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The Journal of Cardiovascular Surgery 1999 June;40(3):463-4

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

The Rumel tech­nique. An aid for dif­fi­cult dia­phrag­mat­ic clo­sures

Barone G. W., Hudec W. A.

From the Department of Surgery University of Arkansas for Medical Sciences Little Rock, Arkansas, USA


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The inher­ent weak­ness of repair­ing the sur­gi­cal­ly divid­ed res­pir­a­to­ry dia­phragm is ­that it is a mus­cle to mus­cle clo­sure ­which can eas­i­ly ­tear. During the thor­a­coab­dom­i­nal expo­sure of the tho­rac­o­lum­bar verte­brae, the ­left hem­i­di­aph­ragm is divid­ed cir­cum­fe­ren­tial­ly. Possible due to ­unique con­di­tions relat­ed to ­these oper­a­tions the dia­phragm ­could not initial­ly be reap­prox­i­mat­ed pri­mar­i­ly in ­about 20% of the ­patients. A mod­i­fied Rumel tech­nique is ­described as an aid for clos­ing ­these dif­fi­cult divid­ed dia­phragms. This sim­ple tech­niques suc­ceeds by dis­trib­ut­ing the ­wound ten­sion ­along the ­entire dia­phrag­mat­ic ­suture ­line and not on one ­suture espe­cial­ly ­while ­being ­tied.

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