Endoscopic components separation for abdominal compartment syndrome

Miranda Voss*, Jose Pinheiro, James Reynolds, Rebecca Greene, Mark Dewhirst, Steven N. Vaslef, Erik Clary, W. Steve Eubanks

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)158-163
Number of pages6
JournalAmerican Journal of Surgery
Volume186
Issue number2
DOIs
StatePublished - Aug 2003
Externally publishedYes

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