A new method for therapeutic paracentesis: The automated low flow pump system. Comments in the context of the history of paracentesis

摘要

Paracentesis is reported for the treatment of ascites since the time of Hippocrates (460-370 BC). The first detailed description of the procedure was made by Celsus (30 BC-50 AC). The technique consisted in opening the abdominal wall by a puncture with a cautery or a scalpel and inserting a cannula with a proximal end curved outward or one that had a rounder protuberance in the middle to avoid its loss into the peritoneal cavity [1]. Sanc-torious Sanctorio (1561-1636), a surgeon from Padova University, designed the first trocar for paracentesis (a round needle enclosed within a cannula through which ascitic fluid was able to flow upon withdrawal of the needle). This was a fundamental advance since the trocar permitted the control of the amount of ascites extracted, as well as easy repetition of the procedure. Jean Palfyn (1644-1730), a Belgian gynecologist, was the first to propose the left lower abdominal quadrant for trocar insertion [1].