Transposition of the greater omentum in the prevention and treatment of radiation injury.

The greater omentum provides a tissue flap that can readily be transposed for surgical reconstruction both inside and outside the abdominal cavity. To prevent radiation enteritis, an omental sling or envelope can be constructed at the end of an abdominal operation to displace small bowel from the pelvis prior to radiotherapy. The immunological and angiogenic properties of the omentum are particularly useful when reconstruction is required in a region of late radiation injury. Indications for omental transposition in this context include reinforcement of anastomoses, pelvic fistula repair, chest wall and axillary reconstruction, vascular cover, pharyngostoma, bronchopleural fistula and possibly lymphoedema.