Variation in surface marking of superior epigastric vessels. A guide to safe laparoscopic port insertion

This study aimed to map surface markings of the superior epigastric artery, to provide safe landmarks for the placement of trochars in laparoscopic surgery. Seventeen cadavers were dissected and surface anatomy of the superior epigastric artery was defined at two levels: the xiphoid process, and midway between the xiphoid process and umbilicus. Safe sites for insertion of ports were determined in cadavers by dissecting and locating the main trunks of the superior epigastric artery. At the level of the xiphoid process, the distance from the midline ranged from 3.9cm to 4.8cm with a mean of 4.3cm (SD +/- 0.2cm) while midway between the xiphoid process and umbilicus, the distance of the superior epigastric artery from the midline ranged from 4 to 7.5cm, with a mean of 5.7cm (SD +/- 0.7cm). In this area the artery is vulnerable to damage, hence it can be declared as a danger zone.