Pressurized hydrodissection for CT-guided percutaneous peritoneal navigation: The hydro jet technique

Area of Science:

• Minimally Invasive Surgery
• Interventional Radiology

Background:

• Percutaneous procedures require accurate localization of target tissues.
• Displacement of peritoneal structures is crucial for safe access to the retroperitoneal space.
• Traditional methods for peritoneal displacement can be challenging and carry risks.

Discussion:

• Hydrodissection with pressurized 5% dextrose in water (D5W) offers a novel approach for peritoneal structures displacement.
• This technique was evaluated in two cases of percutaneous fiducial marker placement prior to retroperitoneal lymphadenectomy.
• The fluid volume used ranged from 125-200 mL, with a mean peritoneal crossing time of 6 minutes 47 seconds.

Key Insights:

• Pressurized D5W hydrodissection effectively creates a safe pathway through the peritoneum.
• The method demonstrated safety in displacing bowel and small vessels, crucial for percutaneous access.
• This technique facilitates secure navigation to retroperitoneal lymph nodes.

Outlook:

• Hydrodissection may enhance the safety and efficiency of percutaneous procedures.
• Further research is warranted to explore its broader applications in interventional oncology.
• This technique holds potential for improving preoperative localization marker placement.