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Inguinal hernia, hydrocele, and other hernias of the abdominal wall
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Sophia Abdulhai, Todd A. Ponsky
A transverse incision is made in the lowest inguinal skin crease above the external inguinal ring on the affected side (Figure 24.2). Be aware of the superficial epigastric vein here to avoid bleeding. Scarpa's fascia is incised and the external oblique aponeurosis is identified. This is exposed and traced inferiorly to the inguinal ligament and medially to expose the decussating external (superficial) inguinal ring enveloping the emerging spermatic cord. This technique minimizes the risk of opening the inguinal canal too medially.
Pre-, intra-, and post-treatment use of duplex ultrasound (thermal and non-thermal)
Published in Joseph A. Zygmunt, Venous Ultrasound, 2020
Immediate post-treatment interrogation has two main purposes. First, patency of the deep vein, either femoral (for GSV ablation) or popliteal (for SSV ablation) is confirmed with both Doppler and color flow analysis, and second, the post-treatment vein wall and saphenous patency are examined. With regard to the deep system patency, the corresponding deep venous structures are examined for free flow and the lack of any thrombus. Also, and especially at the SFJ, patency and flow through the superficial epigastric vein (SEV) are also confirmed. This has two significant components. First, with maintenance of flow, the drainage of the abdominal wall or other pelvic sources is confirmed so “frustrated drainage,” which is hypothesized to cause neovascularization and a nesting of varices near the junction, is avoided. Second, this flow from the SEV helps to “wash out” the proximal GSV at the junction, helping to prevent the development of thrombus extension (EHIT). Figure 9.27 demonstrates all of these aspects.
The Spleen(SP)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Superficial epigastric vein: The superficial epigastric veins provide collateral circulation routes for abdominopelvic venous blood. These valveless veins offer an additional route for venous blood to return to the heart in cases of inferior vena caval obstruction or ligation. Usually, the superficial epigastric vein is a tributary of the great saphenous vein.
New microvascular anastomotic device for end-to-side anastomosis using negative pressure; a preliminary study
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Kazufumi Tachi, Katsuko S. Furukawa, Isao Koshima, Takashi Ushida
Ethical approval was obtained from the University of Tokyo Animal Ethics Committee (Med.P10-041) before beginning the experiments. Nine end-to-side anastomoses were performed with the devices on nine male Wistar rats weighing 450–535 g. The superficial epigastric veins (diameter: 0.75–0.95 mm) were used as end-vessels, and the femoral veins (diameter: 1.1–1.5 mm) were used as side-vessels (Figure 3). The rats were anesthetized with intraperitoneal administration of sodium pentobarbital (3.0 mg/100 g body weight). A cutaneo-adipose flap, which depends on the superficial epigastric artery, was elevated and assumed to be useful as a monitor of the patency of the anastomosis. The epigastric vein was dissected from the junction with the femoral vein, peripherally to the point where it had its first large branch. The femoral vein was dissected and exposed from the inguinal ligament to the junction with the superficial epigastric vein. All small branches of these vessels were ligated and divided. The device was placed on the femoral vein, 8 mm proximal to the junction. The superficial epigastric vein was transected a little distal to the junction and placed in the device. The femoral vein was clamped on both ends using the two clamp parts of the device for the side vessel. A window was made on the femoral vein through the central opening. The lumen of the vein was irrigated with heparinized natural saline and prepared for the anastomosis. Each edge of the vein was installed in the device and assembled with the device (Figure 4). Right after the procedure, the patency was assessed by a distal squeeze test on the end vessel; when the blood flow came from the side vessel and filled the lumen of the end vessel after the forceps’ clamping was released, the anastomosis was assessed patent.