Anatomy of the left upper quadrant for cannula insertion.

Study Objective: To determine the anatomy of the left upper quadrant (LUQ) of the abdomen in women with different body mass indexes.
Design: Review of computed tomographic (CT) scans and medical records (Canadian Task Force classification II-2).
Setting: Large tertiary care medical center.
Patients: Sixty-three women over age 18 years who had scans performed for any indication. Nine women were excluded because of contraindication to LUQ laparoscopic cannula insertion and five because of incomplete records. Intervention. None.
Measurements and Main Results: The closest organs to the LUQ insertion site were the liver and stomach. There was significantly more subcutaneous fat at the umbilicus than at the insertion site. A positive correlation was found between body mass index and distance between structures and the site.
Conclusion: Cannulas should not be inserted in the LUQ in women with hepatomegaly or splenomegaly. Because the stomach is so close to the insertion site, gastric drainage should be performed before cannula insertion. The site is likely safe in obese women whose abdominal organs are far away from it, and who have less subcutaneous fat there than at the umbilicus.