The risk of injury to inferior epigastric artery (IEA) subjects during abdominal procedure

“The anatomical position of the inferior epigastric artery (IEA) subjects it to risk of injury during abdominal procedures that are close to the artery, such as laparoscopic trocar insertion, insertion of intra-abdominal drains, Tenckhoffâ catheter (peritoneal dialysis catheter) and paracentesis. This article aims to raise the awareness of the anatomical variations of the course of the IEA in relation to abdominal landmarks in order to define a safer zone for laparoscopic ancillary trocar placement. Methods of managing the IEA injury as well as techniques to minimise the risk of injury to the IEA are reviewed and discussed.”

Conclusion: The best preventative measure to avoid ancillary trocar injury to the IEA is inserting the trocar after identifying the IEA with direct laparoscopic visualisation. It is a good
practice to inspect all ancillary trocar sites for signs of IEA injury before the laparoscope is finally withdrawn. Tamponade, suturing, trans-catheter arterial embolisation and ultrasound-guided thrombin injection have been shown to arrest bleeding effectively.”

(Wong)

Wong C, et al Inferior epigastric artery: Surface anatomy, prevention and management of injury. Aust N Z J Obstet Gynaecol. 2016 Apr;56(2):137-41.

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