1. Surgical treatment of venous obstruction and insufficiency
John J. Bergan, M.D., James S.T. Yao, M.D., Ph.D., William R. Flinn, M.D., Walter J. McCarthy, M.D. 
Journal of Vascular Surgery 
Volume 3, Issue 1, Pages (January 1986)
DOI: / (86)
Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

2. Fig. 1
The ingenuity of the Palma operation of crosspubic bypass is shown in this diagram, which indicates a single venovenous anastomosis and bypass of the obstructed iliac vein by autogenous tissue. Sites of removal of normal contralateral saphenous vein are indicated, as is placement of incisions for reconstruction.
Journal of Vascular Surgery 1986 3, DOI: ( / (86) )
Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

3. Fig. 2
This diagram indicates bilateral common femoral vein exposures through linear incisions and vena cava exposure achieved by mobilizing right colon, duodenum, and pancreas.
Journal of Vascular Surgery 1986 3, DOI: ( / (86) )
Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

4. Fig. 3
Externally reinforced polytetrafluoroethylene graft is fashioned to create bifurcation, which will be placed advantageously in retroperitoneum.
Journal of Vascular Surgery 1986 3, DOI: ( / (86) )
Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

5. Fig. 4
Externally reinforced graft is tunneled through appropriate avenues of access so that end-to-side anastomoses can be made from graft to femoral vein and from graft to suprarenal vena cava.
Journal of Vascular Surgery 1986 3, DOI: ( / (86) )
Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

6. Fig. 5
These diagrams show the mobilization of venous tributary to the common femoral vein that lies posterior to the superficial femoral artery. It is anastomosed end-to-side to superficial femoral artery and tagged with monofilament nonabsorbable suture, which is looped around vein and placed in subcutaneous tissue for easy access at later date. If closure of arteriovenous fistula is desirable later, this can be done simply with the patient under local anesthesia by isolating the monofilament suture and trying it down.
Journal of Vascular Surgery 1986 3, DOI: ( / (86) )
Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions