To determine the location of deep epigastric vessels in pediatric patients using Doppler ultrasonography, aiming to identify safe zones for trocar placement to minimize injury risk.
Key Findings:
Mean distances of deep epigastric vessels from the midline were 6.18 cm (±0.7) at the right pubic symphysis, 4.64 cm (±0.6) at the umbilicus, and 3.21 cm (±0.5) at the xiphoid on the right; 6.46 cm (±0.69), 4.64 cm (±0.6), and 3.19 cm (±0.5) on the left.
No significant differences in vessel distances between male and female children.
Identified relatively safe avascular areas for lateral trocar placement.
Interpretation:
The significant variation in the distance of deep epigastric vessels from the midline underscores the necessity for careful trocar placement to minimize injury risk during pediatric laparoscopic surgery.
Limitations:
Exclusion of patients with certain conditions may limit the generalizability of the findings.
Technical limitations in Doppler ultrasonography could affect the visualization of vessels.
Conclusion:
Ultrasonography effectively maps deep epigastric vessels in children, providing critical information for safer trocar insertion during laparoscopic procedures.
Patients with preoperative vitamin D deficiency had higher postoperative pain scores and opioid use after mastectomy, including more than triple the odds of moderate to severe pain within 24 hours of surgery.
