Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.
A vessel that directly interconnects an artery and a vein, and that acts as a shunt to bypass the capillary bed. Not to be confused with surgical anastomosis, nor with arteriovenous fistula.
Fastening devices composed of steel-tantalum alloys used to close operative wounds, especially of the skin, which minimizes infection by not introducing a foreign body that would connect external and internal regions of the body. (From Segen, Current Med Talk, 1995)
A Y-shaped surgical anastomosis of any part of the digestive system which includes the small intestine as the eventual drainage site.
Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES).
A technique of closing incisions and wounds, or of joining and connecting tissues, in which staples are used as sutures.
Breakdown of the connection and subsequent leakage of effluent (fluids, secretions, air) from a SURGICAL ANASTOMOSIS of the digestive, respiratory, genitourinary, and cardiovascular systems. Most common leakages are from the breakdown of suture lines in gastrointestinal or bowel anastomosis.
A surgical procedure involving the excision of the COLON and RECTUM and the formation of an ILEOANAL RESERVOIR (pouch). In patients with intestinal diseases, such as ulcerative colitis, this procedure avoids the need for an OSTOMY by allowing for transanal defecation.
Sacs or reservoirs created to function in place of the COLON and/or RECTUM in patients who have undergone restorative proctocolectomy (PROCTOCOLECTOMY, RESTORATIVE).
Materials used in closing a surgical or traumatic wound. (From Dorland, 28th ed)
The distal segment of the LARGE INTESTINE, between the SIGMOID COLON and the ANAL CANAL.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Surgical creation of an external opening into the ILEUM for fecal diversion or drainage. This replacement for the RECTUM is usually created in patients with severe INFLAMMATORY BOWEL DISEASES. Loop (continent) or tube (incontinent) procedures are most often employed.
Excision of a portion of the colon or of the whole colon. (Dorland, 28th ed)
Homopolymer of tetrafluoroethylene. Nonflammable, tough, inert plastic tubing or sheeting; used to line vessels, insulate, protect or lubricate apparatus; also as filter, coating for surgical implants or as prosthetic material. Synonyms: Fluoroflex; Fluoroplast; Ftoroplast; Halon; Polyfene; PTFE; Tetron.
Acute INFLAMMATION in the INTESTINAL MUCOSA of the continent ileal reservoir (or pouch) in patients who have undergone ILEOSTOMY and restorative proctocolectomy (PROCTOCOLECTOMY, RESTORATIVE).
The terminal segment of the LARGE INTESTINE, beginning from the ampulla of the RECTUM and ending at the anus.
Diversion of the flow of blood from the entrance to the right atrium directly to the pulmonary arteries, avoiding the right atrium and right ventricle (Dorland, 28th ed). This a permanent procedure often performed to bypass a congenitally deformed right atrium or right ventricle.
Pathologic process consisting of a partial or complete disruption of the layers of a surgical wound.
Surgery performed on the digestive system or its parts.
The distal and narrowest portion of the SMALL INTESTINE, between the JEJUNUM and the ILEOCECAL VALVE of the LARGE INTESTINE.
Surgical shunt allowing direct passage of blood from an artery to a vein. (From Dorland, 28th ed)
The surgical construction of an opening between the colon and the surface of the body.
The condition of an anatomical structure's being constricted beyond normal dimensions.
Device constructed of either synthetic or biological material that is used for the repair of injured or diseased blood vessels.
Pathological processes in the COLON region of the large intestine (INTESTINE, LARGE).
The performance of surgical procedures with the aid of a microscope.
Surgical formation of an external opening (stoma) into the esophagus.
The degree to which BLOOD VESSELS are not blocked or obstructed.
Direct myocardial revascularization in which the internal mammary artery is anastomosed to the right coronary artery, circumflex artery, or anterior descending coronary artery. The internal mammary artery is the most frequent choice, especially for a single graft, for coronary artery bypass surgery.
Microsurgical revascularization to improve intracranial circulation. It usually involves joining the extracranial circulation to the intracranial circulation but may include extracranial revascularization (e.g., subclavian-vertebral artery bypass, subclavian-external carotid artery bypass). It is performed by joining two arteries (direct anastomosis or use of graft) or by free autologous transplantation of highly vascularized tissue to the surface of the brain.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Surgical formation of an opening through the ABDOMINAL WALL into the JEJUNUM, usually for enteral hyperalimentation.
Excision of part (partial) or all (total) of the esophagus. (Dorland, 28th ed)
Surgical portasystemic shunt between the portal vein and inferior vena cava.
Surgical formation of an opening (stoma) into the COMMON BILE DUCT for drainage or for direct communication with a site in the small intestine, primarily the DUODENUM or JEJUNUM.
Restoration of integrity to traumatized tissue.
The muscular membranous segment between the PHARYNX and the STOMACH in the UPPER GASTROINTESTINAL TRACT.
Hand-held tools or implements used by health professionals for the performance of surgical tasks.
Surgical anastomosis of the pancreatic duct, or the divided end of the transected pancreas, with the jejunum. (Dorland, 28th ed)
Arteries arising from the external carotid or the maxillary artery and distributing to the temporal region.
The vessels carrying blood away from the capillary beds.
Obstruction of flow in biological or prosthetic vascular grafts.
The main artery of the thigh, a continuation of the external iliac artery.
Surgical insertion of BLOOD VESSEL PROSTHESES to repair injured or diseased blood vessels.
Any impairment, arrest, or reversal of the normal flow of INTESTINAL CONTENTS toward the ANAL CANAL.
Inflammation of the COLON that is predominantly confined to the MUCOSA. Its major symptoms include DIARRHEA, rectal BLEEDING, the passage of MUCUS, and ABDOMINAL PAIN.
The middle portion of the SMALL INTESTINE, between DUODENUM and ILEUM. It represents about 2/5 of the remaining portion of the small intestine below duodenum.
A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.
Elements of limited time intervals, contributing to particular results or situations.
Predominantly extrahepatic bile duct which is formed by the junction of the right and left hepatic ducts, which are predominantly intrahepatic, and, in turn, joins the cystic duct to form the common bile duct.
Operative procedures for the treatment of vascular disorders.
A mitosporic Ceratobasidiaceae fungal genus that is an important plant pathogen affecting potatoes and other plants. There are numerous teleomorphs.
Procedures used to reconstruct, restore, or improve defective, damaged, or missing structures.
A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy.
Excision of the whole (total gastrectomy) or part (subtotal gastrectomy, partial gastrectomy, gastric resection) of the stomach. (Dorland, 28th ed)
Left bronchial arteries arise from the thoracic aorta, the right from the first aortic intercostal or the upper left bronchial artery; they supply the bronchi and the lower trachea.
Passage of blood from one fetus to another via an arteriovenous communication or other shunt, in a monozygotic twin pregnancy. It results in anemia in one twin and polycythemia in the other. (Lee et al., Wintrobe's Clinical Hematology, 9th ed, p737-8)
A stricture of the ESOPHAGUS. Most are acquired but can be congenital.
A tissue preparation technique that involves the injecting of plastic (acrylates) into blood vessels or other hollow viscera and treating the tissue with a caustic substance. This results in a negative copy or a solid replica of the enclosed space of the tissue that is ready for viewing under a scanning electron microscope.
The venous trunk which receives blood from the lower extremities and from the pelvic and abdominal organs.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the ESOPHAGUS and the beginning of the DUODENUM.
Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression.
Pathological developments in the RECTUM region of the large intestine (INTESTINE, LARGE).
The aorta from the DIAPHRAGM to the bifurcation into the right and left common iliac arteries.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
A hydroxylated form of the imino acid proline. A deficiency in ASCORBIC ACID can result in impaired hydroxyproline formation.
Surgical formation of an opening into the DUODENUM.
A polyposis syndrome due to an autosomal dominant mutation of the APC genes (GENES, APC) on CHROMOSOME 5. The syndrome is characterized by the development of hundreds of ADENOMATOUS POLYPS in the COLON and RECTUM of affected individuals by early adulthood.
Control of bleeding during or after surgery.
Pathological processes consisting of the union of the opposing surfaces of a wound.
Incision into the side of the abdomen between the ribs and pelvis.
The maximum stress a material subjected to a stretching load can withstand without tearing. (McGraw-Hill Dictionary of Scientific and Technical Terms, 5th ed, p2001)
The vein which drains the foot and leg.
The normal process of elimination of fecal material from the RECTUM.
The excision of the head of the pancreas and the encircling loop of the duodenum to which it is connected.
An abnormal anatomical passage between the INTESTINE, and another segment of the intestine or other organs. External intestinal fistula is connected to the SKIN (enterocutaneous fistula). Internal intestinal fistula can be connected to a number of organs, such as STOMACH (gastrocolic fistula), the BILIARY TRACT (cholecystoduodenal fistula), or the URINARY BLADDER of the URINARY TRACT (colovesical fistula). Risk factors include inflammatory processes, cancer, radiation treatment, and surgical misadventures (MEDICAL ERRORS).
Any surgical procedure performed on the biliary tract.
A series of steps taken in order to conduct research.
A noninflammatory, progressive occlusion of the intracranial CAROTID ARTERIES and the formation of netlike collateral arteries arising from the CIRCLE OF WILLIS. Cerebral angiogram shows the puff-of-smoke (moyamoya) collaterals at the base of the brain. It is characterized by endothelial HYPERPLASIA and FIBROSIS with thickening of arterial walls. This disease primarily affects children but can also occur in adults.
Abnormal passage communicating with the PANCREAS.
Either of two large arteries originating from the abdominal aorta; they supply blood to the pelvis, abdominal wall and legs.
A variety of surgical reconstructive procedures devised to restore gastrointestinal continuity, The two major classes of reconstruction are the Billroth I (gastroduodenostomy) and Billroth II (gastrojejunostomy) procedures.
The duration of a surgical procedure in hours and minutes.
Coronary artery bypass surgery on a beating HEART without a CARDIOPULMONARY BYPASS (diverting the flow of blood from the heart and lungs through an oxygenator).
The channels that collect and transport the bile secretion from the BILE CANALICULI, the smallest branch of the BILIARY TRACT in the LIVER, through the bile ductules, the bile ducts out the liver, and to the GALLBLADDER for storage.
The period following a surgical operation.
A plastic operation on the esophagus. (Dorland, 28th ed)
An increase in the number of cells in a tissue or organ without tumor formation. It differs from HYPERTROPHY, which is an increase in bulk without an increase in the number of cells.
Pathological processes which result in the partial or complete obstruction of ARTERIES. They are characterized by greatly reduced or absence of blood flow through these vessels. They are also known as arterial insufficiency.
Pathological development in the JEJUNUM region of the SMALL INTESTINE.
A segment of the COLON between the RECTUM and the descending colon.
Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature which is also transferred to the new site. They are often used in plastic surgery for filling a defect in a neighboring region.
Inflammation of the COLONIC DIVERTICULA, generally with abscess formation and subsequent perforation.
Endoscopic examination, therapy or surgery of the fetus and amniotic cavity through abdominal or uterine entry.
The continuation of the femoral artery coursing through the popliteal fossa; it divides into the anterior and posterior tibial arteries.
Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.
Tumors or cancer of the RECTUM.
Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus.
Substances used to cause adherence of tissue to tissue or tissue to non-tissue surfaces, as for prostheses.
The application of electronic, computerized control systems to mechanical devices designed to perform human functions. Formerly restricted to industry, but nowadays applied to artificial organs controlled by bionic (bioelectronic) devices, like automated insulin pumps and other prostheses.
Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels.
Opening or penetration through the wall of the INTESTINES.
Tumors or cancer of the ESOPHAGUS.
Non-human animals, selected because of specific characteristics, for use in experimental research, teaching, or testing.
Large veins on either side of the root of the neck formed by the junction of the internal jugular and subclavian veins. They drain blood from the head, neck, and upper extremities, and unite to form the superior vena cava.
The anterior and posterior arteries created at the bifurcation of the popliteal artery. The anterior tibial artery begins at the lower border of the popliteus muscle and lies along the tibia at the distal part of the leg to surface superficially anterior to the ankle joint. Its branches are distributed throughout the leg, ankle, and foot. The posterior tibial artery begins at the lower border of the popliteus muscle, lies behind the tibia in the lower part of its course, and is found situated between the medial malleolus and the medial process of the calcaneal tuberosity. Its branches are distributed throughout the leg and foot.
The venous trunk which returns blood from the head, neck, upper extremities and chest.
One of a pair of thick-walled tubes that transports urine from the KIDNEY PELVIS to the URINARY BLADDER.
A short thick vein formed by union of the superior mesenteric vein and the splenic vein.
Pathological processes in the SIGMOID COLON region of the large intestine (INTESTINE, LARGE).
An abnormal direct communication between an artery and a vein without passing through the CAPILLARIES. An A-V fistula usually leads to the formation of a dilated sac-like connection, arteriovenous aneurysm. The locations and size of the shunts determine the degree of effects on the cardiovascular functions such as BLOOD PRESSURE and HEART RATE.
Polyester polymers formed from terephthalic acid or its esters and ethylene glycol. They can be formed into tapes, films or pulled into fibers that are pressed into meshes or woven into fabrics.
Veins in the neck which drain the brain, face, and neck into the brachiocephalic or subclavian veins.
A polyester used for absorbable sutures & surgical mesh, especially in ophthalmic surgery. 2-Hydroxy-propanoic acid polymer with polymerized hydroxyacetic acid, which forms 3,6-dimethyl-1,4-dioxane-dione polymer with 1,4-dioxane-2,5-dione copolymer of molecular weight about 80,000 daltons.
Congenital obliteration of the lumen of the intestine, with the ILEUM involved in 50% of the cases and the JEJUNUM and DUODENUM following in frequency. It is the most frequent cause of INTESTINAL OBSTRUCTION in NEWBORNS. (From Stedman, 25th ed)
The inferior and superior venae cavae.
Devices used to hold tissue structures together for repair, reconstruction or to close wounds. They may consist of adsorbable or non-adsorbable, natural or synthetic materials. They include tissue adhesives, skin tape, sutures, buttons, staples, clips, screws, etc., each designed to conform to various tissue geometries.
The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
Veins which drain the liver.
Surgical procedure in which the STOMACH is transected high on the body. The resulting small proximal gastric pouch is joined to any parts of the SMALL INTESTINE by an end-to-side SURGICAL ANASTOMOSIS, depending on the amounts of intestinal surface being bypasses. This procedure is used frequently in the treatment of MORBID OBESITY by limiting the size of functional STOMACH, food intake, and food absorption.
A procedure in which total right atrial or total caval blood flow is channeled directly into the pulmonary artery or into a small right ventricle that serves only as a conduit. The principal congenital malformations for which this operation is useful are TRICUSPID ATRESIA and single ventricle with pulmonary stenosis.
Diseases in any part of the BILIARY TRACT including the BILE DUCTS and the GALLBLADDER.
The vessels carrying blood away from the heart.
Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.
The transference of a part of or an entire liver from one human or animal to another.
Pathological development in the ILEUM including the ILEOCECAL VALVE.
Congenital abnormality characterized by the lack of full development of the ESOPHAGUS that commonly occurs with TRACHEOESOPHAGEAL FISTULA. Symptoms include excessive SALIVATION; GAGGING; CYANOSIS; and DYSPNEA.
Diseases in any part of the ductal system of the BILIARY TRACT from the smallest BILE CANALICULI to the largest COMMON BILE DUCT.
Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life.
Short thick veins which return blood from the kidneys to the vena cava.
Arteries originating from the subclavian or axillary arteries and distributing to the anterior thoracic wall, mediastinal structures, diaphragm, pectoral muscles and mammary gland.
Temporary or permanent diversion of the flow of urine through the ureter away from the URINARY BLADDER in the presence of a bladder disease or after cystectomy. There is a variety of techniques: direct anastomosis of ureter and bowel, cutaneous ureterostomy, ileal, jejunal or colon conduit, ureterosigmoidostomy, etc. (From Campbell's Urology, 6th ed, p2654)
The shortest and widest portion of the SMALL INTESTINE adjacent to the PYLORUS of the STOMACH. It is named for having the length equal to about the width of 12 fingers.
A strain of albino rat developed at the Wistar Institute that has spread widely at other institutions. This has markedly diluted the original strain.
The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.
Loss of blood during a surgical procedure.
The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)
A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
A twisting in the intestine (INTESTINES) that can cause INTESTINAL OBSTRUCTION.
Three-dimensional representation to show anatomic structures. Models may be used in place of intact animals or organisms for teaching, practice, and study.
Nonexpendable apparatus used during surgical procedures. They are differentiated from SURGICAL INSTRUMENTS, usually hand-held and used in the immediate operative field.
The act of dilating.
Any of various animals that constitute the family Suidae and comprise stout-bodied, short-legged omnivorous mammals with thick skin, usually covered with coarse bristles, a rather long mobile snout, and small tail. Included are the genera Babyrousa, Phacochoerus (wart hogs), and Sus, the latter containing the domestic pig (see SUS SCROFA).
An autologous or commercial tissue adhesive containing FIBRINOGEN and THROMBIN. The commercial product is a two component system from human plasma that contains more than fibrinogen and thrombin. The first component contains highly concentrated fibrinogen, FACTOR VIII, fibronectin, and traces of other plasma proteins. The second component contains thrombin, calcium chloride, and antifibrinolytic agents such as APROTININ. Mixing of the two components promotes BLOOD CLOTTING and the formation and cross-linking of fibrin. The tissue adhesive is used for tissue sealing, HEMOSTASIS, and WOUND HEALING.
Abnormal communication between two ARTERIES that may result from injury or occur as a congenital abnormality.
A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION.
Radiography of blood vessels after injection of a contrast medium.
The direct continuation of the brachial trunk, originating at the bifurcation of the brachial artery opposite the neck of the radius. Its branches may be divided into three groups corresponding to the three regions in which the vessel is situated, the forearm, wrist, and hand.
ENDOSCOPES for examining the abdominal and pelvic organs in the peritoneal cavity.
The plan and delineation of prostheses in general or a specific prosthesis.
Application of a ligature to tie a vessel or strangulate a part.
Methods of creating machines and devices.
Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body.
Restoration of an organ or other structure to its original site.
The main trunk of the systemic arteries.
Artificial openings created by a surgeon for therapeutic reasons. Most often this refers to openings from the GASTROINTESTINAL TRACT through the ABDOMINAL WALL to the outside of the body. It can also refer to the two ends of a surgical anastomosis.
A branch of the celiac artery that distributes to the stomach, pancreas, duodenum, liver, gallbladder, and greater omentum.
The outer margins of the ABDOMEN, extending from the osteocartilaginous thoracic cage to the PELVIS. Though its major part is muscular, the abdominal wall consists of at least seven layers: the SKIN, subcutaneous fat, deep FASCIA; ABDOMINAL MUSCLES, transversalis fascia, extraperitoneal fat, and the parietal PERITONEUM.
A chronic transmural inflammation that may involve any part of the DIGESTIVE TRACT from MOUTH to ANUS, mostly found in the ILEUM, the CECUM, and the COLON. In Crohn disease, the inflammation, extending through the intestinal wall from the MUCOSA to the serosa, is characteristically asymmetric and segmental. Epithelioid GRANULOMAS may be seen in some patients.
A double-layered fold of peritoneum that attaches the STOMACH to other organs in the ABDOMINAL CAVITY.
Either of the two principal arteries on both sides of the neck that supply blood to the head and neck; each divides into two branches, the internal carotid artery and the external carotid artery.
The period of confinement of a patient to a hospital or other health facility.
Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.
Artery arising from the brachiocephalic trunk on the right side and from the arch of the aorta on the left side. It distributes to the neck, thoracic wall, spinal cord, brain, meninges, and upper limb.
Arteries originating from the subclavian or axillary arteries and distributing to the anterior thoracic wall, mediastinal structures, diaphragm, pectoral muscles, mammary gland and the axillary aspect of the chest wall.
A dead body, usually a human body.
Instruments for the visual examination of interior structures of the body. There are rigid endoscopes and flexible fiberoptic endoscopes for various types of viewing in ENDOSCOPY.
The largest bile duct. It is formed by the junction of the CYSTIC DUCT and the COMMON HEPATIC DUCT.
The largest of the cerebral arteries. It trifurcates into temporal, frontal, and parietal branches supplying blood to most of the parenchyma of these lobes in the CEREBRAL CORTEX. These are the areas involved in motor, sensory, and speech activities.
Tomography using x-ray transmission and a computer algorithm to reconstruct the image.
The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)
The innermost layer of an artery or vein, made up of one layer of endothelial cells and supported by an internal elastic lamina.
Procedures that avoid use of open, invasive surgery in favor of closed or local surgery. These generally involve use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device.
An abnormal balloon- or sac-like dilatation in the wall of AORTA.
A birth defect characterized by the narrowing of the AORTA that can be of varying degree and at any point from the transverse arch to the iliac bifurcation. Aortic coarctation causes arterial HYPERTENSION before the point of narrowing and arterial HYPOTENSION beyond the narrowed portion.
Removal of an endotracheal tube from the patient.
A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects.
The deformation and flow behavior of BLOOD and its elements i.e., PLASMA; ERYTHROCYTES; WHITE BLOOD CELLS; and BLOOD PLATELETS.
Wounds caused by objects penetrating the skin.
The segment of LARGE INTESTINE between ASCENDING COLON and DESCENDING COLON. It passes from the RIGHT COLIC FLEXURE across the ABDOMEN, then turns sharply at the left colonic flexure into the descending colon.
A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)
Abnormal passage communicating with the ESOPHAGUS. The most common type is TRACHEOESOPHAGEAL FISTULA between the esophagus and the TRACHEA.
The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.
The largest cartilage of the larynx consisting of two laminae fusing anteriorly at an acute angle in the midline of the neck. The point of fusion forms a subcutaneous projection known as the Adam's apple.
A surgical specialty concerned with the diagnosis and treatment of disorders and abnormalities of the COLON; RECTUM; and ANAL CANAL.
Vein formed by the union (at the hilus of the spleen) of several small veins from the stomach, pancreas, spleen and mesentery.
The portion of the GASTROINTESTINAL TRACT between the PYLORUS of the STOMACH and the ILEOCECAL VALVE of the LARGE INTESTINE. It is divisible into three portions: the DUODENUM, the JEJUNUM, and the ILEUM.
Non-cadaveric providers of organs for transplant to related or non-related recipients.
Apparatus, devices, or supplies intended for one-time or temporary use.
A group of compounds having the general formula CH2=C(CN)-COOR; it polymerizes on contact with moisture; used as tissue adhesive; higher homologs have hemostatic and antibacterial properties.
Pathological outpouching or sac-like dilatation in the wall of any blood vessel (ARTERIES or VEINS) or the heart (HEART ANEURYSM). It indicates a thin and weakened area in the wall which may later rupture. Aneurysms are classified by location, etiology, or other characteristics.
The flow of BLOOD through or around an organ or region of the body.
The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and SALIVARY GLANDS, and convey afferent information for TASTE from the anterior two-thirds of the TONGUE and for TOUCH from the EXTERNAL EAR.
A vascular connective tissue formed on the surface of a healing wound, ulcer, or inflamed tissue. It consists of new capillaries and an infiltrate containing lymphoid cells, macrophages, and plasma cells.
Methods to repair breaks in abdominal tissues caused by trauma or to close surgical incisions during abdominal surgery.
Pathological processes involving any part of the AORTA.
The circulation of the BLOOD through the LUNGS.
Surgery performed on the thoracic organs, most commonly the lungs and the heart.

Colon and rectal anastomoses do not require routine drainage: a systematic review and meta-analysis. (1/1718)

OBJECTIVE: Many surgeons continue to place a prophylactic drain in the pelvis after completion of a colorectal anastomosis, despite considerable evidence that this practice may not be useful. The authors conducted a systematic review and meta-analysis of randomized controlled trials to determine if placement of a drain after a colonic or rectal anastomosis can reduce the rate of complications. METHODS: A search of the Medline database of English-language articles published from 1987 to 1997 was conducted using the terms "colon," "rectum," "postoperative complications," "surgical anastomosis," and "drainage." A manual search was also conducted. Four randomized controlled trials, including a total of 414 patients, were identified that compared the routine use of drainage of colonic and/or rectal anastomoses to no drainage. Two reviewers assessed the trials independently. Trial quality was critically appraised using a previously published scale, and data on mortality, clinical and radiologic anastomotic leakage rate, wound infection rate, and major complication rate were extracted. RESULTS: The overall quality of the studies was poor. Use of a drain did not significantly affect the rate of any of the outcomes examined, although the power of this analysis to exclude any difference was low. Comparison of pooled results revealed an odds ratio for clinical leak of 1.5 favoring the control (no drain) group. Of the 20 observed leaks among all four studies that occurred in a patient with a drain in place, in only one case (5%) did pus or enteric content actually appear in the effluent of the existing drain. CONCLUSIONS: Any significant benefit of routine drainage of colon and rectal anastomoses in reducing the rate of anastomotic leakage or other surgical complications can be excluded with more confidence based on pooled data than by the individual trials alone. Additional well-designed randomized controlled trials would further reinforce this conclusion.  (+info)

Is early post-operative treatment with 5-fluorouracil possible without affecting anastomotic strength in the intestine? (2/1718)

Early post-operative local or systemic administration of 5-fluorouracil (5-FU) is under investigation as a means to improve outcome after resection of intestinal malignancies. It is therefore quite important to delineate accurately its potentially negative effects on anastomotic repair. Five groups (n = 24) of rats underwent resection and anastomosis of both ileum and colon: a control group and four experimental groups receiving daily 5-FU, starting immediately after operation or after 1, 2 or 3 days. Within each group, the drug (or saline) was delivered either intraperitoneally (n = 12) or intravenously (n = 12). Animals were killed 7 days after operation and healing was assessed by measurement of anastomotic bursting pressure, breaking strength and hydroxyproline content. In all cases, 5-FU treatment from the day of operation or from day 1 significantly (P<0.025) and severely suppressed wound strength; concomitantly, the anastomotic hydroxyproline content was reduced. Depending on the location of the anastomosis and the route of 5-FU administration, even a period of 3 days between operation and first dosage seemed insufficient to prevent weakening of the anastomosis. The effects of intravenous administration, though qualitatively similar, were quantitatively less dramatic than those observed after intraperitoneal delivery. Post-operative treatment with 5-FU, if started within the first 3 days after operation, is detrimental to anastomotic strength and may compromise anastomotic integrity.  (+info)

Right atrial bypass grafting for central venous obstruction associated with dialysis access: another treatment option. (3/1718)

PURPOSE: Central venous obstruction is a common problem in patients with chronic renal failure who undergo maintenance hemodialysis. We studied the use of right atrial bypass grafting in nine cases of central venous obstruction associated with upper extremity venous hypertension. To better understand the options for managing this condition, we discuss the roles of surgery and percutaneous transluminal angioplasty with stent placement. METHODS: All patients had previously undergone placement of bilateral temporary subclavian vein dialysis catheters. Severe arm swelling, graft thrombosis, or graft malfunction developed because of central venous stenosis or obstruction in the absence of alternative access sites. A large-diameter (10 to 16 mm) externally reinforced polytetrafluoroethylene (GoreTex) graft was used to bypass the obstructed vein and was anastomosed to the right atrial appendage. This technique was used to bypass six lesions in the subclavian vein, two lesions at the innominate vein/superior vena caval junction, and one lesion in the distal axillary vein. RESULTS: All patients except one had significant resolution of symptoms without operative mortality. Bypass grafts remained patent, allowing the arteriovenous grafts to provide functional access for 1.5 to 52 months (mean, 15.4 months) after surgery. CONCLUSION: Because no mortality directly resulted from the procedure and the morbidity rate was acceptable, this bypass grafting technique was adequate in maintaining the dialysis access needed by these patients. Because of the magnitude of the procedure, we recommend it only for the occasional patient in whom all other access sites are exhausted and in whom percutaneous dilation and/or stenting has failed.  (+info)

Endovascular stent graft repair of aortopulmonary fistula. (4/1718)

Two patients who had aortopulmonary fistula of postoperative origin with hemoptysis underwent successful repair by means of an endovascular stent graft procedure. One patient had undergone repeated thoracotomies two times, and the other one time to repair anastomotic aneurysms of the descending aorta after surgery for Takayasu's arteritis. A self-expanding stainless steel stent covered with a Dacron graft was inserted into the lesion through the external iliac or femoral artery. The patients recovered well, with no signs of infection or recurrent hemoptysis 8 months after the procedure. Endovascular stent grafting may be a therapeutic option for treating patients with aortopulmonary fistula.  (+info)

Factors influencing the development of vein-graft stenosis and their significance for clinical management. (5/1718)

OBJECTIVES: To assess the influence of clinical and graft factors on the development of stenotic lesions. In addition the implications of any significant correlation for duplex surveillance schedules or surgical bypass techniques was examined. PATIENTS AND METHODS: In a prospective three centre study, preoperative and peroperative data on 300 infrainguinal autologous vein grafts was analysed. All grafts were monitored by a strict duplex surveillance program and all received an angiogram in the first postoperative year. A revision was only performed if there was evidence of a stenosis of 70% diameter reduction or greater on the angiogram. RESULTS: The minimum graft diameter was the only factor correlated significantly with the development of a significant graft stenosis (PSV-ratio > or = 2.5) during follow-up (p = 0.002). Factors that correlated with the development of event-causing graft stenosis, associated with revision or occlusion, were minimal graft diameter (p = 0.001), the use of a venovenous anastomosis (p = 0.005) and length of the graft (p = 0.025). Multivariate regression analysis revealed that the minimal graft diameter was the only independent factor that significantly correlated with an event-causing graft stenosis (p = 0.009). The stenosis-free rates for grafts with a minimal diameter < 3.5 mm, between 3.5-4.5 and > or = 4.5 mm were 40%, 58% and 75%, respectively (p = < 0.05). Composite vein and arm-vein grafts with minimal diameters > or = 3.5 mm were compared with grafts which consisted of a single uninterrupted greater saphenous vein with a minimal diameter of < 3.5 mm. One-year secondary patency rates in these categories were of 94% and 76%, respectively (p = 0.03). CONCLUSIONS: A minimal graft diameter < 3.5 mm was the only factor that significantly correlated with the development of a graft-stenosis. However, veins with larger diameters may still develop stenotic lesions. Composite vein and arm-vein grafts should be used rather than uninterrupted small caliber saphenous veins.  (+info)

Cylindrical or T-shaped silicone rubber stents for microanastomosis--technical note. (6/1718)

The ostium of the recipient artery and the orifice of the donor artery must be clearly visualized for the establishment of microvascular anastomosis. Specially designed colored flexible cylindrical or T-shaped silicone rubber stents were made in various sizes (400 or 500 microns diameter and 5 mm length) and applied to bypass surgery in patients with occlusive cerebrovascular disease such as moyamoya disease and internal carotid artery occlusion. The colored flexible stents facilitated confirmation of the ostium of the artery even in patients with moyamoya disease and allowed precise microvascular anastomosis without problems caused by the stent.  (+info)

Subclavian artery resection and reconstruction for thoracic inlet cancers. (7/1718)

PURPOSE: We previously described an original transcervical approach to resect primary or secondary malignant diseases that invade the thoracic inlet (TI). The purpose of this study was to evaluate the technical aspects and long-term results of the resection and revascularization of the subclavian artery (SA). METHODS: Between 1986 and 1998, 34 patients (mean age, 49 years) underwent en bloc resection of TI cancer that had invaded the SA. The surgical approach was an L-shaped transclavicular cervicotomy in 33 patients. In 14 of these patients, this approach was associated with a posterolateral thoracotomy (n = 10) or a posterior midline approach (n = 4). In one patient, the procedure was achieved with a single posterolateral thoracotomy approach. An end-to-end anastomosis was performed in 16 patients. In one patient, a subclavian-left common carotid artery transposition was performed. In one other patient, an end-to-end anastomosis was performed between the proximal innominate artery and the SA. The right carotid artery was transposed into the SA in an end-to-side fashion. In 16 patients, prosthetic revascularization with a polytetrafluoroethylene graft was performed. Thirty-three patients underwent postoperative radiation therapy. RESULTS: There were no cases of perioperative death, neurologic sequelae, graft infections or occlusions, or limb ischemia. There were two delayed asymptomatic polytetrafluoroethylene graft occlusions at 12 and 31 months. The 5-year patency rate was 85%. During this study, 20 patients died: 18 died of tumor recurrence (5 local and systemic and 13 systemic), one of respiratory failure, and one of an unknown cause at 74 months. The overall 5-year survival rate was 36%, and the 5-year disease-free survival rate was 18%. CONCLUSION: Tumor arterial invasion per se should not be a contraindication to TI cancer resection. This study shows that cancers that invade the SA can be resected through an L-shaped transclavicular cervicotomy, with good results with a concomitant revascularization of the SA.  (+info)

Laparoscopic aortofemoral bypass grafting: human cadaveric and initial clinical experiences. (8/1718)

