caa a22 4500 463200071 CHVBK 20180405153110.0 cr unu---uuuuu 170326e20070301xx s 000 0 eng 10.1007/s00276-007-0186-4 doi (NATIONALLICENCE)springer-10.1007/s00276-007-0186-4 Potential foramen to allow communication between the pleural cavity and retroperitoneal space during laparoscopic surgery: a cadaver study of Bochdalek's triangle [Elektronische Daten] [Michihiro Kawada, Gen Murakami, Toshiyuki Yajima, Toshio Sato, Shunji Mizobuchi, Shiro Sasaguri] The indications for laparoscopic retroperitoneal surgery have recently been greatly extended and the technique has become popular, but concomitant pleural injury or pneumothorax has been reported from numerous hospitals in Japan. Which anatomical information is useful to avoid surgical injury of the suggested weak portion of the diaphragm? We identified a diaphragm-free triangular area or Bochdalek's triangle in 90.1% of elderly Japanese cadavers (100/111 cadavers), comprising about 622.8mm2 in area (height 47.9mm, base 25.0mm). In most cases (80.1%; 129/161), the entire triangle was restricted to the superior side of the 12th rib in addition to the medial side of the distal end of the rib. A "potential foramen” (PF) was defined as the diaphragm-free triangle >100mm2 in area on the parietal pleura. Most triangles (77.6%, 125/161) met this criterion. The PF was often covered by the kidney (93.3%), and had a mean area of 318.9mm2. The PF was located 42.3mm from the distal end of the 12th rib, while the inferior pleural margin was 27.8mm superior to the rib end. When the triangle was large, the PF was also large, with the PF often occupying >50% of the triangle area (62/125; 49.6%). To avoid the distal end of the 12th rib, in laparoscopic retroperitoneal surgery, we recommend making a transverse skin incision at the midpoint between the end of the 12th rib and the iliac crest. Springer-Verlag, 2007 Laparoscopic retroperitoneal surgery nationallicence Pneumothorax nationallicence Bochdalek's triangle, diaphragm nationallicence Human anatomy nationallicence Kawada Michihiro Second Department of Surgery, Kochi University School of Medicine, 783-8505, Okoucho, Nangoku, Japan aut Murakami Gen Department of Anatomy, Sapporo Medical University School of Medicine, South 1, West 17, 060-8556, Sapporo, Japan aut Yajima Toshiyuki Department of Oral Anatomy, Health Sciences University of Hokkaido School of Dentistry, Tobetsu, 061-0293, Hokkaido, Japan aut Sato Toshio Department of Anatomy, Sapporo Medical University School of Medicine, South 1, West 17, 060-8556, Sapporo, Japan aut Mizobuchi Shunji Second Department of Surgery, Kochi University School of Medicine, 783-8505, Okoucho, Nangoku, Japan aut Sasaguri Shiro Second Department of Surgery, Kochi University School of Medicine, 783-8505, Okoucho, Nangoku, Japan aut Surgical and Radiologic Anatomy Springer-Verlag 29/2(2007-03-01), 105-113 0930-1038 29:2<105 2007 29 276 https://doi.org/10.1007/s00276-007-0186-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00276-007-0186-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kawada Michihiro Second Department of Surgery, Kochi University School of Medicine, 783-8505, Okoucho, Nangoku, Japan aut NATIONALLICENCE 700 1- Murakami Gen Department of Anatomy, Sapporo Medical University School of Medicine, South 1, West 17, 060-8556, Sapporo, Japan aut NATIONALLICENCE 700 1- Yajima Toshiyuki Department of Oral Anatomy, Health Sciences University of Hokkaido School of Dentistry, Tobetsu, 061-0293, Hokkaido, Japan aut NATIONALLICENCE 700 1- Sato Toshio Department of Anatomy, Sapporo Medical University School of Medicine, South 1, West 17, 060-8556, Sapporo, Japan aut NATIONALLICENCE 700 1- Mizobuchi Shunji Second Department of Surgery, Kochi University School of Medicine, 783-8505, Okoucho, Nangoku, Japan aut NATIONALLICENCE 700 1- Sasaguri Shiro Second Department of Surgery, Kochi University School of Medicine, 783-8505, Okoucho, Nangoku, Japan aut NATIONALLICENCE 773 0- Surgical and Radiologic Anatomy Springer-Verlag 29/2(2007-03-01), 105-113 0930-1038 29:2<105 2007 29 276 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer