Iranian Journal of Surgery

New Suggestion for Port insertion during Laparoscopy for Penetrating Thoracoabdominal Injuries

Document Type : Original Article

Authors

Sh Paydar 1
M Dehbozorgi 2
A Askari 3
H Rezaei 4
H Abdolrahimzadeh Fard 5

1 Professor, Department of General Surgery, Shiraz University of Medical Sciences, Haj Mohammad Esmaeil Imtiaz Hospital and Shahid Rajaee Surgical Emergencies, Trauma Department

2 Resident of Plastic, Reconstruction and Burn Surgery, Burn and Wound healing Research Center, Department of Plastic Surgery, Shiraz University of Medical Sciences, Amiralmomenin Hospital, Shiraz, Iran

3 Assistant Professor, Department of Cardiovascular Surgery, Iran University of Medical Sciences, Shahid Rajaee Hospital

4 Assistant Professor, Department of General Surgery, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz

5 Assistant Professor, Department of General Surgery, Shiraz University of Medical Sciences, Haj Mohammad Esmaeil Imtiaz Hospital and Shahid Rajaee Surgical Emergencies, Trauma Department

Abstract
Penetrating trauma to thoracoabdominal area can cause diaphragmatic injury. Diagnostic Laparoscopy is an acceptable method for evaluating the diaphragmatic injuries. Due to insertion sites of ports in classic diagnostic laparoscopy, evaluation of diaphragm behind liver and spleen needs more experience. In patients with suspicious to diaphragmatic injury and according to available facilities in our centers, we suggest that in unilateral injuries instead of contralateral midclavicular 5mm port, insert a 5mm port in subxyphoid area. In bilateral injuries, if enough exposure doesn’t achieve, we can add a 5mm port in subxiphoid area. In bilateral injuries, if enough exposure doesn’t achieve, we can add a 5mm port in subxiphoid area. In absence of 30 degrees cameras, use of 10mm port in subxiphoid can give surgeons better exposure of diaphragm with zero-degree cameras.

Keywords

Penetrating Trauma
Thoracoabdominal
Diagnostic Laparoscopy
Diaphragmatic Injury
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Iranian Journal of Surgery
Volume 31, Summer
Summer 2023
Pages 73-78

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