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A D V E R T I S E M E N T | |||||
Open Soave Images |
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Mark-Up |
Description / Link to Frame |
Full Size |
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Pre-op positioning. |
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Foley catheter inserted. |
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Pre-op positioning with colon overlaid. |
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Incision markings. |
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Transition zone between aganglionic and normal colon. |
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Stoma for "leveling colostomy". |
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View after leveling colostomy, with colon overlaid. |
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Stoma sewn shut prior to stage two of soave procedure. |
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Incision markings for stage two of soave procedure. |
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Stoma dissected free of abdominal wall, and two limbs stapled separately. |
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Stoma section removed and tested for ganglion cells. |
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Ascending colon mobilized, and checked to see if it reaches pelvis. |
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Ascending colon mobilized, and checked to see if it reaches pelvis (labeled). |
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Bulldog clamp placed on artery. |
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Bulldog clamp used to test colon viability if artery removed. |
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Artery removed to mobilize ganglionated segment of colon. |
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Ganglionated colon mobilized. |
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Once mobilized, ganglionated colon reaches pelvis. |
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View into pelvis with ganglionated colon under tension. |
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Long segment of agangiolic colon after its mesentery is divided. |
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Epinephrine injected into bowel wall to lift mucosa. |
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Colon prior to injection. |
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Injection of epinephrine. |
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Incision made in bowel wall with #15 blade. |
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Start of incision. |
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Mucosa dissected free and intact from bowel wall (1). |
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Mucosa dissected free and intact from bowel wall (2). |
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Mucosal tube defined. |
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Stay sutures placed in muscular sleeve to aid dissection. |
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Muscular cuff split posteriorly to aid dissection. |
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Mucosal tube descending into muscular sleeve. |
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Clamp passed into anus to check progress of dissection. |
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Mucosal sleeve. |
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Mucosal sleeve grasped and everted out anus (1). |
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Mucosal sleeve grasped and everted out anus (2). |
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Mucosal sleeve grasped and everted out anus (3). |
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Everted mucosa shows completed dissection. |
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Position of patient when working from below. |
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Silk stay sutures placed to evert anus. |
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Mucosal sleeve prior to incision. |
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Mucosal sleeve opened for half its circumference. |
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Mucosal sleeve opened for half its circumference (photo inset). |
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Clamp passed through opened muscular sleeve to grasp colon. |
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Colon pulled down and through anus. |
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Staple line removed from ganglionated colon. |
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Ganglionated colon sutured to anus. |
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Mucosal sleeve left in place posteriorly for orientation in placing sutures evenly. Sleeve is removed prior to placement of final sutures. |
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This page was last modified on 7/15/1999. A D V E R T I S E M E N T
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