Most of the cases had a well-defined transition zone on contrast enema which was further substantiated by a seromuscular
biopsy undertaken at the time of laparotomy for a transverse loop colostomy.
Embedding fistulojejunostomy has been suggested by Luo et al., in which thefistula tract is disconnected from the abdominal wall and drained externally through a transluminal tube drain, with both the drain and the tract fixed to a Roux loop of the jejunum with seromuscular
Wedge resection of the uterine wall entails removal of the seromuscular
layer at the identified location of adenomyotic tissue, with subsequent repair of the remaining muscular and serosal layers surrounding the wound.
Then, 4-0 absorbable sutures were used to strengthen the suture of the seromuscular
layer of the anastomotic stoma; meanwhile, 4-0 absorbable sutures were used to close the stump, for further strengthening the suture of the seromuscular
layer of the stump.
Rectal mucosal biopsy compared with laparoscopic seromuscular
biopsy in the diagnosis of intestinal neuronal dysplasia in children with slow-transit constipation.
Subsequent laparoscopic dissection of the seromuscular
layer is achieved by making a pseudoperforation, and dissection is done by an ultrasonically activated device.
After reinversion of the tissue, the seromuscular
layer was removed by the same procedure, leaving only the jejunal submucosa (Figure 1).
Caption: Figure 6: CASE 2, exploratory laparotomy and removal of ParaGard IUD from the seromuscular
layer of the bladder.
The stump of the lifted jejunal limb was covered by interrupted seromuscular
Intra-operatively, short acting anaesthetic agents like sevoflurane/atracurium were used, bowel anastomosis were performed by hand-sewn method using two-layer anastomosis, first-layer continuous suturing full thickness technique and second-layer interrupted seromuscular
sutures using vicryl # 4/0 suture material.
For full-thickness and larger single defects, a double-layer closure is recommended with a full-thickness inner layer (including the mucosa) in which the mucosa is inverted luminally with 3-0 absorbable suture in a running or interrupted fashion followed by a seromuscular
outer layer of 3-0 absorbable or silk sutures placed in interrupted imbricating Lembert stitches.