Intestinal Anastomoses Prior to 1882; a Legacy of Ingenuity, Persistence, and Research Form a Foundation for Modern Gastrointestinal Surgery

Dietz, Ulrich; Debus, Eike-Sebastian

doi:10.1007/s00268-004-7720-x

Cited by 30 publications

(25 citation statements)

References 13 publications

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“…The third layer in our closure for open fetal surgical procedures, representing our modification to the MOMS trial technique, creates serosal-toserosal apposition that may increase myometrial thickness and reduce hysterotomy complications. Serosal-toserosal apposition has been a fundamental technique of bowel anastomoses since it was first proposed by Antoine Lembert in 1826 [9].…”

Section: Discussionmentioning

confidence: 99%

Modified Hysterotomy Closure Technique for Open Fetal Surgery

et al. 2017

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Objective: We reviewed our experience with open fetal surgical myelomeningocele repair to assess the efficacy of a new modification of the hysterotomy closure technique regarding hysterotomy complication rates at the time of cesarean delivery. Methods: A modification of the standard hysterotomy closure was performed on all patients undergoing prenatal myelomeningocele repair. The closure consisted of an interrupted full-thickness #0 polydioxanone (PDS) retention suture as well as a running #0 PDS suture to re-approximate the myometrial edges, and the modification was a third imbricating layer resulting in serosal-to-serosal apposition. A standard omental patch was placed per our routine. Both operative reports and verbal descriptions of hysterotomy from delivering obstetricians were reviewed. Results: A total of 49 patients underwent prenatal repair of myelomeningocele, 43 having adequate follow-up for evaluation. Of those, 95.4% had completely intact hysterotomy closures, with only 1 partial dehiscence (2.3%) and 1 thinned scar (2.3%). There were no instances of uterine rupture. Discussion: In patients undergoing this modified hysterotomy closure technique, a much lower than expected complication rate was observed. This simple modified closure technique may improve hysterotomy healing and reduce obstetric morbidity.

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Section: Discussionmentioning

confidence: 99%

Modified Hysterotomy Closure Technique for Open Fetal Surgery

et al. 2017

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“…He inserted the afferent limb into the efferent limb and secured the invagination with two interrupted mucosa-to-serosa sutures [ 1 ]. The patient survived and died 1-year later from pneumonia [ 1 ].…”

Section: Historical Perspectivementioning

confidence: 98%

“…Vincenz von Czerny in 1882 proposed a two-layered intestinal anastomosis. Only 1-year after it was fi rst published, the technique was widely accepted and became a standard method for performing anastomosis [ 1 ]. Later, William Stewart Halsted proved in 1887 using canine experiments that the submucosa provided suffi cient strength and he popularized the single layer intestinal anastomosis [ 1 ].…”

Section: Historical Perspectivementioning

confidence: 99%

“…Later, William Stewart Halsted proved in 1887 using canine experiments that the submucosa provided suffi cient strength and he popularized the single layer intestinal anastomosis [ 1 ]. With these beginnings nearly 300 years ago, gastrointestinal (GI) anastomosis has been transformed from a life-threatening adventure to a safe and routinely performed procedure [ 1 ].…”

Section: Historical Perspectivementioning

confidence: 99%

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Minimally Invasive Surgical Techniques for Cancers of the Small Intestine

Ahmed

Weerasinghe

Nussbaum

2014

Surgery for Cancers of the Gastrointestinal Tract

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The small intestine is a convoluted tube extending from the pylorus to the ileocecal valve. It is about 7 m long, and gradually diminishes in size from its commencement to its termination. The small intestine is divisible into three portions: the duodenum, the jejunum, and the ileum. In this chapter we will focus on the jejunum and the ileum. The upper 40 % constitutes the jejunum and the remainder is the ileum. There is no morphological line of distinction between the two and the division is arbitrary. However there are subtle changes that make this distinction possible.The jejunum has a thicker wall and a wider lumen whereas the ileum has a thinner wall and a smaller lumen. Adipose tissue is more abundant in the mesentery of the ileum, thus vessels in the mesentery are not as well visualized. The small intestinal mesentery is fan-shaped with a root of about 15 cm extending obliquely from the left L2 lumbar vertebral transverse process level to the right sacroiliac joint and crossing over the third portion of the duodenum, the aorta, inferior vena cava, and the right ureter. Between the two leaves of the mesentery are the mesenteric vessels and lymph nodes. The superior mesenteric artery (SMA) is the artery of the small intestine. The jejunum has fewer (2-3) series of vascular arcades per segment and the vasa recta are longer; whereas, the ileum has more (4-5) series of arcades and the vasa recta are shorter.The proximal jejunum and distal ileum are more important for absorption than the rest of the small intestine. Massive resection of small bowel (e.g., in mesenteric vascular disease) or repeated resections (e.g., in Crohn's disease) may result in short bowel syndrome and malabsorption. Resection of a signifi cant portion of the terminal ileum is associated with a loss of absorption of the fat soluble vitamins (i.e., vitamins A, D, E, K, and B12). Major ileal resection also creates changes in cholesterol metabolism and bile acid reabsorption. If undigested fats and bile acids transit directly into the transverse colon, the osmotic pressure of the colon is elevated and diarrhea may result.

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“…The outlook for bowel surgery requiring anastomosis was quite dismal early on, as illustrated by Lorenz Heister in his 1719 book ''Chirurgie''; ''it does not matter which technique is used to repair bowel injuries since the majority of patients are not salvageable'' [1]. In 1732, George Arnaud de Ronsil performed the first right hemicolectomy with ''double-barrel ileostomy'' for gangrenous ascending colon herniated at the groin [2].…”

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confidence: 99%