Laparoscopic Duodenal Ulcer Suturing with Graham Patch

Omental patching began in 1937, when Roscoe Reid Graham of Toronto reported 51 cases of perforated peptic ulcer successfully treated with an omental patch. The ulcer successfully treated with an omental patch laid over three sutres which are then tied being more than sufficient for closure of the  duodenal perforation (without an attempt for primary closure of the perforation).

In Graham’s initial cases, he concluded that routine gastroenterostomy was unnecessary, the omental patch being more than sufficient for closure of the duodenal perforation.

More than 80 years after its initial description, this technique is still extremely useful in selected patients with perforated duodenal ulcers.

References:

Graham's Omentopexy versus Modified Graham'sOmentopexy in Perforated Duodenal Ulcers - APros pective StudyManoj Kumar Sethy1, Subham Ranjan Narendra2, M V Kameswar Rao3, Seshdev Panigrahi4

Razvan C Opreanu, MD, MS Resident Physician in General Surgery, Department of Surgery, Michigan State University College of Human Medicine (Medscape)