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Omental transposition for low pelvic anastomoses.
B Topor1, R D Acland, V Kolodko
1Price Institute of Surgical Research, Department of Surgery, University of Louisville, School of Medicine, Louisville, KY 40292, USA.
American Journal of Surgery
|January 5, 2002
Summary
Omental transposition to the pelvis is a surgical technique that can be performed quickly with minimal blood loss. This procedure may help reduce complications following low pelvic intestinal anastomoses.
Area of Science:
- Surgical Anatomy
- Gastrointestinal Surgery
Background:
- The role of the omentum in low pelvic intestinal anastomoses is debated among surgeons.
- Defining the anatomy and surgical technique for omental transposition to the pelvis is crucial.
Purpose of the Study:
- To define the anatomy and surgical technique of omental transposition to the pelvis.
- To elucidate surgical aspects of omental mobilization, lengthening, and transposition.
Main Methods:
- Cadaveric study of 45 specimens to analyze omental anatomy and surgical mobilization.
- Intraoperative study of omental transposition in 20 patients undergoing pelvic reconstructive surgery.
Main Results:
- Detailed analysis of omental arterial supply variants (right, middle, left omental arteries).
- Described a three-stage surgical technique: detachment, lengthening, and pelvic placement of the omentum.
- Demonstrated that omental pedicle creation is a rapid procedure with low blood loss.
Conclusions:
- Omental transposition is an achievable surgical technique for pelvic reconstruction.
- This procedure has the potential to decrease the incidence of complications after low pelvic anastomoses.