Control of inferior vena cava injury during laparoscopic surgery using a double balloon-equipped central venous catheter: proof of concept in a live porcine model

Yukio Iwashita, Hiroki Uchida, Hiroomi Takayama, Michihiro Ichimanda, Katsuya Taniguchi, Hideki Kiguchi, Tetsumi Sakaguchi, Hajime Fujishima, Kunihiro Saga, Kazuhiro Tada, Takao Hara, Kiminori Watanabe, Teijiro Hirashita, Yuichi Endo, Masayuki Ohta, Masafumi Inomata

Research output: Contribution to journalArticle

Abstract

Background: Iatrogenic inferior vena cava (IVC) injury is a rare but potentially life-threatening complication during laparoscopic surgery. This experimental study aimed to assess the hemostatic ability of a new device, double balloon-equipped central venous (DB-CV) catheter, for IVC injury. Methods: The DB-CV catheter comprises a triple-lumen sphincterotome combined with two dilating balloons having a diameter of 25 mm. The experimental procedures were performed in five pigs. The DB-CV catheter was inserted via the right femoral vein. For the IVC occlusion test, correct placement of the balloons was confirmed by indocyanine green fluorescence imaging, and hemodynamic data were recorded. For the IVC injury test, a 3- to 4-mm circumferential incision was created in IVC, and hemostasis was initiated using balloon inflation 5 s after the injury. Results: Hemodynamic changes were minimal, with a 20 mmHg reduction in the mean arterial pressure because of IVC occlusion. All bleeding from IVC injuries was successfully temporarily stopped by direct balloon compression, with a mean time to hemostasis of 69 s and mean blood loss of 32 ml. Subsequently, the positioning of IVC injuries between two balloons made it possible to suture the injured IVC. Conclusions: Balloon occlusion using the DB-CV catheter provides a rapid temporal hemostatic effect and can overcome the serious condition of massive hemorrhage from IVC injuries.

Original languageEnglish
Pages (from-to)2397-2401
Number of pages5
JournalSurgical endoscopy
Volume32
Issue number5
DOIs
Publication statusPublished - May 1 2018

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Central Venous Catheters
Inferior Vena Cava
Laparoscopy
Swine
Wounds and Injuries
Hemostatics
Hemostasis
Hemodynamics
Hemorrhage
Balloon Occlusion
Indocyanine Green
Femoral Vein
Optical Imaging
Economic Inflation
Sutures
Arterial Pressure
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Surgery

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Control of inferior vena cava injury during laparoscopic surgery using a double balloon-equipped central venous catheter : proof of concept in a live porcine model. / Iwashita, Yukio; Uchida, Hiroki; Takayama, Hiroomi; Ichimanda, Michihiro; Taniguchi, Katsuya; Kiguchi, Hideki; Sakaguchi, Tetsumi; Fujishima, Hajime; Saga, Kunihiro; Tada, Kazuhiro; Hara, Takao; Watanabe, Kiminori; Hirashita, Teijiro; Endo, Yuichi; Ohta, Masayuki; Inomata, Masafumi.

In: Surgical endoscopy, Vol. 32, No. 5, 01.05.2018, p. 2397-2401.

Research output: Contribution to journalArticle

Iwashita, Y, Uchida, H, Takayama, H, Ichimanda, M, Taniguchi, K, Kiguchi, H, Sakaguchi, T, Fujishima, H, Saga, K, Tada, K, Hara, T, Watanabe, K, Hirashita, T, Endo, Y, Ohta, M & Inomata, M 2018, 'Control of inferior vena cava injury during laparoscopic surgery using a double balloon-equipped central venous catheter: proof of concept in a live porcine model', Surgical endoscopy, vol. 32, no. 5, pp. 2397-2401. https://doi.org/10.1007/s00464-017-5938-6
Iwashita, Yukio ; Uchida, Hiroki ; Takayama, Hiroomi ; Ichimanda, Michihiro ; Taniguchi, Katsuya ; Kiguchi, Hideki ; Sakaguchi, Tetsumi ; Fujishima, Hajime ; Saga, Kunihiro ; Tada, Kazuhiro ; Hara, Takao ; Watanabe, Kiminori ; Hirashita, Teijiro ; Endo, Yuichi ; Ohta, Masayuki ; Inomata, Masafumi. / Control of inferior vena cava injury during laparoscopic surgery using a double balloon-equipped central venous catheter : proof of concept in a live porcine model. In: Surgical endoscopy. 2018 ; Vol. 32, No. 5. pp. 2397-2401.
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T2 - proof of concept in a live porcine model

