Colon resection using the invagination technique.
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Animals↗
Biomedical subjects
B Ravo
Publications and source records attributed to B Ravo.
A new technique for indirect inguinal hernia repair.
This report concerns a preliminary study of a new technique for indirect herniorraphy, which was used in 242 patients from December 1988 through March 1991. Its main characteristics are the creation of a deep neo-inguinal ring in a more medial site, shortening of the inguinal canal by transposition of the superficial ring to the point where the inferior border of the internal oblique muscle is well represented, reinforcement of the inguinal canal by overlapping the external oblique aponeurosis in a double-breast fashion, and maintenance of the cremasteric muscle. Follow-up in our outpatient clinic was carried out at 1, 6, 12, and 24 months in 71% of our patients. There were no recurrences, except for one crural pseudo-recurrence, no mortality, and no testicular atrophy. Thirteen percent of patients had subcutaneous serous collection; 1% had hematomas; 2% temporary testicular edema; and 0.4% wound infection.
Abdominal Muscles↗
[Aseptic resection of the intraluminal colon in laparoscopy].
Laparoscopic surgery is an "old" technique extending to new applications including colon surgery. Basically, even though surgical technique and indications do not differ from traditional surgery, it has the advantage to eliminate most of the complications associated with an abdominal incision. In order to improve also the outcome of intestinal anastomoses, an aseptic technique by intestinal intussusception previously described (3) has been modified and carried out laparoscopically in 3 pigs and 3 dogs successfully. The animals were sacrificed after 2 months. Anastomoses were evaluated endoscopically by barium enema and by gross and microscopic examination. Results indicated no mortality or complications except for a small area of mucosal peri-anastomotic necrosis in one dog, which spontaneously healed. Therefore, it seems that the aseptic resection of the colon is possible with laparoscopy obtaining at the same time a decreased morbidity related to the abdominal incision and colonic anastomosis.
Anastomosis, Surgical↗
Modern operative thoracoscopy.
Laparoscopic surgery has demonstrated advantages of less pain, early recovery, and cosmesis. Applying laparoscopic surgical techniques to thoracic procedures may allow for similar advantages. New instrumentation provides for greater versatility in treating thoracic conditions. Described herein is the use of thoracoscopy for a variety of thoracic procedures.
Biopsy↗
Insertion of the Coloshield through a colotomy after completion of a colonic anastomosis.
A modified technique of an intracolonic bypass procedure after an anastomosis has already been completed is described. Its use would be in place of those situations where the surgeon is contemplating protecting the completed anastomosis with a temporary colostomy/ileostomy.
Anastomosis, Surgical↗
Effect of fecal loading with/without peritonitis on the healing of a colonic anastomosis: an experimental study.
An experimental randomized prospective study was carried out in 64 dogs to evaluate the effect of intraluminal fecal matter at the anastomosis with/without peritonitis on the healing of a colonic anastomosis. The animals, none of whom had bowel preparation, were randomized in four groups: group I sigmoid resection and anastomosis, group II sigmoid resection and intraluminal fecal diversion from the anastomosis, group III induced fecal peritonitis, sigmoid resection and anastomosis and group IV induced fecal peritonitis, sigmoid resection and intraluminal fecal diversion from the anastomosis. Forty-eight hours before sacrifice at 5, 10 and 15 days, 10 microCi/kg C14 proline was given intravenously. Specimens were analyzed for hydroxyproline content, tissue counts and specific activity. The tissue counts and specific activity were analyzed by three-way analysis of variance. Overall, regardless of the groups, there was a statistically significant decrease in specific activity and tissue count from day 5 to day 15 and day 10 to day 15 at the anastomosis (p less than 0.05). When comparing groups II and IV to groups I and III, there was a significant increase in specific activity and tissue count at the anastomosis of group II and IV (p less than 0.05). This experimental study demonstrates that early anastomotic healing can occur even in presence of treated peritonitis as long as the fecal matter is diverted and prevented from coming in contact with the anastomotic site without disrupting the bowel continuity or function.
Anastomosis, Surgical↗
The use of absorbable staples for construction of a bladder tube.
Stapling instruments have been widely used in general surgery but not in the surgical treatment of the urinary tract. The stapler Poly CS-57 (Auto Suture, U. S. S. C.) with absorbable staples has been evaluated in the construction of ten bladder tubes for ureteral substitution in three dogs and six pigs. The dogs and pigs were sacrificed at two, three and six months. There was no mortality rate, no infections, no suture leakages and no crystal or stone formation. There were three instances of ureterovesical anastomotic stenosis. It appears that the absorbable staple can be safely used in urologic operations and that the use of the Poly CS 57 stapler for the construction of a bladder tube makes the procedure safer, simpler and faster.
Absorption↗
[Partial splenectomy using a stapler and the role of regeneration of the residual splenic stump].
Current evidence indicates that only complete or partial intact spleen can protect the organism against pneumococcal sepsis. What is not clear is the amount of minimal splenic tissue needed to protect the organism against such infection. This study has been carried out on 20 dogs which underwent partial or total splenectomy with stapler. Animals were divided into 8 groups according to the quantity of the remnant splenic tissue: 0% (4 dogs); 5% (4); 15% (1); 25% (1); 35% (2); 50% (2); 75% (2); 100% (4), and were followed up for 6 and 12 months. No mortality or bleeding was registered. Results showed a splenic regeneration, histologically demonstrated as an increased number of germinal follicles, in 12 out of 16 dogs, more evident in the animals sacrificed at one year. In conclusion, even a small amount (5%) of splenic tissue preserved with its blood supply can regenerate and acquire with time enough immunological function to protect the organism against post-splenectomy sepsis.
Animals↗
The value of endoluminal ultrasonography and computed tomography in the staging of rectal cancer: a preliminary study.
A prospective study was carried out in 14 patients with rectal cancer. Tumors were staged preoperatively by endoluminal ultrasonography (EU) and computed tomography (CT). Patients were followed postoperatively for 2 years by the same modalities. Extramural spread was 100% (9/9), accurately assessed by EU and 77.8% (7/9) with CT. Lymph node sensitivity was 87.5% for EU and 37.5 for CT (P less than 0.05). Overall accuracy of lymph node metastases was 85.7% for EU and 57.1% for CT (P less than 0.1). In conclusion, the study shows EU to be statistically more accurate for nodal metastases than CT; therefore, its routine use can be recommended in the preoperative staging of rectal carcinoma in those patients for whom a sphincter-saving procedure is considered.
Female↗
Colonic anastomotic leakages.
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Anastomosis, Surgical↗
[A bladder tube construction using a stapler with absorbable stitches (Poly CS-57)].
A new technique for the construction of a bladder tube, using a Poly CS-57 stapler, has been tested on six pigs. With this procedure the operative time is shortened without complications. In fact, no crystal formation, dehiscence or infection was observed during a 3 month follow-up.
Animals↗