U-shaped Sutures Research Articles

Atraumatic Partial Nephrectomy

The aim of the described method of partial nephrectomy is to minimize injury to the kidney, if possible without causing unnecessary loss of blood, and without interrupting the arterial or venous blood flow during surgery. Use of a pedicle clamp, compressing forceps for the renal parenchyma or hypothermia is superfluous. Following pre- and intraoperative estimation of the dimensions of the area of the renal parenchyma to be removed, virtual hemostasis is achieved by applying a continuous U-shaped suture distal to the portion of the kidney to be resected, using an atraumatic chromic catgut suture. Total hemostasis in the area to be excised is attained with the aid of a second U-shaped suture, running parallel to the first but entering on the opposite renal margin. Following excision, the raw surfaces are then reapproximated by means of a continuous suture and thus sealed. To conclude the operation a temporary nephrostomy is inserted. The immediate and later follow-up results and the advantages and potential complications of the new technique are described in 112 consecutive patients presenting for treatment during a period of 12 years.

腎切石術における腎実質縫合法の研究

The principle of treatment for staghorn calculi and the indication of nephrolithotomy have been described. In nephrolithotomy, operative technique, especially the method of parenchymal suture, has several variations but there is no convulsive method.In 1967, Dr. Taguchi originally designed a new method of parenchymal suture and he has performed it in more than 50 patients with good result. In his operation, closure of the renal parenchymal incision is made with one layer interrupted suture from pelvic mucosa to renal capsule by 2-0 plain cat gut. Hemostatic suture or ligation and the suture of pelvic mucosa are not necessary. Therefore, the operative technique is very simple and the clamp time of renal pedicle can be shortened.The ways of renal parenchymal suture in nephrolithotomy were classified into 6 groups. They were:1. The method without suture at alla) sutureless nephrotomyb) wrapping kidney in Oxycel gauze2. The method of capsular suturea) interrupted or continuous suture of renal capsule onlyb) subcapsular circular suture3. The method of interposition of muscle, fatty tissue or others4. Mattress suture and its variationsa) horizontal mattress sutureb) vertical mattress suturec) plate suture5. The method of parenchymal suture other than mattress suturea) U-shaped suture in margin of renal incisionb) interrupted suture of renal parenchyma6. Anatrophic nephrotomy (by Boyce, W. H. et al)One layer interrupted suture of renal wound originally designed by Dr. Taguchi belongs to the group 5-b, but it is considered the simplest and the most advanced technique.

THE CLYPEUS AND THE EPISTOMAL SUTURE IN HYMENOPTERA

The frontoclypeal suture in the Hymenoptera does not arch upwards into the frontal region but retains its primitive position at the horizontal level of the mouth, the clypeus remaining preoral in position. The genae and postgenae have continued or resumed their ventral growth, the inner margins of the genae have fused with the previously free lateral edges of the clypeus, and a pair of clypeogenal sutures, continuous with the frontogenal, have formed along the lines of fusion. The clypeogenal sutures form the vertical or oblique elements of the U-shaped epistomal suture, while the frontoclypeal suture forms its horizontal component. The anterior tentorial pits, within the bases of the frontogenal sutures, lie at the junction of the frontoclypeal with the clypeogenal sutures. These changes in the structure of the face have caused a ventral shifting of the mandibular articulations.