Diagnostic Peritoneal Lavage (DPL)


Insertion of the guidewire through cannula

Diagnostic Peritoneal Lavage (DPL) is performed when intra-abdominal bleeding secondary to trauma is suspected. The procedure is performed when alternative diagnostic methods such as computerized tomography (CT) or ultrasound imaging are unavailable, or when the patient’s condition does not allow them to be performed.

The DPL procedure is complex and involves multiple steps. First, the appropriate site is selected and a small incision made after local anesthesia. A cannula is inserted in the incision and is used to penetrate the midline fascia in the abdominal wall. During insertion, a sudden give or "pop" can be felt as the cannula passes through the fascia. Care must be taken not to insert the cannula too deeply and perforate the bowel. A flexible guidewire is passed through the cannula. The cannula is then removed and a catheter threaded over the guidewire. The guidewire is then removed. A syringe fitted on the catheter is used for aspiration. If gross blood is detected, bleeding is confirmed. If no blood is aspirated, the syringe is removed. Saline solution is introduced into the abdominal cavity through the catheter. The solution is then drained and sent for analysis.

We have developed a computer-based simulator for this procedure. The simulation runs on a PC-based computer running Windows NT.The CathSim™ AccuTouch™ vascular access device by Immersion Medical is used to simulate surgical instrument insertion.

Our system is presently used as part of an Introduction to Surgery course for 3rd year medical students. Our system was also used in an experimental Advanced Trauma Life Support® course performed without animals or cadavers.

Video

This video demonstrates the DPL simulator as it was presented at MMVR 2001.

Project Members

Alan Liu