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.
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.
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.
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.
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
After pouch construction, ileopouch-anal anastomosis can be either manual or stapled.