PURPOSE: Postoperative complications are mainly related to the surgical trauma derived from the extensive abdominal incision and dissection after a conventional aortofemoral bypass grafting procedure. In an attempt to reduce postoperative complications, a concept of video-endoscopic vascular surgery on the infrarenal aortoiliac artery has been developed. On the basis of our experience with the practicability of video-endoscopic vascular surgery in the pelvic region in an animal study and in a pilot study of human cadavers, the purpose of this report was to describe three different methods that we evaluated on human cadavers and that we partly applied to patients. METHODS: In this experimental study, three different approaches were used to perform video-endoscopic aortofemoral bypass grafting. We performed an observational trial on human corpses (n = 24) with the transabdominal-retroperitoneal approach (TARA), the extraperitoneal approach (EPA), and the transabdominal left paracolic approach (TAPA). The EPA also was applied to patients with aortoiliac occlusive diseases. RESULTS: The TARA on cadavers (n = 4) soon was abandoned because it caused a burdensome sliding of the intestine into the operative field adjacent to the renal vessels, particularly in cases with obese subjects. In comparison, the TAPA (n = 6) with right-sided positioning of the patient retained the intestine in the right upper abdomen throughout the procedure. Until a surgeon actually is acquainted with the anatomic landmarks and the laparoscopic preparation technique, the EPA (n = 14) is a challenging procedure that necessitates thorough training. As with the TAPA, the EPA represents a procedure that reveals constant exposure of the operating field, even in cases with obese subjects. In the clinical observational study (n = 7), aortobifemoral bypass grafting was achieved totally laparoscopically with the EPA. The mean operating time was 6.5 hours and ranged from 3 to 10 hours. Blood transfusions were necessary after surgery in three patients (range, 1 to 3 red packed blood cells). One patient, who had had occlusion of the inferior mesenteric artery, died of ischemic colitis at postoperative day 10. The other patients had uneventful postoperative courses with minor wound discomfort. CONCLUSION: Laparoscopic vascular surgery seems to be a promising procedure to minimize postoperative complications. On the basis of our experience, we do not favor the TARA. Because it necessitates steep Trendelenburg positioning to displace intra-abdominal organs, the TARA is not an appropriate approach, particularly in obese and cardiopulmonary frail cases. Contrarily, the TAPA and the EPA deliver potentially better results in terms of exposing the operative field and thus reducing operating time and perioperative morbidity rates. A prospective cadaveric and clinical trial may be justified to further evaluate the use of these surgical techniques.  (+info)

