Skip to Main Content

++
++
++
++
++
++
++
++
++
++
++

The Polya procedure, or a modification of it, is one of the safest and most widely used repairs after extensive gastric resections have been performed, whether for ulcer or cancer.

++

The schematic drawing (Figure 1) shows the position of the viscera after this operation is completed, which in principle consists of uniting the jejunum to the open end of the stomach. The jejunum may be anastomosed either behind or in front of the colon. In the retrocolic anastomosis, a loop of jejunum is brought through a rent in the mesentery of the colon to the left of the middle colic vessels and near the ligament of Treitz (Figure 2). In the antecolic anastomosis, a longer loop must be used in order to pass in front of the colon freed of fatty omentum. If the resection has been done for ulcer to control the acid factor, it is important that the afferent jejunal loop be made reasonably short, since long loops are more prone to subsequent marginal ulceration. The jejunum is grasped with Babcock forceps and brought up through the opening made in the mesocolon, with the proximal portion in juxtaposition to the lesser curvature of the stomach (Figure 2). The abdomen is then completely walled off with warm, moist sponges. The jejunal loop is grasped in an enterostomy clamp and approximated to the posterior surface of the stomach adjacent to the noncrushing clamp by a layer of closely placed, interrupted 00 silk mattress sutures (Figure 3). This posterior row should include both the greater curvature and the lesser curvature of the stomach. Otherwise, subsequent closure of the angles may be insecure. The ends of the sutures are cut, except those at the lesser and greater curvatures, B and A, which are retained for purposes of traction (Figure 4). When the end of the stomach ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.