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Biomedical subjects

F M Steichen

Publications and source records attributed to F M Steichen.

At least 19 recordsLinked to original sources
PubMed1992

Bricker-Johnston sigmoid colon graft for repair of postradiation rectovaginal fistula and stricture performed with mechanical sutures.

In patients with postradiation rectovaginal fistula who are otherwise healthy and cured of their cancer, repair of the fistula with return to a normal lifestyle is indicated if this repair can be achieved with minimal morbidity, no mortality, and a good prospect for a functionally satisfactory result. The Bricker-Johnston vascular sigmoid colon graft fulfills these conditions by respecting the tissular equilibrium of the radiated rectum and supplying the area with a sound, vascular sigmoid pedicle graft. While this improves tissue vitality locally, it restores rectal function to a near-normal preradiation level and preserves the previously intact sphincter muscles. The concept of this repair is very sound, and its implementation is greatly facilitated technically by the use of mechanical suture instruments. In this presentation, we describe and show the use of stapling instruments in achieving a three-stage repair of a rectovaginal fistula with Bricker and Johnston's technique.

Anastomosis, Surgical↗
PubMed1987

[Development of the mechanical suture and comparison with the manual suture in surgery].

Mechanical sutures in surgery were first used in 1908 by Hültl. Since then they have found a large field of application in thoracic and abdominal surgery because of their ease in handling and consequent reduction of duration of operation, as well as reduction of contamination from hollow organs. Safety, diminished tissue trauma and early function of anastomotic continuity are other advantages that recommend the use of staplers over hand sutures.

Humans↗
PubMed1987

The modified Duhamel operation for Hirschsprung's disease performed entirely with mechanical sutures.

The Duhamel operation of retrorectal transanal pull-through is a widely used technique in the treatment of Hirschsprung's disease. Modifications of the technique have been made with the introduction of stapling instruments. The construction of a side-to-side colorectal anastomosis has been facilitated with the introduction of the GIA linear anastomosing instrument. The advent of the EEA stapling device has allowed us to perform a modified Duhamel operation in a 9-month-old boy with Hirschsprung's disease using mechanical sutures entirely. The technique for the procedure is described.

Hirschsprung Disease↗
PubMed1987

Penetrating cardiac injuries: twenty-year experience.

Analysis of 228 patients who sustained penetrating cardiac injuries (1963-1983) reveals that among patients who arrived with vital signs, survival was 73 per cent as opposed to 29 per cent of patients who arrived in extremis; and delay in thoracotomy contributed to an increased mortality among patients in profound shock who failed to respond promptly to volume expansion and agonal patients who were transported to the operating room for thoracotomy. An increasing incidence of gunshot wounds and a greater frequency of patients presenting in extremis was noted in the latter years of the study as compared with the earlier period. Our data indicate that there is an increasing need for emergency room thoracotomy in the management of cardiac injuries. Urban trauma centers should be equipped for major procedures in the emergency room and, ideally, should have operating rooms in this area.

Adolescent↗
PubMed1986

Abdominal approach to the Collis gastroplasty and Nissen fundoplication.

A technique to perform the Collis-Nissen operation through an abdominal approach has been described. This method is especially indicated in patients with severe reflux esophagitis and dilatable esophageal strictures, where existing cardiac and pulmonary disease would make a thoracic approach a greater liability to the patient.

Esophagus↗
PubMed1984

Contemporary stapling instruments and basic mechanical suture techniques.

This article provides a description and demonstration of the basic linear staple closures and anastomoses, as well as of circular anastomoses. Depending on the technique used, bowel may be closed in a mucosa-to-mucosa or serosa-to-serosa fashion, and comparable results with either modality are demonstrated.

Equipment Design↗
PubMed1984

Varieties of stapled anastomoses of the esophagus.

The rationale for esophageal replacement or bypass is described, and based on the substitute organ chosen, various anastomoses and reconstruction of gastrointestinal continuity are demonstrated.