TY - GEN. T1 - Growth effects of anastomosis site on patient-specific aortic hemodynamics after coarctation correction. T2 - 10th Asian Control Conference, ASCC 2015. AU - Mao, Le. AU - Zhang, Weimin. AU - Hong, Haifa. AU - Sun, Qi. AU - Huang, Junrong. AU - Liu, Jinfen. AU - Liu, Jinlong. AU - Zhu, Zhongqun. AU - Qian, Yi. AU - Wang, Qian. AU - Umezu, Mitsuo. PY - 2015/9/8. Y1 - 2015/9/8. N2 - Coarctation of the aorta (CoA) is one of the most common congenital cardiac anomalies that could be corrected by surgery. However, the effects of surgical anastomosis on aortic arch flow are still unknown. In this study, a unique three-dimensional way was utilized to measure the growth of anastomotic site and computational fluid dynamics (CFD) was applied to investigate the hemodynamic effects of the growth of anastomosis site on patient-specific aortic arch flow before, 1 year and 2 years after surgery. The volume of anastomotic site, distribution of total pressure, wall shear stress (WSS), streamlines, ...
TY - JOUR. T1 - Comparison of one-layer (continuous Lembert) versus two-layer (simple continuous/Cushing) hand-sewn end-to-end anastomosis in equine jejunum. AU - Nieto, Jorge. AU - Dechant, Julie E. AU - Snyder, Jack R.. PY - 2006/10. Y1 - 2006/10. N2 - Objective - To evaluate single and double layer end-to-end anastomosis in equine jejunum. Study Design - Experimental in vitro study. Animals - Mid-jejunal sections from 12 adult horses without gastrointestinal disease. Methods - Jejunal end-to-end anastomoses were performed by a continuous Lembert pattern or a simple continuous pattern oversewn with a Cushing pattern. Jejunal segments were distended with fluid at 1 L/min, and intraluminal pressure at failure, and mode of failure were recorded. Bursting pressure and bursting wall tension were calculated. Anastomosis construction time and degree of luminal reduction were recorded. Results - Single layer anastomoses were constructed in less time than 2-layer anastomoses. Both anastomotic ...
Invalidating anorectal dysfunctions are common after restorative rectal surgery. Improvement of functional results by the technically more demanding J-pouch has been demonstrated in comparison with the straight coloanal anastomosis. In the present multicenter randomized trial we assessed whether the J-pouch is also superior to the side-to-end coloanal anastomosis ...
PROGRAMME OUTLINE. MONDAY. 08:30 Meet at St. Marks Hospital Main Entrance. 08:45 Coffee. 09:00 Introduction to the microsurgical workshop. 09:15 Use and care of the operating microscope. 09:30 Demonstration: Microsurgical suturing techniques. 09:45 Exercise: End-to-end anastomosis of a simulated tissue. 10:30 Coffee. 10:45 Demonstration: End-to-end anastomosis of a simulated vessel. 11:00 Exercise: End-to-end anastomosis of a simulated vessel. 12:00 Lunch. 13:15 Demonstration: End-to-end anastomosis of the femoral artery. 13:30 Exercise: End-to-end anastomosis of the femoral artery. 14:45 Coffee. 15:00 Exercise: End-to-end anastomosis of the femoral artery. 16:30 End of session. TUESDAY. 08:30 Exercise: End-to-end anastomosis of the femoral artery. 10:15 Coffee. 10:30 Demonstration: End-to-end anastomosis of the femoral vein. 10:45 Exercise: End-to-end anastomosis of the femoral vein. 12:00 Lunch. 13:00 Exercise: End-to-end anastomosis of the femoral artery and vein. 15:00 Coffee. 15:45 ...
A cuff is used to provide a form for curing fluid about the exterior of an end-to-end anastomosis site. The cuff includes a port through which fluid may be injected to reach an interior space defined between the exterior of tissue at the anastomosis site and the inner surface of the cuff. A circular stapler may be used as a mandrel for the cuff and fluid. Alternatively, inflatable balloons may be used as a mandrel. The curing fluid may comprise a mixture of fibrin and thrombin.
PURPOSE: Functional results after low anterior resection with straight coloanal anastomosis are poor. Although certain functional aspects are improved with
The experiments in this report were designed to evaluate the effect of superficial temporal-middle cerebral artery (STA-MCA) anastomosis on the course of middle cerebral artery (MCA) occlusion by emboli while avoiding a vessel clipping technique as well as the use of long-acting barbiturate anesthesia. Dogs were divided into 3 general groups: A) embolus placement 1 h following anastomosis; B) embolus placement 5 h prior to anastomosis; C) control group without anastomosis. Anastomosis prior to MCA occlusion has a favorable clinical effect and reduces the size of an infarction. Anastomosis 5 h after embolus placement is deleterious unless other therapeutic modalities can be shown to delay the course of infarction. ...
TY - JOUR. T1 - [Development of hemostatic sealant for arterial anastomosis; clinical application].. AU - Morita, Shigeki. AU - Matsuda, Takehisa. AU - Eto, Masataka. AU - Oda, Shinichiro. AU - Tominaga, Ryuji. PY - 2013/5. Y1 - 2013/5. N2 - For the purpose of examining the clinical applicability of a newly developed surgical sealant, animal experiments were performed, and clinical trial was followed. In animal experiments, several animal models, including carotid artery anastomosis model and coronary artery bypass grafting model were undertaken. In each model, complete hemostasis of the anastomoses using four simple interrupted sutures, was obtained. In addition, elastomeric property of the sealant prevented thinning of the arterial wall. The clinical trial performed in patients with thoracic aortic surgery showed significantly better hemostasis even under heparinized condition. Based on these excellent results, clinical usage of the sealant was approved.. AB - For the purpose of examining the ...
Patient was in the right lateral decubitus position with the lower body slightly tilted to the left, and a left thoracoabdominal incision was performed. The cardiopulmonary bypass was established by a venous cannula placed in the right atrium through the left femoral vein and 2 arterial return cannulas inside both femoral artery and ascending aorta. If the proximal thoracic descending aorta was not involved by the aneurysm and was long enough for both clamping and anastomosis (usually Crawford extent III TAAA), proximal aortic anastomosis was performed under mild hypothermic cardiopulmonary bypass and beating heart. otherwise, it was performed using an open technique with profound hypothermic circulatory arrest.. During our modified multiple branched graft replacement of TAAA, the proximal aortic anastomosis was performed first. After a proximal aortic clamp was placed just distal to the left subclavian artery or profound hypothermic circulatory arrest was established, a distal aortic clamp was ...
Distal anastomosis devices and associated methodology are described herein. Connector and connector components as well as tools associated therewith are disclosed. The connectors are preferably adapted to produce an end-to-side anastomosis at a graft/coronary artery junction. A fitting alone, or a fitting in combination with a collar may be used as a connector. Each fitting may be deployed by deflecting its shape to provide clearance for a rear segment that rotates about adjoining hinge section(s) so to fit the connector within an aperture formed in a host vessel. Upon return to a substantially relaxed position, a rear segment anchors the fitting it in place. The distal fitting may include additional side features for interfacing with the host vessel/coronary artery. The collar may include features complimentary to those of a fitting and provisions for strain relief and securing the graft vessel.
Distal anastomosis devices and associated methodology are described herein. Connector and connector components as well as tools associated therewith are disclosed. The connectors are preferably adapted to produce an end-to-side anastomosis at a graft/coronary artery junction. A fitting alone, or a fitting in combination with a collar may be used as a connector. Each fitting may be deployed by deflecting its shape to provide clearance for a rear segment that rotates about adjoining hinge section(s) so to fit the connector within an aperture formed in a host vessel. Upon return to a substantially relaxed position, a rear segment anchors the fitting it in place. The distal fitting may include additional side features for interfacing with the host vessel/coronary artery. The collar may include features complimentary to those of a fitting and provisions for securing the graft vessel.
Methods and devices use magnetic force to form a magnetic port in a hollow body. Additional methods and devices form anastomoses between two or more hollow bodies. First and second anastomotic securing components create a fluid-tight connection between the lumens of the hollow bodies. End-to-side, side-to-side and end-to-end anastomoses can be created without using suture or any other type of mechanical fasteners, although mechanical attachment structure may be used in conjunction with the magnetic attachment. The securing components have magnetic, ferromagnetic or electromagnetic properties and may include one or more materials, for example, magnetic and nonmagnetic materials arranged in a laminated structure. The system of anastomotic securing components may be used in many different applications including the treatment of cardiovascular disease, peripheral vascular disease, forming AV shunts, etc. The system may be sized and configured for forming an anastomosis in or between a specific hollow body,
Head and neck anastomosis techniques present common aspects with any type of anastomosis but their localisation at the junction of the respiratory and digestive tracts makes them often delicate to perform. In the present article, we first review the different surgical indications and the laryngeal, tracheal, pharyngeal and oesophageal anastomosis techniques. The main types of flaps also used for this purpose are highlighted. We then review the cases observed during the 5 last years in our department, type and technique of surgery used. In this general review, we illustrate our stand point although aware of the multiple variants favoured by different schools. ...
INTRODUCTION. Conventional vascular anastomosis requires extensile exposure, circumferential dissection and temporary occlusion of the vessels. This technique was initially described by Alexis Carrel, in 1902[1], and despite several technical improvements it has remained basically the same.. Several devices for sutureless anastomosis were developed since that time, as grafts with rings[2], connectors[3], clips[4] and even magnets[5].. In complex aortic surgeries, the time to perform an anastomosis is related to ischemic and reperfusion injuries and can lead to renal failure, mesenteric ischemia and systemic inflammatory response. Thus, is advisable to simplify and shorten this period of the surgery.. In 2008, Lachat et al.[6] described a technique of sutureless anastomosis by telescoping a stent graft (Viabahn, W. L. Gore & Associates, Flagstaff, AZ) in order to facilitate complex vascular reconstruction in debranching procedures for thoracoabdominal aneurysms. The advantages of this technique ...
An apparatus for anastomosing an organ of a subject to be anastomosed such as patient comprises a pair of magnets being disposed to predetermined sites or regions of organs of the subject each other so as to be opposed through wall portions of the respective organs, the magnets being adsorbed to each other so as to form an anastomosis site having a through hole for making communication between the organ walls, a flexible soft guide wire detachably mounted to at least one of the paired magnets, and a guide tube inserted into a body of the subject with the guide wire being inserted therein, the guide tube coming into contact with a guide wire mount surface of the one of magnets so as to support the one magnet when the guide wire is removed from the one magnet and the guide tube being inserted into the through hole of the anastomosis site to maintain formation of the through hole.
A method and devices are provided for performing end-to-side anastomoses between the severed end of a first hollow organ and the side-wall of a second hollow organ utilizing transluminal approach with endoscopic assistance, wherein the first and second hollow organs can be secured utilizing a biocompatible glue, clips or by suturing. In an alternative embodiment, the method utilizes a modified cutter catheter which is introduced into the first hollow organ in combination with a receiver catheter which is introduced into the second hollow organ. The distal end of the receiver catheter includes a receiver cavity and a selectively activatable magnetic material. The magnetic material is selected so that it will interact with a magnetically susceptible material disposed in the distal end of the modified cutter catheter when the modified cutter catheter is disposed in proximity to the proposed site for anastomosis whereby the severed end of the first hollow organ is matingly engaged with the sidewall of the
An anastomotic device and method for receiving the free ends of anatomic tubular structures to be anastomosed, the device having a pair of ring members for securement to the free end of each of the tubular members to be anastomosed and the ring members having annular connecting structure which mate with each other to connect the ring members. Novel securement structure is associated with the annular connecting structure to enable the securement of the ring members in a fixed relationship at a predetermined distance from each other. Structure is provided to connect each tubular member free end over a ring member so that the free ends are positioned contiguous to each other around the connecting structure to enable the ends to grow together in an atmosphere outside the flow path of the tubular members to be anastomosed and approximate the outer surface of the tubular member.
The Cambridge Anastomosis Workshop is a practical hands-on intensive 4-day workshop covering a wide range of anastomoses - small and large bowel, oesophagus, stomach, vascular and urology. These are the fundamental techniques any surgeon must know. A leaking anastomosis usually kills the patient yet safe anastomoses can be reliably made. In the workshop, youll have each technique explained, then see it on live demonstration.. You will carry out the procedure under close supervision. You can expect to carry out over 20 anastomoses during the course and will have opportunities to examine them from the inside. Teaching is in a large lab in the Pathology Department with excellent facilities. Faculty members are surgeons with years of experience teaching practical surgical techniques.. Eligibility- Minimum of CT1 and designed for ST level trainees The course is held on Downing Site in their Path Lab ...
TY - JOUR. T1 - CO2‐welded venous anastomosis. T2 - Enhancement of weld strength with heterologous fibrin glue. AU - Cikrit, Dolores F.. AU - Dalsing, Michael C.. AU - Weinstein, Todd S.. AU - Palmer, Kevin. AU - Lalka, Stephen G.. AU - Unthank, Joseph L.. PY - 1990. Y1 - 1990. N2 - The milliwatt CO2 laser was used to perform end‐to‐end anastomoses in canine jugular veins. There was a high disruption rate (50%) in laser‐welded veins (n = 10). Fibrin glue (n = 17), formed from human fresh‐frozen plasma, enhanced the weld strength decreasing the disruption rate (18%), resulting in an 82% patency which nearly equaled the contralateral sutured vein patency (93%). The bursting strength was improved with fibrin glue. Transmural necrosis was present initially in all groups but extended for a longer distance in the vessel wall in laser‐welded anastomoses. Sutured anastomoses exhibited a greater inflammatory response. In laser‐welded anastomoses endothelial cells were not as confluent as in ...
