Mucosal proctectomy using an ultrasonic scalpel

Tomas M. Heimann, Robert J. Kurtz, Susan Shen, Arthur H. Aufses

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Mucosal proctectomy is becoming the operation of choice in the surgical treatment of patients with ulcerative colitis and familial polyposis coli. Dissection of the rectal mucosa and submucosa from the underlying muscularis is often difficult and, in some instances, impossible to perform. The feasibility of using an ultrasonic device to perform mucosal proctectomy was studied in eight dogs. This technique produced coagulative necrosis of the mucosa and muscularis mucosa with marked edema and congestion of the submucosa. The muscularis propria remained intact. Complete destruction of the distal 7 cm of rectal mucosa required a total duration of exposure to the ultrasonic probe of at least 12 minutes. In another five dogs, total colectomy was performed above the area of the mucosal proctectomy followed by endorectal pull-through of the ileum. Follow-up studies revealed healing of the ileoanal anastomosis without retraction or stricture. This technique should allow mucosal proctectomy to be performed in those patients in whom standard dissection is not possible due to fibrosis of the submucosal plane.

Original languageEnglish
Pages (from-to)803-806
Number of pages4
JournalAmerican Journal of Surgery
Volume147
Issue number6
DOIs
StatePublished - Jun 1984

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