Intraoperative use of the Hemobahn endograft is feasible and effective in restoring adequate distal perfusion in the short term, especially when combined with conventional recanalization techniques.
Intraoperative use of the Hemobahn endograft is feasible and effective in restoring adequate distal perfusion in the short term, especially when combined with conventional recanalization techniques.
Internal abdominal hernias are rare and often are first seen when causing ileus. Three different internal hernias were operated on laparoscopically: a patient with a hernia duodeno-jejunalis causing recurrent pain in the upper bowel, vomitus and ileus; two patients with an intersigmoidal hernia and pelvic hernia causing ileus without prodroma. Each case was operated on laparoscopically during or short after ileus. In all cases the hernia could be assured and treated by retracting the gut into the abdominal cavity and either wide opening of the hernia's entrance or closing it by suture. It is concluded that internal hernias can be diagnosed and treated laparoscopically as well as in conventional operation techniques.
A few months ago an endovascular implantable PTFE stent graft became commercially available. Since May 1998 we have treated 15 patients with extensive vascular occlusion at the femoropopliteal level. The implantation is carried out via a single inguinal approach in combination with conventional vascular surgical techniques like orthograde ringstripping of the superficial femoral artery, local TEA and patch-grafting of the femoral bifurcation, angioplasty, local lysis, etc. The self-expanding thin-walled PTFE stent prothesis appears to be a viable alternative to the femoropopliteal P1 bypass and can be performed under local anesthesia, percutaneously or through a small inguinal incision. The implantation can be carried out with minimal tissue trauma.
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