Arnulf Thiede – författare

Bioabsorbable anastomotic rings (BAR) represent a fascinating concept: the standardization of anastomoses and expulsion of the material without residues are among the many advantages. The data presented here provides an up-to-date overview of this new anastomosing technique. The development of BAR means that a single technique can be used to perform the classical end-to-end, end-to-side, and side-to-side anastomoses in most areas of the gastrointestinal tract without an auxiliary tool. This brings a great advantage in terms of practicality. The book provides experimental and clinical data on the compression anastomosis technique with the bioabsorbable Valtrac ring and considers the future prospects for the technique.

Der Einzug der minimalinvasiven Chirurgie hat in der Chirurgie in den letzten 3 Jahren zu einem Umbruch gef}hrt. Aber erst die Einf}hrung von speziell entwickelten Klammer- nahtinstrumenten f}r den laparoskopischen undthorakosko- pischen Einsatz hat zur Verbreitung dieser Techniken f}hren k|nnen. Dies ist eine aktuelle Zusammenstellung der M|glichkeiten und Indikationsgebiete f}r die Anwendung von Klammernaht- instrumenten in der konventionellen und minimalinvasiven Chirurgie. Das Buch behandelt schwerpunktm{~ig die klinische und praktische Anwendung der Klammernahtinstrumente, zeigt neue Perspektiven f}r die minimalinvasive Chirurgie durch die Anwendung von Klammernahtinstrumenten auf und gibt eine ]bersicht }ber Indikationen, Ergebnisse und Komplikationen.

In ubersichtlicher Weise werden Viszerosyntheseverfahren fur den oberen und unteren Gastrointestinaltrakt dargestellt. Fundierte experimentelle Grundlagen und die klinischen Anwendungen sind zum Teil als Studien dokumentiert. Die sich standig fortentwickelnde chirurgische Anastomosentechnik mit den typischen Verfahren der Hand-, Stapler- und Kompressionsanastomose wird erganzt durch die laparoskopischen Nahtverfahren im Gastrointestinaltrakt.

Preclinical experimental transplantation research that is based on microsurgical models in rats fulfills two indispensable conditions for modern organ transplanta­ tion research: Almost all organ grafts can be performed on the rat with an amount of technical effort that is still justifiable. Thus transplantation models that are analogous to human organ transplantation can be developed, tested, and evaluated. This fulfills a necessary condition from the standpoint of surgery. With the species rat, we have a great variety of genetically different inbred strains. From the immunological point of view this is an indispensable prerequisite for the investigation of preclinical transplantation models that can be expected to produce controllable, reproducible results. In vivo experimental results can be supplemented by and correlated to in vitro tests. Lately these experimental results are being greatly expanded and more precisely defined by the application of immunohistological methods that have been established recently in Kiel. In this book we hope to present a cross section of the microsurgical models in use today and of current immunological and immunohistological models. Furthermore, we wish to record the present state of microsurgical organ transplantation research and to show its relationship to the current state and development of clinical organ transplantation. A special aspect of our Kiel research group is the long-term, well-functioning, interdisciplinary cooperation between surgery, immunology, and pathology. Through this cooperation we attempt to provide an atmosphere in which theoretical and practical viewpoints can mutually influence each other.

In contrast to the continuously increasing success in kidney, liver, heart, and pancreas transplantation, small-bowel transplantation has not shown simi­ larly impressive progress until recently. The few clinical attempts at small-intestinal transplantation in the late 1960s and early 1970s were unsuccessful. In spite of these initial failures, a few groups of surgeons continued to investigate the problems of small-bowel transplantation from the technical, functional, and immunologic point of view. Now, about 15 years later, conditions have changed. Total parenteral nutrition has made tremendous progress, thus maintaining patients with short-bowel syndrome who are potential recipients of small-bowel grafts in an acceptable physical condition. Immunologists and clinicians have furt­ hermore been able to expand our knowledge of basic immunologic reactions induced by transplanted organs. In addition, within the last 8 years, new immunosuppressive drugs and regimens have been introduced which have proved to be extremely effective. Taking all these aspects into account, we regarded it as an extremely worthwhile and effective undertaking to invite scientists from all over the world who are working in the field of small-bowel transplantation to participate in a symposium on this topic. This meeting, the first to deal exclusively with small-bowel transplantation, was held in Kiel, West Ger­ many, in October 1985. Its aims were twofold: 1. ) To'stimulate direct communication between basic scientists and clini­ cians 2.