Noble Plication for Intestinal Obstruction

Abstract

A series of 27 patients subjected to Noble plication for obstruction of the small intestine is presented. The follow-up time has ranged from 2 to 20 years, with a mean of 12.9 years. Four recurrences occurred in the series (14.8%). The mortality was 1 patient (3.7%). The conclusions drawn from the series are that single silk sutures should be used, the sutures should be placed at the mesenteric border of the intestine, and that the pockets of the mesenteric root should be closed unconditionally. Three of the four recurrences were due to lack of observance of these rules. The indication for the Noble plication method should be a recurrent intestinal obstruction due to adhesions, and possibly extensive serosal lesions.

Key-words:

• Intestinal adhesions
• intestinal obstruction
• Noble plication