AU - Iwashita, Yukio

AU - Uchida, Hiroki

AU - Takayama, Hiroomi

AU - Ichimanda, Michihiro

AU - Taniguchi, Katsuya

AU - Kiguchi, Hideki

AU - Sakaguchi, Tetsumi

AU - Fujishima, Hajime

AU - Saga, Kunihiro

AU - Tada, Kazuhiro

AU - Hara, Takao

AU - Watanabe, Kiminori

AU - Hirashita, Teijiro

AU - Endo, Yuichi

AU - Ohta, Masayuki

AU - Inomata, Masafumi

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N2 - Background: Iatrogenic inferior vena cava (IVC) injury is a rare but potentially life-threatening complication during laparoscopic surgery. This experimental study aimed to assess the hemostatic ability of a new device, double balloon-equipped central venous (DB-CV) catheter, for IVC injury. Methods: The DB-CV catheter comprises a triple-lumen sphincterotome combined with two dilating balloons having a diameter of 25 mm. The experimental procedures were performed in five pigs. The DB-CV catheter was inserted via the right femoral vein. For the IVC occlusion test, correct placement of the balloons was confirmed by indocyanine green fluorescence imaging, and hemodynamic data were recorded. For the IVC injury test, a 3- to 4-mm circumferential incision was created in IVC, and hemostasis was initiated using balloon inflation 5 s after the injury. Results: Hemodynamic changes were minimal, with a 20 mmHg reduction in the mean arterial pressure because of IVC occlusion. All bleeding from IVC injuries was successfully temporarily stopped by direct balloon compression, with a mean time to hemostasis of 69 s and mean blood loss of 32 ml. Subsequently, the positioning of IVC injuries between two balloons made it possible to suture the injured IVC. Conclusions: Balloon occlusion using the DB-CV catheter provides a rapid temporal hemostatic effect and can overcome the serious condition of massive hemorrhage from IVC injuries.

AB - Background: Iatrogenic inferior vena cava (IVC) injury is a rare but potentially life-threatening complication during laparoscopic surgery. This experimental study aimed to assess the hemostatic ability of a new device, double balloon-equipped central venous (DB-CV) catheter, for IVC injury. Methods: The DB-CV catheter comprises a triple-lumen sphincterotome combined with two dilating balloons having a diameter of 25 mm. The experimental procedures were performed in five pigs. The DB-CV catheter was inserted via the right femoral vein. For the IVC occlusion test, correct placement of the balloons was confirmed by indocyanine green fluorescence imaging, and hemodynamic data were recorded. For the IVC injury test, a 3- to 4-mm circumferential incision was created in IVC, and hemostasis was initiated using balloon inflation 5 s after the injury. Results: Hemodynamic changes were minimal, with a 20 mmHg reduction in the mean arterial pressure because of IVC occlusion. All bleeding from IVC injuries was successfully temporarily stopped by direct balloon compression, with a mean time to hemostasis of 69 s and mean blood loss of 32 ml. Subsequently, the positioning of IVC injuries between two balloons made it possible to suture the injured IVC. Conclusions: Balloon occlusion using the DB-CV catheter provides a rapid temporal hemostatic effect and can overcome the serious condition of massive hemorrhage from IVC injuries.

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