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

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

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

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.