TY - JOUR
T1 - Endoscopic components separation for abdominal compartment syndrome
AU - Voss, Miranda
AU - Pinheiro, Jose
AU - Reynolds, James
AU - Greene, Rebecca
AU - Dewhirst, Mark
AU - Vaslef, Steven N.
AU - Clary, Erik
AU - Eubanks, W. Steve
N1 - Funding Information:
Supported in part by a grant from the United States Surgical Corporation.
PY - 2003/8
Y1 - 2003/8
N2 - Background: Sustained intraabdominal pressures of 14 to 20 mm Hg have significant pathophysiological consequences, but there is currently no satisfactory low-morbidity procedure appropriate for intervention early in the disease process of abdominal compartment syndrome (ACS). The anatomical principles of abdominal wall components separation were used to develop a percutaneous procedure that increased abdominal capacity and decreased abdominal pressure. Methods: Using a porcine model, we determined abdominal capacity changes by helium insufflation. Corn oil was then used to create an episode of sustained intraabdominal hypertension and changes in intraabdominal pressure and intestinal mucosal oxygenation were determined. Results: Endoscopic abdominal wall components separation (EACS) increased abdominal capacity by 1 L (from 0.89 ± 0.39 L to 1.95 ± 0.48 L; P <0.001). During intraabdominal hypertension, EACS decreased abdominal pressure by 31.6% (from 15.9 ± 2.1 to 11.0 ± 1.5 mm Hg; P <0.001). Intestinal PO2 was increased by 61% (18.8 ± 11.4 to 30.3 ± 11.7; P = 0.012) Conclusions: A minimally invasive procedure (EACS) is feasible and has demonstrated effectiveness in a porcine model of ACS.
AB - Background: Sustained intraabdominal pressures of 14 to 20 mm Hg have significant pathophysiological consequences, but there is currently no satisfactory low-morbidity procedure appropriate for intervention early in the disease process of abdominal compartment syndrome (ACS). The anatomical principles of abdominal wall components separation were used to develop a percutaneous procedure that increased abdominal capacity and decreased abdominal pressure. Methods: Using a porcine model, we determined abdominal capacity changes by helium insufflation. Corn oil was then used to create an episode of sustained intraabdominal hypertension and changes in intraabdominal pressure and intestinal mucosal oxygenation were determined. Results: Endoscopic abdominal wall components separation (EACS) increased abdominal capacity by 1 L (from 0.89 ± 0.39 L to 1.95 ± 0.48 L; P <0.001). During intraabdominal hypertension, EACS decreased abdominal pressure by 31.6% (from 15.9 ± 2.1 to 11.0 ± 1.5 mm Hg; P <0.001). Intestinal PO2 was increased by 61% (18.8 ± 11.4 to 30.3 ± 11.7; P = 0.012) Conclusions: A minimally invasive procedure (EACS) is feasible and has demonstrated effectiveness in a porcine model of ACS.
UR - http://www.scopus.com/inward/record.url?scp=0042160309&partnerID=8YFLogxK
U2 - 10.1016/S0002-9610(03)00171-5
DO - 10.1016/S0002-9610(03)00171-5
M3 - Article
C2 - 12885610
AN - SCOPUS:0042160309
SN - 0002-9610
VL - 186
SP - 158
EP - 163
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 2
ER -