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Biomedical subjects

M M Ravitch

Publications and source records attributed to M M Ravitch.

At least 19 recordsLinked to original sources
PubMed1986

Closure of the urinary bladder with stainless steel and absorbable staples.

Stapling is widely accepted in the field of pulmonary and gastrointestinal surgery. However, this has not been the case in urinary tract surgery, presumably because of the possibility of stone formation on the staples. In addressing the issue, both stainless steel staples and absorbable staples (PolysorbTM) were evaluated in 104 linear stapled closures of dog bladders. The mucosa to mucosa closures were performed in bladders with sterile, acutely infected, and chronically infected urine. Staple lines were resected and examined both grossly and microscopically at periods from 1 week to 4 months after the closures. No animal suffered a clinical leak or abscess formation. Four steel closures developed exposed staples, one of which developed a small amount of crystal formation. Twenty-nine absorbable closures contained exposed staples in which two closures developed crystal formation. All closures were secure and healed without difficulty. It appears that closure of the bladder with stainless or absorbable staples is safe and effective.

Absorption↗
PubMed1979

A stapling instrument for end-to-end inverting anastomoses in the gastrointestinal tract.

A stapling instrument is described for end-to-end inverting anastomoses applicable principally to low rectal anastomosis or esophagogastric or esophagojejunal anastomosis. The instrument creates an inverting anastomosis held by a double staggered row of stainless steel wire staples creating an anastomosis 21.2 mm internal diameter with no significant inverted flange. The early experience is encouraging.

Animals↗
PubMed1979

The price of weight loss by jejunoileal shunt.

In the performance of end-to-end jejunoileal shunt, operative mortality can be nearly eliminated and late deaths largely prevented by assiduous care and follow-up. We attempted to prevent serious complications by regular outpatient visits. However, 703 outpatient visits costing $49.00 per visit failed to improve results. There were 170 readmissions among 64 patients lasting 4--57 days (average hospital stay--16 days per admission at $3,000.00). Twenty-four of those patients alive and followed 18 months or more (53%) sustained adequate weight loss and were free of major problems. Patient satisfaction nevertheless appears high, and when there has been a good weight loss, even severe problems tend to be glossed over by the patient. The ultimate outcome is still unknown, but it seems clear that many of the patients are in a state of controlled malnutrition, which may lead to progressive penalties. We have documented gross pathologic lesions in the bypass enteritis syndrome and draw attention to neurologic sequelae of the bypass, which probably represents deficiency manifestations. Despite brilliant results in some patients and satisfactory results in perhaps half, the cost in life, suffering, dollars, patient and physician time, the uncertain long-term effects, and the unpredictability of the weight loss, all place in question the appropriateness of jejunoileal shunt as the remedy for morbid obesity.

Adult↗
PubMed1979

Intussusception.

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Humans↗
PubMed1977

Surgery in 1776.

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General Surgery↗
PubMed1977

The operative management of von Recklinghausen's neurofibromatosis in children, with special reference to lesions of the head and neck.

Eighty-five patients with von Recklinghausen's neurofibromatosis were seen at the Children's Hospital of Pittsburgh from 1952 through 1976. Nineteen of these patients had significant head or neck extracranial lesions. Based upon these and a personal series of seven other head and neck patients, we emphasize several critical points in the care of these patients: (1) large, painful, conspicuous, or strategically placed tumors should be removed: (2) early removal is easier and improves cosmetic results; (3) neck and chest tumors carry a high risk of subsequent rapid vertebral angulation with possible paralysis; (4) close observation allows timely application of appropriate surgical procedures.

Adolescent↗