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Open Soave Images

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Pre-op positioning.
VID 103, frame 1

hirP4053

Foley catheter inserted.
VID 103, frame 2

hirP4054

Pre-op positioning with colon overlaid.
VID 103, frame 3

hirG4055

Incision markings.
VID 103, frame 3

hirG4056

Transition zone between aganglionic and normal colon.
VID 103, frame 4

hirG4057

Stoma for "leveling colostomy".
VID 103, frame 5

hirP4058

View after leveling colostomy, with colon overlaid.
VID 103, frame 5

hirG4059

Stoma sewn shut prior to stage two of soave procedure.
VID 103, frame 6

hirP4060

Incision markings for stage two of soave procedure.
VID 103, frame 7

hirP4061

Stoma dissected free of abdominal wall, and two limbs stapled separately.
VID 103, frame 8

hirP4062

Stoma section removed and tested for ganglion cells.
VID 103, frame 9

hirG4063

Ascending colon mobilized, and checked to see if it reaches pelvis.
VID 103, frame 10

hirG4064

Ascending colon mobilized, and checked to see if it reaches pelvis (labeled).
VID 103, frame 10

hirL4064

Bulldog clamp placed on artery.
VID 103, frame 11

hirP4066

Bulldog clamp used to test colon viability if artery removed.
VID 103, frame 12

hirG4065

Artery removed to mobilize ganglionated segment of colon.
VID 103, frame 12

hirG4067

Ganglionated colon mobilized.
VID 103, frame 12

hirG4068

Once mobilized, ganglionated colon reaches pelvis.
VID 103, frame 13

hirP4069

View into pelvis with ganglionated colon under tension.
VID 103, frame 14

hirP4070

Long segment of agangiolic colon after its mesentery is divided.
VID 103, frame 15

hirP4071

Epinephrine injected into bowel wall to lift mucosa.
VID 103, frame 16

hirP4072

Colon prior to injection.
VID 103, frame 16

hirG4073

Injection of epinephrine.
VID 103, frame 16

hirG4075

Incision made in bowel wall with #15 blade.
VID 103, frame 17

hirP4076

Start of incision.
VID 103, frame 18

hirG4080

Mucosa dissected free and intact from bowel wall (1).
VID 103, frame 18

hirG4083

Mucosa dissected free and intact from bowel wall (2).
VID 103, frame 18

hirG4085

Mucosal tube defined.
VID 103, frame 19

hirG4086

Stay sutures placed in muscular sleeve to aid dissection.
VID 103, frame 20

hirG4087

Muscular cuff split posteriorly to aid dissection.
VID 103, frame 21

hirG4088

Mucosal tube descending into muscular sleeve.
VID 103, frame 22

hirP4089

Clamp passed into anus to check progress of dissection.
VID 103, frame 23

hirP4090

Mucosal sleeve.
VID 103, frame 24

hirG4091

Mucosal sleeve grasped and everted out anus (1).
VID 103, frame 24

hirG4092

Mucosal sleeve grasped and everted out anus (2).
VID 103, frame 24

hirG4093

Mucosal sleeve grasped and everted out anus (3).
VID 103, frame 24

hirG4094

Everted mucosa shows completed dissection.
VID 103, frame 25

hirP4095

Position of patient when working from below.
VID 103, frame 26

hirP4096

Silk stay sutures placed to evert anus.
VID 103, frame 27

hirP4097

Mucosal sleeve prior to incision.
VID 103, frame 28

hirG4098

Mucosal sleeve opened for half its circumference.
VID 103, frame 29

hirG4099

Mucosal sleeve opened for half its circumference (photo inset).
VID 103, frame 29

hirG4100

Clamp passed through opened muscular sleeve to grasp colon.
VID 103, frame 30

hirG4101

Colon pulled down and through anus.
VID 103, frame 30

hirG4102

Staple line removed from ganglionated colon.
VID 103, frame 31

hirG4103

Ganglionated colon sutured to anus.
VID 103, frame 31

hirG4104

Mucosal sleeve left in place posteriorly for orientation in placing sutures evenly. Sleeve is removed prior to placement of final sutures.
VID 103, frame 32

hirP4105

This page was last modified on 7/15/1999.
 

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