Yukio Iwashita, Hiroki Uchida, Hiroomi Takayama, Masamitsu Ichimanda, Hajime Fujishima, Kunihiro Saga, Kazuhiro Tada, Takao Hara, Kiminori Watanabe, Teijiro Hirashita, Yuichi Endo, Masayuki Ohta, Masafumi Inomata. Oita University Faculty of Medicine
Introduction: Iatrogenic inferior vena cava (IVC) injury during laparoscopic surgery is rare but potentially life-threatening. The aim of this experimental study was 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 consists of a triple-lumen sphincterotome combined with two dilating balloons 25 mm in diameter. The procedures were performed in 5 pigs. The DB-CV catheter was inserted via the right femoral vein. For the IVC occlusion test, the placement of the balloons was confirmed by indocyanine green fluorescence imaging, and haemodynamic data were recorded. For the IVC injury test, a 3- to 4-mm circumferential incision was created in the IVC and hemostasis was started using balloon inflation 5 seconds after the injury.
Results: Haemodynamic change was minimal with 20mmHg reduction of mean arterial pressure by the IVC occlusion. All bleeding from the IVC injuries was successfully stopped by direct compression of one dilated balloon, with a mean time for hemostasis of 69 seconds and blood loss of 32ml. Subsequently, placement of two balloons, one on each side of IVC injury, made it possible to suture the injured IVC.
Conclusions: Balloon occlusion using DB-CV catheter provides a rapid hemostatic effect that could control the dangerous condition of massive hemorrhage from IVC.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77911
Program Number: P432
Presentation Session: Poster (Non CME)
Presentation Type: Poster