Demonstration of the epigastric vessels surface anatomy with equation model: An anatomical feasibility study

Abstract

Introduction: The objective of this study is to design a patient-specific model to predict the location of epigastric vessels on the abdominal surface and to show clinicians safe areas before surgical intervention. Material and Methods: A total of 200 patients who underwent color Doppler ultrasound evaluation of the deep epigastric vessel before gynecological laparoscopic surgery were recruited in the study. The deep epigastric vessels were identified at three equal levels between the xiphoid and umbilicus, and five equal levels between the umbilicus and the symphysis pubis. The distance between the epigastric vessels and the midline was measured bilaterally at each level. Linear mixed effect modeling was used to assess the anatomical location of the epigastric vessels. Results: The model with waist circumference term was found to be the model with best performance metric. This model included waist circumferences as a covariate, the region of the epigastric vessel as a categorical variable, and random effects for patients. The model that calculates the expected distance from the midline of the epigastric vessels for different regions and waist circumferences are presented as “Distance to midline (cm) = 2.57 + Region A + Region B × Waist Circumference.” Discussion and Conclusion: With the equation model, we proposed, the location of the epigastric vessels can be determined specifically for the patient and the abdominopelvic regions. This model can be a guide to prevent vascular injury.