Colectomy, Left End-to-End Anastomosis. In: Zollinger RM, Jr, Ellison E, Bitans M, Smith J. Zollinger R.M., Jr, Ellison E, Bitans M, Smith J Eds. Robert M. Zollinger, Jr, et al.eds. Zollingers Atlas of Surgical Operations New York, NY: McGraw-Hill; 2011.§ionid=42074473. Accessed January 18, 2018 ...
A method and instruments used to performing an end-to-end anastomosis between two portions of intestinal tissue is disclosed. The method involves drawing a first portion of intestinal tissue over a portion of a bioabsorbable stent. The end of the first portion of intestinal tissue is everted on the stent to create a collar of exposed inner intestinal tissue. A second portion of intestinal tissue is drawn over the stent and over the exposed intestinal tissue. A bandage containing one adhesive compound selected from the group of an adhesive and an adhesive initiator is wrapped about the juncture. The other adhesive compound is applied to saturate the bandage and the combination of an adhesive and an adhesive initiator sets the adhesive to adhere the first portion and the second portion of adhesive to the bandage.
Fingerprint Dive into the research topics of The effect of various pulmonary artery anastomoses on the hemodynamics of the hilar stripped lung. Together they form a unique fingerprint. ...
In the presence of risk factors, the anastomosis in the small intestine and in the colon are at risk for dehiscence and peritonitis. The apposition of a biological patch around the anastomosis might improve wound healing and therefore might prevent harmful, potentially life-threatening and costy complications. Aim: to verify if Tutomesh® facilitates the functional recovery of the intestinal anastomotic wound area (mucosa) in the pig ileum and colon. Methods: 24 Large White pigs (B.W. 25 kg; age 4-5 months) underwent ileal and colonic anastomosis with or without application of Tutomesh® and compared with healthy (intact) control intestinal segments. At days 2, 7, 14, 30 and 90 following surgery, ileal and colonic mucosa were isolated from similar anastomized and control tracts and mounted in Ussing chambers containing Krebs oxygenated solution at pH 7.4. Electrophysiological parameters, i.e. short circuit current (Isc) and transepithelial resistance (Rt), as markers of mucosal function, were ...
Low rectal anastomosis leakage, keep it or move it, Faramarz Karimian, Karim Darbanian*, Ali Aminian, Rasoul Mirsharifi, Farhad Mehrkhani, Farshad Gharaee
Technique for anastomosis of large bowel in low anterior resection can be done easily and save by suturing of anterior wall of rectum stump interupted stiches and these were used as suspended stitches for exposure of posterior rectal wall, then posterior wass of colon and rectum are sutured together using railroaded technique and the anastomosis is completed by suturing the previous anterior stitches of rectal wall to anterior wall of colon. One layer technique for anastomosis of large bowel was performed.. ...
Die Anastomose am Gastrointestinaltrakt / Intestinal Anastomosis: Symposium, Essen, Juni 1989 German Edition [F.W. Eigler, E. Gross, E. Vogt] on. FREE.
A surgical instrument for performing an end-to-end anastomosis of first and second luminal structures includes a housing having an actuator attached thereto and a selectively removable loading unit attached to a distal end of the housing which supports any array of surgical fasteners at a distal end thereof. The surgical fasteners are simultaneously deformable upon activation of the actuator such that a distal end of each surgical fastener secures each end of each luminal structure to complete the end-to-end anastomosis wherein the resulting eversion is exterior to the luminal structures.
Next is a lecture series detailing the correct procedure for placement of an intracorporeal anastomosis, complete with CD-ROM demonstration, lecture, photo review, and a detailed explanation of the criteria for evaluation of an anastomosis. Once students have become familiar with the methodology, the real challenge begins. Participants are first separated into teams of two, and must cooperate in the placement of an anastomosis on inanimate tissue, which must have no less than eight interrupted sutures on the back wall and a running anastomosis on the front wall. Surgeons will then be instructed in Dr. Rosser s principles regarding optical correctness, port placement, and overall preparation. The participants must then perform the anastomosis on a section of pig bowel, which is much more difficult to work with than inanimate tissue. Once the anastomosis has been completed, it is then examined by instructors using strict grading criteria such as: proper length and depth, uniformity of sutures, ...
Looking for anastomoses? Find out information about anastomoses. A surgical communication made between blood vessels, for example, between the portal vein and the inferior vena cava. An opening created by surgery, trauma,... Explanation of anastomoses
TY - JOUR. T1 - Safety, feasibility, and short-term outcomes of laparoscopic ileal-pouch-anal anastomosis. T2 - A single institutional case-matched experience. AU - Larson, David W.. AU - Cima, Robert R.. AU - Dozois, Eric J.. AU - Davies, Michael. AU - Piotrowicz, Karen. AU - Barnes, Sunni A.. AU - Wolff, Bruce. AU - Pemberton, John. PY - 2006/5/1. Y1 - 2006/5/1. N2 - OBJECTIVE: To compare safety and short-term outcomes of 100 laparoscopic ileal pouch-anal anastomosis (IPAA) versus 200 conventional open IPAA patients. SUMMARY BACKGROUND DATA: Outcomes of laparoscopic IPAA (LAP-IPAA) have been incompletely characterized. Previous reports are characterized by small numbers of patients and rarely include case-matched or randomized trial methodology. This report describes 100 LAP-IPAA patients case matched to 200 open IPAA patients. METHODS: Between 1998 and 2004, 100 consecutive LAP-IPAA patients (75 laparoscopic assisted, 25 hand assisted) were identified and case matched to 200 open IPAA control ...
Results: After exclusion of 10 noninformative pregnancies, perinatal, double, and any survival rates were 61%, 44%, and 77%, respectively. When an anastomosis was detected at each of the 3 time points, perinatal and double survival rates were higher than when one was not (at first treatment, perinatal survival 83% versus 53%, respectively, P = .003; double survival 78% versus 33%, P , .001). Perinatal and double survival (P ,= .01) were poorer with more advanced stage, but any survival rates were not influenced by stage or anastomosis detection. Multiple logistic regression demonstrated that anastomosis detection at treatment increased the chance of perinatal (odds ratio [OR] 5.1, 95% confidence interval [CI] 1.6, 15.9) and double survival (OR 19.3, 95% CI 2.7, 138), independently of stage. For stages I-III at treatment, anastomosis detection predicted better perinatal (100% versus 63%, 100% versus 59%, and 83% versus 44%, respectively) and double survival rates (100% versus 52%, 100% versus ...
Of 2609 relevant studies, 16 randomized controlled trials (RCTs) met our inclusion criteria. Nine RCTs (n=473) compared straight coloanal anastomosis (SCA) to the colonic J pouch (CJP). Up to 18 months postoperatively, the CJP was superior to SCA in most studies in bowel frequency, urgency, fecal incontinence and use of antidiarrheal medication. There were too few patients with long-term bowel function outcomes to determine if this advantage continued after 18 months postop. Four RCTs (n=215) compared the side-to-end anastomosis (STE) to the CJP. These studies showed no difference in bowel function outcomes between these two techniques. Similarly, three RCTs (n=158) compared transverse coloplasty (TC) to CJP. Similarly, there were no differences in bowel function outcomes in these small studies. Overall, there were no significant differences in postoperative complications with any of the anastomotic strategies. ...
When a vein segment is grafted into arterial circulation, biomechanical forces stimulate modification of its structure. This morphological adaptive response is progressive during a medium or long term and occludes the vessel lumen, leading to a graft failure. The objective of this study was to characterize the early morphological response of the vascular wall in a terminal-terminal vascular vein graft model in Wistar rats. A segment of the femoral vein was placed in the femoral circulation. An end to end microsurgical graft anastomosis technique was implemented and standardized in twenty rats. The samples were processed with histological technique to analyze the overall structure with hematoxylin and eosin, the composition of the vessel wall with Masson trichrome technique, the proliferating and smooth muscle cells were detected with immunohistochemistry (anti-PCNA, anti-actin and anti CD68) and the induction of apoptosis with TUNEL technique. The times periods studied were 1, 3 and 5 days ...
REDWOOD CITY, Calif., April 29 /PRNewswire-FirstCall/ -- Cardica, Inc. (Nasdaq: CRDC) today announced that the PAS-Port(R) Proximal Anastomosis System achieved its primary endpoint in a large,
A tool for performing anastomosis connects two tissue structures end-to-end. A clamp holds each tissue structure. The clamps are movable relative to one another, and are registered together such that the flaps of one tissue structure are pressed against the corresponding flaps of the other tissue structure when the clamps come together. Each flap of one tissue structure is connected to a corresponding flap on the other corresponding tissue structure with at least one connector.
A total of 116 one-layer end-to-end anastomoses of the colon and the rectum in 112 patients were studied. Three patients died postoperatively (2.6 per cent). Significant disruption of anastomosis requiring a diverting colostomy occurred in five patie
Logistic regression was used in both univariate and multivariate modelling.. The team used the methods to identify independent preoperative variables associated with the presence of intraoperative leak.. Model parameters were estimated by the maximum likelihood method. From these estimates, odds ratios with 95% confidence intervals were computed.. The investigators found no postoperative anastomotic leaks or mortalities in these series.. Overall, endoscopic evaluation of the gastrojejunostomy resulted in the detection of 16% of intraoperative leaks.. The team noted a difference in the incidence of intraoperative leakage for patients, with 21% older than 40 years, and 10% in those younger than 40 years. In the initial 91 cases, the gastrojejunostomy was performed by the end-to-end anastomosis technique.. The team reported that the subsequent 249 were performed with a combination of linear stapling and handsewn technique. There was a non-significant trend to less leakage in 12% with end-to-end ...
A ring for use in anastomosis. Preferably, the ring is integrally formed from metal, and includes a ring portion and tines and docking members that extend from the ring portion. The ring portion and tines are malleable, and preferably also the docking members are malleable. The ring portion and tines are malleable in the sense that once deformed from a first shape into a second shape, they will not relax back into the first shape from the second. To install the ring in a vessel with the ring portion extending around an incision or other orifice, the tines pierce the tissue around the orifice and are curled against an anvil. The action of curling the tines inverts the tissue near the orifice edges to expose the inside surface of the vessel or organ. Other aspects of the invention are a method and apparatus for installing an anastomosis ring in an incision or other orifice in a vessel or other organ, a method and apparatus for precisely aligning two anastomosis rings (each installed in an incision or
Breakdown of the connection and subsequent leakage of effluent (fluids, secretions, air) from a SURGICAL ANASTOMOSIS of the digestive, respiratory, genitourinary, and cardiovascular systems. Most common leakages are from the breakdown of suture lines in gastrointestinal or bowel anastomosis ...
LifeLike BioTissues Vesico - Urethral Anastomosis Holder SUTURES AND BEHAVES LIKE REAL TISSUE Our Vesico-Urethral Anastomosis Holder is designed to practice resection of the urethra to the bladder. The metal clamp allows for the adjustment or replacement of the bladder. This product is to be used with the LifeLikeBiot
MY VIRTUAL ANASTOMOSIS, is a digital portal that interactively connects scholars in training with expert faculty. The main goal is to help scholars develop their practical surgical skills, and to maximize the training effect through ongoing, personalized feedback provided by an expert surgeon-evaluator. Together with Ethicons Anastomotic Skills labs and the Arroyos Anastomotic Simulator, winner of the EACTS 2011 Ethicon CARDIOVACULAR SIMULATION AWARD, My Virtual Anastomosis delivers a comprehensive educational continuum for development of technical surgical skills in one of the key areas of cardiovascular surgery. ...
a cross-connection between two blood vessels; an interconnection between any two channels, passages or vessels; the surgical creation of a connecting passage between blood-vessels or other channels. Chabner, Davi-Ellen. 2007. The Language of Medicine. 8th ed. Saunders Elsevier, Missouri
RESULTS: In the period of study,19 patients aged over 90 underwent surgery in emergency department for complicated CRC. Of the total, 52.63% were female, with sex ratio F: M of 1.11: 1. Mean age was 92.52 years (range: 90-97 years; SD 1.49). Preoperative assessment of surgical risk was made using American Society of Anesthesiologists (ASA) score. There was no statistically significant difference in terms of in-hospital mortality between patients with ASA score ≤ 3 and patients with an ASA score >3. Primary anastomosis was performed in 6 of 19 patients (31.57%), all of whom had right-side colon cancer. Diverting stoma was created for 12 of 19 patients (63.15%). There was a statistically significant difference in incidence of postoperative complications between patients with right-side colon cancer and patients with left-side colon cancer (p=0.0498). Mean length of hospital stay was 12.78 days (range: 2 31 days; SD 6.31). In-hospital mortality rate was 21.05% (n=4). At follow up, overall ...
Method and apparatus for treating a carotid artery | Lumbar ostia occlusion devices and methods of deploying the same | Surgical string applicator for anastomosis surgery | Surgical clip applier | Flexible transoral endoscopic gastroesophageal flap valve restoration device and method |
The anastomosis device according to the present invention is a one piece device for connecting a graft vessel to a target vessel without the use of conventional sutures. The anastomosis device includes a frame for receiving and holding the end of a graft vessel in an everted position and first and second spreading members configured to be inserted into an opening in the target vessel. The first and second spreading members are arranged substantially in a plane for insertion into an opening in a target vessel, and are moved away from one another to capture the edges of the opening in the target vessel securing the graft vessel to the target vessel. One version of the anastomosis device includes a plurality of linkages arranged in two rows for grasping opposite sides of an opening in the target vessel. A portion of the linkages fold outward to trap vessel walls on opposite sides of the opening in the target vessel. The anastomosis devices greatly
