Reconstructive Microsurgery in Head and Neck Surgery
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
The rectus abdominus flap is based on the deep inferior epigastric artery and its venae comitantes (Figure 93.9). The deep inferior epigastric artery arises from the external iliac artery immediately above the inguinal ligament. It ascends in a lateral to medial direction penetrating the transversalis fascia below the arcuate line, then travelling superiorly between the rectus muscle and the posterior rectus sheath. The artery generally divides into a number of large branches just below the umbilicus, providing numerous perforating branches to the rectus abdominus muscle and the overlying skin. Pedicle lengths from origin to insertion into the muscle range from 8 cm to 14 cm with average vessel diameters of 2.0–3.0 mm. The flap has its sensory and motor supply from the lower six or seven spinal thoracic nerves, making its innervation segmental and less than ideal for functional reconstruction or restoration of sensation.
Hernias
Sam Mehta, Andrew Hindmarsh, Leila Rees in Handbook of General Surgical Emergencies, 2018
The hernial sac passes medial to the inferior epigastric artery through a defect in the posterior wall of the inguinal canal: it occurs most frequently in older malesit is exceptionally rare in womenit rarely extends into the scrotum.
Lower Extremity Surgical Anatomy
Armstrong Milton B. in Lower extremity Trauma, 2006
1. Superficial inferior epigastric artery begins anterior from the CFA and 1 cm from the inguinal ligament, and ascends with it anteriorly. It supplies the superficial inguinal lymph nodes and the superficial fascia and skin. It anastomoses with branches from the inferior epigastric artery.
Comparison of 30-degree and 0-degree laparoscopes in the visualisation of the inferior epigastric vessel, rectus abdominis muscle and bladder dome in gynaecologic laparoscopy
Published in Journal of Obstetrics and Gynaecology, 2022
Satit Klangsin, Nantaka Ngaojaruwong, Hatern Tintara
In the lower abdominal wall, the inferior epigastric artery (IEA) mostly arises from the external iliac artery; however, variants may arise from the femoral artery or share a common trunk with the obturator artery (Wong and Merkur 2016). The IEA runs below the medial edge of the rectus abdominis muscle; the risk of damage to these vessels has led surgeons to opt for laparotomy to avoid any consequent massive haemorrhage (Lin and Grow 1999; Alkatout et al. 2015). The landmarks of the IEA and rectus abdominis muscle at the anterior superior iliac spine vary: 3.7–5.43 cm from midline and 5–6 cm from midline, respectively (Epstein et al. 2004; Rahn et al. 2010; Burnett et al. 2016; Joy et al. 2016, 2017). To prevent an IEA injury, various techniques have been proposed; the most common techniques are direct visualisation of the IEA, edge of the rectus abdominis muscle, and bladder dome via the primary port (Hurd et al. 2003).
The Septum Inguinalis: A Clue to Hernia Genesis?
Published in Journal of Investigative Surgery, 2020
Giuseppe Amato,, Piergiorgio Calò,, Vito Rodolico,, Roberto Puleio,, Antonino Agrusa,, Leonardo Gulotta,, Luca Gordini,, Giorgio Romano
Histologically, the 19 excised septa also showed progressive changes, which correlated to the macroscopic findings. All cases showed medial hyperplasia of the artery, venous congestion, chronic inflammatory infiltration and degenerative change in the muscular structures. The luminal patency of the inferior epigastric artery was reduced to a variable degree by medial hyperplasia. Thrombotic occlusion with recanalization and also complete fibrotic obliteration of the vessels was evident in the advanced stages (Figures 6–8). The muscular arrangement showed all degrees of degenerative damage, from hyaline through fibrotic to fatty degeneration. Fatty muscle dysplasia was found consistently (Figures 6 and 7) Connective tissue showed edema and inflammatory infiltrate, signaling significant degenerative damage (Figures 6 and 7). Fibrotic degeneration of the nerve axons was also widespread (Figure 9A) and Wallerian degeneration could be detected in the late stages (Figure 9B). On overall view of the histological data indicates that all the identified tissue injuries are consistent with chronic compressive damage.
Embolization of a large progressive symptomatic desmoid tumor in the rectus muscle of a female patient with multiple sclerosis: a case report
Published in Acta Chirurgica Belgica, 2018
I. Diebels, M. Blockhuys, P. Willemsen, Y. Pirenne
Embolization was performed one month later. Arterial access was achieved by puncture of the left common femoral artery by Seldinger technique. The sheath was advanced into the left external iliac artery after which the inferior epigastric artery was selectively catheterized. On CT-guidance and after contrast injection, the main artery of the tumor was identified and super selectively catheterized with a 0.021'' microcatheter. No pathological blush was observed. Embolization was performed by injection off 45–150 μm contourparticles in 0.8 ml lipiodol ultrafluid and 0.5 ml histoacryl transparent. Control angiography showed successful occlusion of the main artery of the tumor. The catheters and sheath were removed and the puncture site was closed by manual compression. The patient was discharged in good health the following day.
Related Knowledge Centers
- Anastomosis
- External Iliac Artery
- Inguinal Hernia
- Rectus Sheath
- Artery
- Body
- Inferior Epigastric Vein
- Lateral Umbilical Fold
- Inguinal Triangle
- Arcuate Line of Rectus Sheath