Chapter 4: Table of Contents
Lembert Pattern
The continuous Lembert pattern is often used for closing incisions in hollow viscera such as the stomach, urinary bladder and uterus. It is begun by first creating a partial thickness simple throw across the incision and is continued by inserting the needle perpendicular to the incision through the serosa and muscularis layers 8-10 mm from the incision edge and is surfaced on the same side of the incision 4 mm from the edge. It is then crossed over the incision, and again in a perpendicular fashion is entered 4 mm from the edge, penetrated through the serosa and muscularis and surfaced 8-10 mm from the edge, again on the same incision side. The next needle bite is made by crossing the incision as you would to advance the suture line in a simple continuous pattern and then penetrating the tissue 8-10 mm from the edge, surfacing 4 mm before the incision, and carrying on in this fashion until the end of the incision is reached and the suture is knotted. This pattern inverts the tissues. If done correctly, this pattern should invert the tissues enough to cover the first layer leaving only the knots of the inverting pattern visible.