Abstract
Objective: We evaluated the feasibility and safety of a new technique of operative Superficialization and preservation of the umbilical vein during neonatal laparotomy with central venous catheter insertion.
Methods: 25 neonates were subjected to this new technique during laparotomy. The technique is performed as follows: after transverse or transumbilical laparotomy incisions, the umbilical vein is dissected 2-3 cm cephaled to the umbilicus. A proximal area of the vein almost of 2 cm is skeletonized and passed to be superficial to the rectus muscle. A very small stab equal to the catheter diameter is done 1- 1.5 cm proximal to the incision site, where the end of the vein is passed via the subcutaneous tissue and skin then fixed by sutures to skin after passage of the suitable size catheter.
Results: In 23 cases, no difficulty was encountered. Operative difficulty was reported in 2 cases where there is anomalous course of the vein in one case. Another case with already inserted catheter, need to be flushed with change of the catheter. Catheter slippage, infection and deep insertion reported each once.
Conclusion: This is the first report of operative Superficialization and preservation of the umbilical vein during neonatal laparotomy which is feasible and safe technique.
Citation
Shehata SM, Batrany AE and Effat AM. Umbilical Vein Superficialization and Preservation in Neonates: A Valid Way for Central Line Insertion: First Experience. SM J Pediatr Surg. 2016; 2(3): 1021.