The omentum-pedicled intestinal segment: an experimental model for bowel lengthening.

Various experiments designed to increase the absorptive surface of the intestine to minimize dependence on total parenteral nutrition in short-bowel syndromes have been challenged by the limitations of the vascular supply to the gut. We have investigated the feasibility of small-bowel lengthening in a rabbit model by creating a neo-mesentery for a segment of jejunum. In this method the serosa of the antimesenteric aspect of the jejunum is removed and a flap of omentum is attached to this surface. Intestinal segments were separated from their original mesentery after 5, 6, and 7 weeks of omental revascularization and specimens examined histologically 24 h after vascular division. Our data support the hypothesis that intestinal segments with both omental and mesenteric pedicles are viable and that the small bowel can be divided longitudinally and remodelled for elongation with the vascular support of the two distinct sources.