New surgical technique of omental pedicle graft preparation for omentomyelopexy.

Omental pedicle graft with left gastroepiploic vessels is very rarely used extraabdominally and all existing techniques of graft mobilization and lengthening are related to the graft with right gastroepiploic vessels. The aim of this research was to present the new surgical preparation technique of the omental graft based on the left gastroepiploic vessels for omentomyelopexy. First 100 patients, with injuries of spinal cord on different levels, were included in this prospective clinical study. In all these cases we performed omentomyelopexy with omental pedicle graft based on the new surgical technique of omental mobilization and lengthening. The results revealed that the way of preparation of omental pedicle graft depended on the level of the spinal cord lesion: in most cases for the lesions of cervical spinal cord the omental grafts had to be lengthened, for the midthoracic lesions omental graft was prepared without lengthening, while for the thoracolumbar lesions, only a part of omentum for graft was mostly used. The new surgical technique for preparation of omental pedicle graft for omentomyelopexy enabled the application of one of three possibilities for omentum lengthening. It depended on the type of omental vascularization, based on our own original classification and not on the level of spinal cord lesion. The preparation of omental pedicled graft with the left gastroepiploic vessels enabled the omentomyelopexy regardless of the level of spinal cord injury.