Esophageal Diseases↗
PubMed1983

Emergency room thoracotomy for penetrating cardiac injuries.

The results of emergency room thoracotomy (ERT) and cardiorrhaphy for 91 patients with penetrating cardiac injuries admitted in extremis to Lincoln Medical and Mental Health Center from 1963 to 1981 are reviewed to determine criteria for selection of patients for this procedure. Four groups were defined based on the severity of the effects of their injuries. The survival rates were 32.1 and 33.3%, respectively, for Group I ('fatal') and Group II ('agonal') patients. There were no survivors in Group IV ('D.O.A.') patients for whom ERT is a fruitless procedure. Survival in Group III ('profound shock') patients was only 40%, which might have been improved if ERT had been performed without delay. We conclude that ERT is essential for patients with 'fatal' and 'agonal' wounds and advise prompt ERT for patients in 'profound shock' who do not respond immediately to rapid volume infusion.

Adolescent↗
PubMed1980

Mechanical sutures in esophageal surgery.

Precise, safe and expeditious suturing of the esophagus to the stomach or the small or large bowel is required in procedures designed to re-establish continuity following esophagogastrectomy, partial or total esophagectomy and total gastrectomy, and to control exsanguinating hemorrhage from ruptured esophageal varcies. In the anastomosis of the esophagus to the stomach, small or large bowel, and in the control of hemorrhage from bleeding esophageal varices by a modified Tanner-Boerema procedure, the EEA, the GIA (loaded with SGIA cartridges) and the TA-55 stapling instruments significantly facilitate and simplify these operations.

Colostomy↗
PubMed1979

A stapling instrument for end-to-end inverting anastomoses in the gastrointestinal tract.

A stapling instrument is described for end-to-end inverting anastomoses applicable principally to low rectal anastomosis or esophagogastric or esophagojejunal anastomosis. The instrument creates an inverting anastomosis held by a double staggered row of stainless steel wire staples creating an anastomosis 21.2 mm internal diameter with no significant inverted flange. The early experience is encouraging.

Animals↗
PubMed1978

Autosuture ileal conduit construction: experience in 110 cases.

Our experience with 110 cases of ileal conduit construction with autosuture stapling devices is discussed. The technique is described briefly and the results are compared to results with ileal conduits constructed with the conventional suture technique. Analysis of our data revealed a significant reduction in operating time and postoperative morbidity.

Adolescent↗
PubMed1977

The creation of autologous substitute organs with stapling instruments.

After partial or total esophagectomy, total gastrectomy, pancolectomy, and urinary cystectomy, it becomes necessary to reestablish continuity and/or replace function by the creation of a substitute organ obtianed from the various portions of the gastrointestinal tract. Ideally, the creation of the substitute organ should be undertaken at the same operation in which the original organ is excised. At times, however, the surgeon may elect a two-stage approach by replacing the afflicted organ during a separate operation either prior to or after excision, as dictated by the circumstances surrounding each individual patient. The use of stapling instruments has greatly facilitated the precision, neatness, and speed with which substitute organs can be constructed. This is especially spectacular in those patients in whom a one-stage procedure is elected.

Adolescent↗
PubMed1976

Dilation of intraheptic bile ducts in choledochal cyst: case report with follow-up review of the literature.

Fifty-five cases of intrahepatic dilation of the bile ducts associated with choledochal cyst have been found in the literature, mostly reported over the past five years. Obstructive jaundice is often not present at an early stage in this group of patients, but dissociation of the serum bilirubin and alkaline phosphatase levels could be an early manifestation of this condition. Recent advances in diagnosis and new concepts of the cause and surgical management are reviewed. A case is reported where choledochocystojejunostomy was performed using automatic stapling instruments. Disappearance of symptoms, normalization of liver functions, and reduction in size of the cysts were observed during the two-year postoperative period.

Adolescent↗