pressure which is low enough to allow placement of a Veress needle into the peritoneal space without causing preperitoneal insufflation, yet high enough to separate abdominal viscera from the parietal peritoneum.

methodsA pressure test was performed on twelve fresh porcine carcasses to determine the minimum preperitoneal insufflation pressure and the minimum initial peritoneal cavity insufflation pressure. Each porcine model had five needle placement categories. One category tested the initial peritoneal cavity insufflation pressure beneath the umbilicus. The four remaining categories tested the preperitoneal insufflation pressure at four different anatomical locations on the abdomen that can be used for initial entry. The minimum initial insufflation pressures from each carcass were then compared to the preperitoneal insufflation pressures to obtain an optimal range for initial insufflation.

resultsIncreasing the insufflation pressure increased the probability of preperitoneal insufflation. Also, there was a statistically significant difference (p < 0.05) between the initial peritoneal cavity insufflation pressures (8.83 ± 4.19 mmHg) and the lowest preperitoneal pressures (32.54 ± 7.84 mmHg) (mean ± SD).

conclusionPressures greater than 10 mmHg resulted in initial cavity insufflation and pressures greater than 20 mmHg resulted in preperitoneal insufflation in porcine models. By knowing the minimum pressure required to separate the layers of the abdominal wall, the risk of preperitoneal insufflation can be mitigated while obtaining safe and efficient entry into the peritoneal cavity. The findings in this research are not a guideline for trocar or Veress needle placement, but instead reveal preliminary data which may lead to more studies, technology, etc.

Indexed as

Abdominal WallInsufflationLaparoscopyAnimalsNeedlesPeritoneal CavityPneumoperitoneum, ArtificialSwineInsufflationLaparoscopic surgeryPneumoperitoneumPreperitoneal insufflationPressure profile testVeress needle

Identifiers

PMID33481111

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.