Suture between

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  •   Dhaman or Oriental Ratsnake Ptyas mucosus is a common species of colubrid snake found in parts of South and Southeast Asia. Growing to nearly two metres, they are large snakes and their colour varies from pale browns in dry regions to nearly black in moist forest areas. They are frequently found in urban areas where rodents thrive. 1. Scientific classification Kingdom: Animalia Phylum: Chordata Class: Reptilia Order: Squamata Suborder: Serpentes Family: Colubridae Genus: Ptyas Species: P. mucosus 2.

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  • The "ski-tip" style ends of the robotic retractor blades are longed into the anterior leaflet, then the atrial septum is lifted to visualize PM. The length of the artificial chordae loops were determined with the measure of the distance between the correct plane of apposition on an adjacent normal non-prolapsing segment of the mitral leaflet and the respective PM (done with a More Suture Ruler device). Artificial chordae, with 4 loops each, were constructed of 4-0 PTFE GORE-TEX per the technique by von Oppel and Mohr.

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  • The length of chordae was a measurement of the distance between the head of the PM and the free edge of the posterior leaflet. Length of the opposing chordae of the posterior leaflet was measured directly by using a calliper. Double-armed mattress sutures with CV-5 GORE-TEX were placed at the fibrous tip of the PM using PTFE on both sides and tied down firmly. In all cases Doi performed Duran ring annuloplasty. Thereafter, the ePTFE suture is placed through the anterior leaflet.

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  • The procedure described by Young involved a transverse incision between the ischial tuberosities 2 cm above the anus (Young, 1926). The ischiorectal fossa was then opened by blunt finger dissection, carrying the dissection medially and reflecting the rectum posteriorly. The central tendon of the perineum was then cut exposing the recto-urethralis muscle which was opened by sharp dissection and reflected laterally, exposing the capsule of the prostate (figure 5). The abnormal area on the prostate was grasped with Allis forceps and excised widely and deeply.

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  • Nowadays most Authors agree that preserving the rectum is useless, so it is sectioned at the level of anorectal junction. The preparation of the rectum toward anorectal junction is usually intramesorectal, which rises the risk of bleeding but also reduces the risk of nerve lesions. However mesorectal excision is mandatory in case of either severe dysplasia or cancer. After pouch construction, ileopouch-anal anastomosis can be either manual or stapled.

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