PMC7530214_01
CT scan showing hook or J shape of the C (indicated by the white arrow).
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The Findings of the aortogram images in the sagittal plane revealed narrowing and hook shape of the celiac main trunk [Fig. 1].
Lateral inspiratory and expiratory angiogram of celiac trunk with orange arrows pointing to the hook deformity.
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This narrowing was accentuated in end expiratory phase [Fig. 2].
Laparoscopic port positions.
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Five port were placed in the upper abdomen [Fig. 3].
A - Division of Median arcuate ligament fibres (white arrow), B - Division of Celiac plexus neural tissue (yellow arrow).
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The diaphragmatic fibers then were carefully divided from the hiatus downwards exposing the aorta [Fig. 4A]. The celiac plexus and the ganglia were also found tightly arching over the celiac artery hence were divided individually till the celiac artery was completely free of all the muscle, nerves and fibro-fatty tissue covering it [Figs. 4B, 5].
Completed division of all neuro-muscular and fibro-fatty tissue overlying the Celiac Artery.
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The celiac plexus and the ganglia were also found tightly arching over the celiac artery hence were divided individually till the celiac artery was completely free of all the muscle, nerves and fibro-fatty tissue covering it [Figs. 4B, 5].