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Recurrent Intestinal Obstruction

AMA Arch Surg. 1960;80(4):670-676. doi:10.1001/archsurg.1960.01290210138028.
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Postoperative peritoneal adhesions are still one of the main complications of abdominal surgery. Patients with repeated attacks of intestinal obstruction due to these adhesions present a very difficult problem. The best approach to the management of this problem has been to develop controlled adhesions. The production of controlled adhesions, or small-bowel fixation, was described by Noble3,5,6 in 1937, through the use of suture plication. White4 in 1956, reported the use of intraluminal tube fixation for this same purpose.

For several years we have attempted to compare both of these operations and the results, using experimental animals. In addition, 10 clinical cases have been operated upon with use of the intraluminal tube for fixation. The purpose of this paper is to report the experimental results and clinical use of the tube procedure.

The Noble plication method consists of suturing the small intestine to itself back and forth in an


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