Research conducted in our laboratory focuses on the fundamental aspects of fluid mechanics and mass transport that are involved in the modulation of mammalian cell function. Special attention is given to the cells in the arterial circulation and to the development of tissue-engineered vascular implants.. Our research activities include the development of instrumentation and methods for the accurate in vitro evaluation of cell function in variable mechanical environments. A main objective is to develop experimental models and theoretical analysis that will provide a good description of the dynamic process occurring in the arterial surface in early atherosclerosis. We are interested in the identification of physical mechanisms involved in cell pathobiology. In specific, we study cell communication, adhesion and injury in well controlled disturbed flow fields in vitro.. Three dimensional numerical simulations of the fluid flow in models of graft anastomosis and arterio-venous reconstructions are ...
The management of concomitant aortic and aortic valve disease with left ventricular assist device (LVAD) implantation for patients with severe cardiomyopathy is challenging, and has not been established given the complexity of LVAD surgery with concomitant aortic interventions. A 45-year-old patient presented to our institution with end-stage heart failure symptoms and non-ischemic cardiomyopathy. The patient was found to have a bicuspid aortic valve, severe native aortic regurgitation, a significant ascending aortic aneurysm, and severely depressed left ventricular (LV) function requiring two inotropes. He underwent a successful hemiarch repair of the ascending aortic aneurysm using a back table outflow graft anastomosis technique, and subsequent placement of a HeartWare Ventricular Assist Device (HVAD) with concomitant aortic valve closure with a modified Parks stitch. The patient did well postoperatively and is currently listed for heart transplantation.. ...
Postoperative anastomotic suture line complications, such as hemorrhage and pseudoaneurysm, are often encountered in thoracic aortic surgery. To minimize these complications different anastomotic techniques have been developed. We hereby describe a new distal anastomotic technique, which involves positioning the graft inside the aorta at the distal end, reinforcing the suture line with an externally placed Teflon felt strip, and finishing the anastomosis with a circumferential and continued suture technique called backstitch.
Background: Fibrin-based biological adhesives are used for tissue adhesion improving the outcome of gastrointestinal sutures. The objective was to assess the effectiveness of fibrin-based biological adhesives for prevention of anastomotic leakage in high-risk gastrointestinal anastomoses. Methods: A randomized clinical trial was designed to recruit patients underwent a rectal resection surgery. A subgroup of patients with rectal anastomosis were recruited from 2 different hospital centres. Patients in which a biological fibrin-based biological adhesive was applied to the suture line (study group) were compared versus a control group under standard practice. The main outcome measures was presence or absence of leakage and need for reoperation. Results: Thirty seven patients underwent a rectal resection and anastomosis. In 21 standard practice was applied and a fibrin-based adhesive was used in 16. Fourteen patients (37.8%) had a clinical or subclinical anastomotic leak, 11 belonging to control group
For patients with interrupted aortic arches, distal aortic arch dysplasia, long coarctation segments, or obvious vascular calcification and older children and adults, we adopted a Gore-Tex vascular graft bypass (Figure 1). First, we performed end-to-side anastomosis between the Gore-Tex vascular graft and normal descending aorta distal from the coarctation, and the anastomosis was continuously sutured with 5/0 prolene line, tightened and lined with strips of autologous pericardium. Next, we restored the cardiopulmonary bypass, allowed perfusion, and warmed up the blood. After expelling gas from the vascular graft and clamping the said graft, we performed end-to-side anastomosis between the Gore-Tex vascular graft and normal ascending aorta. We only performed end-to-side anastomosis between the vascular graft and normal descending aorta with circulatory arrest. This can decrease the total surgical time and facilitate good anastomosis. Lining with stripped autologous pericardium can prevent vessel ...
Colorectal anastomotic complications are dreaded and dramatically affect outcomes. Causes are multifactorial, with the size of the end-to-end anastomosis (
Congenital long segment megacolon is still a serious therapeutic problem. It is generally accepted that conservative treatment without surgical intervention will not give satisfactory results. The purpose of this case report is to show how subtotal colectomy and anastomosis cecorectalis is the operation of choice. At the Childrens Hospital in Zagreb we have had only two cases on which we performed cecorectal anastomosis. The patients general condition and enormous dilatation of the ganglionic region indicated surgery and only anus praeter bipollaris was performed on the colon ascendens. The second operation took place one year after the first operation. At the second operation we performed subtotal colectomy with cecorectal anastomosis. The postoperative clinical course was without complications. The wound cured regularly. Digitorectal examination revealed no anomalies in the anastomosis. The children had 1-2 stools daily. After six months we performed a check up examination with irigography, ...
TY - JOUR. T1 - Early and midterm patency of the proximal anastomoses of saphenous vein grafts made with a Symmetry Aortic Connector System. AU - Kitamura, Hideki. AU - Okabayashi, Hitoshi. AU - Hanyu, Michiya. AU - Soga, Yoshiharu. AU - Nomoto, Takuya. AU - Johno, Hiroyuki. AU - Nakano, Jota. AU - Matsuo, Takehiko. AU - Kai, Masashi. AU - Umehara, Eitaro. PY - 2005/10/1. Y1 - 2005/10/1. N2 - Objective: The purpose of this study was to investigate (1) the early and midterm patency rates in saphenous vein grafts that were anastomosed with the Symmetry Aortic Connector System (St Jude Medical, Inc, St Paul, Minn) and (2) risk factors for graft occlusion. Methods: Thirty-one patients underwent off-pump coronary artery bypass grafting for proximal saphenous vein graft anastomoses with the aortic connector system. Intraoperative graft flow was studied with transit time flowmetry, and angiography was performed before discharge in 29 cases. Midterm (at least 1 year after the operation) saphenous vein ...
ASA 2018 Abstracts: Better Function With A Colonic J-pouch Or A Side-to-end Anastomosis? A Randomized Controlled Trial To Compare The Complications, Functional Outcome And Quality Of Life In Patients With Low Rectal Cancer After A J-pouch Or A Side-to- End Anastomosis
Fistula development after esophageal resection is considered as one of the most serious postoperative complications. The authors reported a case on clinical experiences in the postoperative diagnostic and successful therapeutic management of a tracheomediastinal fistula after esophageal resection, using endoscopic application of fibrin glue. The early approach of an anastomotic insufficiency after esophageal resection because of a squamous cell carcinoma (pT3pN0M0G2) below the tracheal bifurcation including transposition of a re-modelled gastric tube and end-to-side anastomosis 24 hours postoperatively in a 55-year old patient combined i) surgical re-intervention from the periesophageal site (reanastomosis, gastroplication, lavage, local and mediastinal drainage) and, later on, ii) extensive rinsing with consecutive endoscopic fibrin glue application into the tracheal mouth of the subsequently developed tracheomediastinal fistula as a consequence of the inflammatory changes within the ...
INTRODUCTION. In view of the high incidence of infection of the peritoneal cavity in surgical practice, many investigators have the relationship between peritonitis and healing of intestinal anastomoses. Contradictory results have been obtained in studies of the influence of infection on the development of colon anastomoses healing in experimental animals, with some investigators reporting high rates of dehiscense and mortality6,8,21 and others reporting little or no effect of infection on the anastomotic lesion12,18,20. Thus, the present study was conducted to determine the effect of peritonitis on the healing of experimentally induced colon anastomoses in rats.. METHOD. The study was conducted on 40 male rats (Rattus norvegicus albinus, Rodentia mammalia) of the Wistar-Tecpar strain aged 114 to 130 days and weighing on average 298 g. The animals were divided in two groups S (control) and P (experimental).. The animals were anesthetized with ether, weighed and identified. The ventral abdominal ...
1. (Science: anatomy) a vessel that directly interconnects an artery and a vein, and that acts as a shunt to bypass the capillary bed. Not to be confused with surgical anastomosis, nor with arteriovenous fistula. 2. (a) The direct or indirect connection of separate parts of a branching system to form a network, especially among blood vessels. (b) The surgical connection of separate or severed tubular hollow organs to form a continuous channel as between two parts of the intestine. 3. The connection of normally separate parts or spaces so they intercommunicate. An anastomosis may be naturally occurring or artificially constructed and be created during the process of embryonic development or by surgery, trauma or pathological means. An anastomosis may, for example, connect two blood vessels (as in a naturally occurring arteriovenous anastomosis, a connection between an artery and a vein) or it may connect the healthy sections of the colon or rectum after a cancerous or otherwise diseased portion ...
BACKGROUND: Revascularization of the posterior inferior cerebellar artery (PICA) is typically performed with the occipital artery (OA) as an extracranial donor. The p3 segment is the most accessible recipient site for OA-PICA bypass at its caudal loop inferior to the cerebellar tonsil, but this site may be absent or hidden due to a high-riding location. OBJECTIVE: To test our hypothesis that freeing p1 PICA from its origin, transposing the recipient into a shallower position, and performing OA-p1 PICA bypass with an end-to-end anastomosis would facilitate this bypass. METHODS: The OA was harvested, and a far lateral craniotomy was performed in 16 cadaveric specimens. PICA caliber and number of perforators were measured at p1 and p3 segments. OA-p3 PICA end-to-side and OA-p1 PICA end-to-end bypasses were compared. RESULTS: OA-p1 PICA bypass with end-to-end anastomosis was performed in 16 specimens; whereas, OA-p3 PICA bypass with end-to-side anastomosis was performed in 11. Mean distance from OA at the
Aortic coarctation | Resection with end-to-end anastomosis. Cardiosurgery: Treatment in Ulm, Germany ✈. Prices on - booking treatment online!
Planned elective and subacute procedures with a polytetrafluoroethylene (PTFE) graft including at least one expected end-to-side anastomosis of a PTFE graft to the femoral artery (e.g. femoral-femoral cross-over, aorto-(bi)femoral, axillo-(bi)femoral, femoro-popliteal, femoro-crural bypass grafting), a PTFE patch angioplasty of the femoral artery, or an end-to-side anastomosis of a PTFE graft to an upper extremity artery in connection with arteriovenous bypass grafting for dialysis access ...
Surgical treatment of coarctation of the aorta with resection and end-to-end anastomosis (costs for program #187291) ✔ University Hospital Marburg UKGM ✔ Department of Cardiac, Thoracic and Vascular Surgery ✔
Objective: due to the advantages of Laser Assisted Vascular Anastomosis (less occurrence of myointimal hyperplasia with better hemodynamic evolution, shorter surgical time, absence of diameter incompatibility, absence of anaphylaxis, easy execution) the evaluation of the ideal diode laser wavelength to perform anastomosis in elastic arteries, without solder, is a great advance in the surgical practice. Method: End-to-end anastomosis was performed on the common carotid arteries of swines, bilaterally, using diode lasers by the wavelengths: 808 nm (n=16), 980 nm (n=16), 1470 nm (n=16) and 1908 nm (n=16) with the same parameters (CW, spot size= 2mm, P≅ 5,1W, t=26s, E= 132,6J, I= 164,51 W/cm2, F= 4277,4 J/cm2). Following, the occurrence of bleeding was verified. When the anastomosis did not bleed a mechanical resistance test was performed. Results: In group 808 nm, there was no welding of the vessels. In group 1908 nm, carbonization of all arterial edges was observed. In groups 980 nm and 1470 nm, ...
Looking for online definition of preputial anastomosis in the Medical Dictionary? preputial anastomosis explanation free. What is preputial anastomosis? Meaning of preputial anastomosis medical term. What does preputial anastomosis mean?
Background: Antithrombin III is known as the most important natural inhibitor of thrombin activity and has been shown to attenuate local harmful effects of ischemia-reperfusion injury in many organs. In recent animal studies, delaying effect of remote organ ischemia-reperfusion injury on healing of intestinal anastomoses has been demonstrated. In this study, we investigated whether antithrombin III reduces deleterious systemic effects of ischemia-reperfusion injury on healing of colonic anastomoses in rats. ...
TY - JOUR. T1 - Impact of aberrant arterial anatomy and location of anastomosis on technical outcomes after liver transplantation. AU - Abouljoud, Marwan S.. AU - Kim, Dean Y.. AU - Yoshida, Atsushi. AU - Arenas, Juan. AU - Jerius, John. AU - Malinzak, Lauren. AU - Raoufi, Mohammad. AU - Brown, Kimberly A.. AU - Moonka, Dilip K.. PY - 2005/5/1. Y1 - 2005/5/1. N2 - Variations in donor and recipient arterial anatomy frequently present challenges for surgeons when attempting to establish proper arterial inflow during liver transplantation. We reviewed our data on 233 adult primary liver transplants, conducted from January 1996 through December 2001, to determine the impact of these variations on the outcomes after liver transplantation. Twenty-four (10.3%) arterial complications were encountered at a mean of 2.27 months after transplant. Carrel patches for the anastomoses were not used in 33 patients (14%), which had no relation to arterial complications (P = 0.7). Sixty-one donors (26.2%) had at ...
He was felt to be too high risk for surgery, and it was decided to attempt percutaneous angioplasty. A 4-F cut pigtail catheter and straight 0.035-inch wire was used to access the outflow cannula. Reference vessel diameter was 14 to 15 mm, and the region of stenosis was 8 to 9 mm in diameter (Fig. 4). An Amplatz 0.035-inch Super Stiff guidewire (St. Jude Medical, Golden Valley, Minnesota) was placed in the mid-cannula retrograde through the outflow graft, and a 14 mm × 4-cm Cordis Opta-Pro balloon angioplasty balloon (Cordis Corp., Miami, Florida) was inflated twice at the anastomosis to a maximal pressure of 4 atm. There was resolution of the waist narrowing with the second inflation (Figs. 5 and 6⇓⇓, Online Videos 1 and 2). During each inflation, HM2 flow was decreased transiently to 1 l/min for 3 to 4 s at a time. Post-angioplasty, Doppler flow velocity at the anastomosis improved from 1.9 m/s to 1 m/s. LVEDD decreased from 59 mm to 39 mm. The patient was discharged 4 days later, and HM2 ...
