Fistula - Therapeutic Use

Therapeutic Use

In end stage renal failure patients, a cimino fistula is often deliberately created in the arm by means of a short day surgery in order to permit easier withdrawal of blood for hemodialysis.

As a radical treatment for portal hypertension, surgical creation of a portacaval fistula produces an anastomosis between the hepatic portal vein and the inferior vena cava across the omental foramen (of Winslow). This spares the portal venous system from high pressure which can cause esophageal varices, caput medusae, and hemorrhoids.

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    As a science of the unconscious it is a therapeutic method, in the grand style, a method overarching the individual case. Call this, if you choose, a poet’s utopia.
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