Exposure of the abdominal aorta and visceral branches for hemorrhage control: A 2020 EAST Master Class Video...

Rapid control of abdominal hemorrhage is a potentially life-saving surgical skill. Although open exposure and control of the abdominal aorta and its visceral branches is a fundamental part of surgical training, familiarity with the anatomy and spacial relationships of the surrounding structures can be challenging for even the experienced surgeon.

Using a fresh perfused cadaver, this video provides a step by step visual guide for aortic exposure from the diaphragmatic hiatus to the iliac bifurcation. Key maneuvers including control of the supraceliac aorta, left medial visceral rotation with identification of superior mesenteric and celiac arteries, and exposure of the perirenal aorta and proximal renal vessels are outlined. Damage control and definitive management strategies are discussed and potential tips and pitfalls in addressing intraabdominal hemorrhage are highlighted.

The critical application of aortic exposure for hemorrhage control is a life-saving intervention if done rapidly and effectively. This requires a sound understanding of aortic anatomy and necessary steps for adequate exposure and subsequent repair. This video outlines the necessary steps to perform these interventions.