Additional to our previous edition of this workshop, we have included a practical part for our participants following the live demonstration performed by Dr. Victor Volovici.. In the first part, a theoretical lecture will be followed by a demonstration of a microvascular anastomosis technique, as well as an interactive demonstration on a live rat of an intermediate level anastomosis, performed by Dr. Victor Volovici. This part will end with a discussion on the future and directions of cerebrovascular microvascular anastomoses.. The second part of the workshop aims to provide an insight into a cutting edge procedure: surgery under the microscope. It will include an introductory presentation regarding microsurgery, the instruments that are used in this field, together with the correct handling of the surgical microscope. Among this, dexterity excercises and last but not least, knots and sutures under the microscope on non-biological material will be performed by the participants.. ...
The use of intraoperative procedures to prevent dehiscence of the anastomosis, such as the addition of additional manual points, the mechanical suture and / or patches of collagen (reinforcement so called also buttressing) or sealants (fibrin or cyanoacrylate glues, such as Glubran® 2) is the rationale that led to the design of this study. Although today we have technologically advanced mechanical staplers, it is crucial to prevent anastomotic dehiscence. At the moment experimental results show that Glubran® 2 is a suitable potential reinforcement of intestinal anastomoses both manual and linear intracorporeal. Glubran 2 applied after the packaging of the mechanical anastomosis, polymerizes in a short time closing the micro spaces of the suture line between one point and the other, expressing an adhesive, hemostatic and sealant action on the tissues, creating an effective antiseptic barrier against the most common infectious agents or pathogens.. The aim of the study is to evaluate the ...
The use of intraoperative procedures to prevent dehiscence of the anastomosis, such as the addition of additional manual points, the mechanical suture and / or patches of collagen (reinforcement so called also buttressing) or sealants (fibrin or cyanoacrylate glues, such as Glubran® 2) is the rationale that led to the design of this study. Although today we have technologically advanced mechanical staplers, it is crucial to prevent anastomotic dehiscence. At the moment experimental results show that Glubran® 2 is a suitable potential reinforcement of intestinal anastomoses both manual and linear intracorporeal. Glubran 2 applied after the packaging of the mechanical anastomosis, polymerizes in a short time closing the micro spaces of the suture line between one point and the other, expressing an adhesive, hemostatic and sealant action on the tissues, creating an effective antiseptic barrier against the most common infectious agents or pathogens.. The aim of the study is to evaluate the ...
Materials and Methods: Forty male Sprague Dawley rats were randomly divided into 2 groups. Femoral artery anasto- mosis was performed in rats of the control group (n = 20) through heparinized serum (10 U/ml) irrigation. In the rats of the study group (n = 20), however, femoral artery anastomosis was performed through heparinized serum (10 U/ml)+0.5 cc bile irrigation. After the 1st week, anastomosis patency was evaluated with color duplex ultrasonography. A 1 cm segment of the femoral artery involving the anastomosis line was removed for histopathological evaluation ...
Doctors give unbiased, helpful information on indications, contra-indications, benefits, and complications: Dr. Nishi on colectomy lap anastomosis: There is an ileorectal anastomosis - when the colon is removed we can attach the ileum - part of the end of the small intestine - to the rectum. There is also an ileosigmoid anastomosis - when the ileum is attached to the sigmoid colon. Often the area is called the rectosigmoid region so this leads to the confusion. There is no ileorectal sigmoid anastomosis.
Nontraditional sites for vascular anastomoses to enable kidney transplantation in patients with major systemic venous thromboses.
A graft vessel preparation device and a method for using the graft vessel preparation device is provided. The graft vessel preparation device establishes and maintains a critical dimension on a graft vessel which corresponds to a dimension of an anastomosis site on a target vessel. One example of a graft vessel preparation device which prepares a graft vessel for a vascular anastomosis procedure includes a parallelogram linkage, a first spreader arm and a second spreader arm. The first spreader arm and the second spreader arm mount on opposing members of the parallelogram linkage in a parallel configuration. The spreader arms are configured in order to allow the placement of an end of a graft vessel over the spreader arms. The spreader arms are also configured to separate within an interior of the graft vessel once the graft vessel is placed over the spreader arms in order to establish a critical dimension. The critical dimension is established using a critical dimension locator. The critical dimension
Esophagogastric anastomosis in human surgery is part of the surgical treatment of esophageal cancer. Anastomotic leak is responsible for a third of all perioperative deaths. We suggest an enhanced healing of esophagogastric anastomosis, NO-system dependent, with stable gastric pentadecapeptide BPC 157. Throughout 4 days after esophagogastric anastomosis creation, rats received medication (/kg ip once daily: BPC 157 (10pg, 10ng), L-NAME (5mg), L-arginine (100mg) alone and/or combined). Daily assessment includes damage in stomach (sum of longest diameters, mm), esophagus (esophagitis, scored 0-4), anastomosis (ml H2O before leak), pressure in pyloric sphincter and in esophagus at anastomosis (cmH2O) and weight loss (g). In the control group we noted progressing stomach damage, severe esophagitis, rapid anastomosis leak, decrease of pressure, severe in pyloric sphincter as well as less pressure assessed in esophagus at anastomosis, alongside with prominent weight loss. By contrast, BPC 157 treated ...
Methods: Two patients, one with a congenital small bowel web, and one with a cecal mass are studied. The Gelpointtm System (Applied Medical, Rancho Santa Margarita, CA) is utilized for access. The congenital web is resected using endoscopic stapling devices, a stapled anastomosis is performed, and the common channel is closed with traction stitches and another firing of an endoscopic stapler. The cecal mass is resected via a right hemicolectomy, ileo-colic stapled anastomosis created, and closure of the common channel is accomplished with two layered running suture ...
Background: The aim of this study was to investigate patients with symptomatic anastomotic leakage diagnosed after hospital discharge. Methods: Patients undergoing low anterior resection of the rectum for cancer (n=234) who were included in a prospective multicenter trial (NCT 00636948) and who developed symptomatic anastomotic leakage diagnosed after hospital discharge (late leakage, LL; n=18) were identified. These patients were assessed in regard to patient characteristics, operative details, recovery on postoperative day five, length of hospital stay, and how the leakage was diagnosed. A comparison with those who did not develop symptomatic leakage (no leakage, NL; n=189) was performed. Minimum follow up was 24 months. Results: Median age was 69 years, 61% were females, and 6% had UICC cancer stage IV in LL. On postoperative day 5, LL had a postoperative course similar to NL in regard to morning temperature, per oral intake and bowel activity. The proportion of patients being on antibiotic ...
In the study of [Improvement in the healing of colonic anastomoses by vitamin B5 and C supplements. Experimental study in the rabbit] [Article in French], by Vaxman F, Chalkiadakis G, Olender S, Maldonado H, Aprahamian M, Bruch JF, Wittmann T, Volkmar P, Grenier JF., posted in US National Library of Medicine National Institutes of Health, researchers found that Vitamins B5 and C enhance the colonic wound healing process in the rabbit, acting together in synergy in vivo as well as in vitro, as previously demonstrated ...
PURPOSE: Colon anastomotic leakage remains a serious and common surgical complication. Animal models are valuable to determine the pathophysiological mechanisms and to evaluate possible methods of prevention. The aim of this study was to develop an optimal model of clinical colon anastomotic leakage in a technically insufficient anastomosis in the mouse. METHODS: A total of 110 mice were used in three pilot studies (1-3) and two experiments (A, B). Due to the high complication rates, the analgesic regimen and surgical techniques were changed throughout the pilot studies/experiments. In the final successful experiment (B), eight and four absorbable sutures were used in the control and intervention anastomoses, respectively, and buprenorphine in chocolate spread was used for pain treatment. RESULTS: In the final model (experiment B), significantly more animals in the intervention group had clinical anastomotic leakage compared with controls (40 vs. 0 %, p = 0.003). The weight loss was greater and ...
A medical device which can be implanted at a target site in a living body. The device includes an inner flange formed by radial expansion of the device and an outer flange formed by axial compression of the device. The device can include an implant portion and a discard portion which separate from each other during formation of the outer flange. The separation can occur by fracturing a frangible linkage or by mechanically separating a portion of the outer flange from a deployment tool. The device can be a one piece anastomosis device for connecting a graft vessel to a target vessel without the use of conventional sutures. The inner and outer flanges capture the edges of an opening in a target vessel and secure the graft vessel to the opening in the target vessel. The device greatly increases the speed with which anastomosis can be performed over known suturing methods.
The authors present a novel synthetic vascular model for microanastomosis training. This model is suitable for trainees with intermediate level of microsurgical skills, and useful as a bridging model between simple suturing exercise and in vivo rat vessel anastomosis during pre-clinical training.
The CycloneTM System (Castlewood Surgical, Inc., Concord, MA) is a novel device that facilitates the attachment of the saphenous vein onto the ascending aorta for the purpose of creating a bypass graft during a coronary artery bypass grafting (CABG) operation. It allows the surgeon to perform a hand-sewn anastomosis with no disruption of the intima of the aorta, and no need for partial clamping. During a 36-month period 109 CABG operations were performed, and the CycloneTM System (and its predecessor, the HexalonTM) was utilized to create 138 proximal anastomoses. This study demonstrates that this is a safe and effective method of creating a clampless, no-touch proximal anastomoses during off-pump CABG.
Two Kelly clamps are placed over a section of mesentery, and the section is divided with a knife or cautery pencil between the two clamps; then it is ligated. This process is continued, until the diseased portion and the anastomosis site have been isolated ...
Hypothesis: In France, approximately 12,000 new rectal cancers are diagnosed each year. Frequency is one and a half times higher in men than in w
The gastric pouch-jejunal limb anastomosis is usually done by circular staple in our institute. We use the instruments from commercial PEG set to facilitate the procedure. Under direct vision from the endoscope inside the pouch, The tiny hole is create by cautery from outside. The snare is passed through this hole into peritoneal cavity to retrieve the nilon loop which insert via the laparoscopic port. After the loop is bought out from the patients mouth, the anvil of the staple is fixed to this loop. The loop is drawn backward, so the anvil is introduced into the gastric pouch. The EEA staple shaft is inserted into peritoneal cavity via the extended port incision. The anvil is attached and approximated to the shaft, then the staple is fired. The completeness of the anastomosis is ensured.. Conclusion ...
The impact of donor arterial variations and their management was investigated retrospectively in 527 consecutive allografts. Anomalous arteries were found in 161 grafts (30.6 per cent). There was no significant difference in the overall incidence of arterial complications between grafts with normal (3.6 per cent) and abnormal (5.6 per cent) anatomy. However, there was a higher incidence of arterial complications in transplants requiring multiple arterial anastomoses (P = 0.02), or anastomosis of donor vessels to recipient aorta with (P = 0.0003) or without (P = 0.04) an interposition graft for arterial reconstruction. The incidence of biliary complications was similar in grafts with a normal (18.8 per cent) or anomalous (18.0 per cent) arterial supply. Anomalies of hepatic arterial anatomy occur in one-third of all livers and do not compromise graft outcome unless multiple anastomoses or direct anastomosis to the recipient aorta are required for arterial reconstruction.
Considering the fact that hemodynamics plays an important role in the patency and overall performance of implanted bypass grafts, this work presents a numerical investigation of pulsatile non-Newtonian blood flow in three different patient-specific aorto-coronary bypasses. The three bypass models are distinguished from each other by the number of distal side-to-side and end-to-side anastomoses and denoted as single, double and triple bypasses. The mathematical model in the form of time-dependent nonlinear system of incompressible Navier?Stokes equations is coupled with the Carreau?Yasuda model describing the shear-thinning property of human blood and numerically solved using the principle of the SIMPLE algorithm and cell-centred finite volume method formulated for hybrid unstructured tetrahedral grids. The numerical results computed for non-Newtonian and Newtonian blood flow in the three aorto-coronary bypasses are compared and analysed with emphasis placed on the distribution of cycle-averaged ...
TY - JOUR. T1 - Endo-therapies for biliary duct-to-duct anastomotic stricture after liver transplantation: Outcomes of a nationwide survey. AU - Cantù, P.. AU - Tarantino, I.. AU - Baldan, A.. AU - Mutignani, M.. AU - Tringali, A.. AU - Lombardi, G.. AU - Cerofolini, A.. AU - Di Sario, A.. AU - Catalano, G.. AU - Bertani, H.. AU - Ghinolfi, D.. AU - Boarino, V.. AU - Masci, E.. AU - Bulajic, M.. AU - Pisani, A.. AU - Fantin, A.. AU - Ligresti, D.. AU - Barresi, L.. AU - Traina, M.. AU - Ravelli, P.. AU - Forti, E.. AU - Barbaro, F.. AU - Costamagna, G.. AU - Rodella, L.. AU - Maroni, L.. AU - Salizzoni, M.. AU - Conigliaro, R.. AU - Filipponi, F.. AU - Merighi, A.. AU - Staiano, T.. AU - Monteleone, M.. AU - Mazzaferro, V.. AU - Zucchi, E.. AU - Zilli, M.. AU - Nadal, E.. AU - Rosa, R.. AU - Santi, G.. AU - Parzanese, I.. AU - De Carlis, L.. AU - Donato, M.F.. AU - Lampertico, P.. AU - Maggi, U.. AU - Caccamo, L.. AU - Rossi, G.. AU - Vecchi, M.. AU - Penagini, R.. N1 - Cited By :1 Export Date: ...

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