[Right hemicolectomy with in situ ileocolic anastomosis. Changes introduced by mechanical suture (author's transl)].
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Biomedical subjects
Publications and source records attributed to J M Turbelin.
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A comparative study has been realized to test the accuracy of oral cholecystography versus real time ultrasonography in 150 patients with gallbladder lithiasis surgery. Oral cholecystography correctly diagnosed 107 cases (70%), whereas ultrasonography diagnosed gallbladder lithiasis in 145 or in 96,5% of the cases. Failure of the technique in the remaining cases was related to a scleroatrophic gall bladder with stones of less than 3 mm. These results confirm that ultrasonography must be proposed as the first examination for the diagnosis of gallstones.
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A technical variant of the end-to-end colorectal anastomosis performed with the EEA stapler is described. It realizes a side-to-end anastomosis, performed via the oral-aboral route. In this manner, indications for stapled anastomoses can be extended to patients with discrepancy in bowel size, and where operative findings involve low anterior resection, with the patient not in the lithotomy--Trendelenburg position. The technique has been used with safety in 17 patients with colorectal and ileorectal anastomoses.
The authors studied the theoretical values of the anastomotic surfaces obtained after using mechanical suture clips of American origin in digestive surgery. The EEA clip enables circular anastomoses to be obtained immediately. The anastomotic surface is defined by the capsule used, whatever the diameter of the digestive tube. The TA clip determined, by using the triangulation principle, anastomoses that have a tendency to become circular. The anastomotic surface varies as a function of the digestive tube diameter and may reach much higher values. With the GIA clip, laterolateral anastomoses can be obtained which are complete by closure of the outgoing orifice of the apparatus. Large variations in anastomosis surface are obtained according to the method used to close the orifice. This study supplies a new aspect of mechanical sutures. It gives the surgeons, who agrees with this suturing method, a supplementary element of choice for the anastomotic procedure.
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Many surgeons are hesitant to use the electrocautery on the gastrointestinal tract. The aim of the present study is to compare, with mechanical and histological criteria, wound healing following abdominal and gastric incisions made by scalpel and diathermy, in the rat. This study revealed no difference in bursting pressure between scalpel and diathermy incisions. Histologically there is not a delay in healing in the gastrointestinal tract following electroincision. It is concluded that in abdominal surgery the diathermy can be used without detriment to the strength of any suture line and with no difference in its final healing.