Da Vinci 'gut feeling' was right, say Indian researchers

Delving into the mysterious workings of the human gut, Indian doctors have stumbled upon a pathbreaking discovery, which has put centuries-old debate on the nature of the insides of the human abdomen to rest.

Researchers from the All India Institute of Medical Sciences (AIIMS), New Delhi and Jawaharlal Institute of Postgraduate Medical Research, (JIPMER), Puducherry, have established that 'Human Gut Mesentery,' a crucial structure that attaches intestines to abdominal wall, is a single entity.

This insight will aid surgeons world over to better maneuver surgeries. To take a closer peek at the human gut, AIIMS doctors dissected cadavers and studied them in meticulous detail.

Interestingly, Indian doctors have validated what Leonardo Da Vinci had suggested in his sketches in the 15th century. Vinci had depicted mesentery as a continuous entity. Later, in the 19th century, this view was contradicted by Treves in his lectures at Royal College of Surgeons in London, who opined that mesentery was fragmented.

"Since then, this view has been consistently followed by standard anatomy and embryology textbooks. For the first time ever, our findings have provided a comprehensive detail of the complete mesentery," said Dr Muneeb Faiq, clinical researcher at AIIMS.

The researchers developed a novel dissection method and produced direct evidence by going into excruciating details, visually documenting each minute fold, and painting a complete picture of how the entire mesentery looked like.

"The world had not seen how a complete mesentery looked like, although it was present in each part of the intra-abdominal gut tube, including the duodenum. In some parts, it was hiding from the view and went unnoticed for centuries. Mesentery for the duodenum has been demonstrated for the first time in the history of human anatomy in our research," said Dr Ashutosh Kumar, a senior researcher at thew Department of Anatomy, AIIMS, and lead investigator of the study.

The new research will aid doctors to develop novel surgical management methods to help improved outcomes in intestinal surgeries.

"Standard dissection techniques have not been able to confirm that the mesentery, an imperatively crucial structure of the human gut, is a single entity. It was believed to be fragmented and present or absent in some parts of the gut in adults, but our findings confirm that it is present throughout. This will create a paradigm shift in surgical approaches related to intestines," he added.

In newborn babies, at times, intestines can be malformed. This new research will help understand these anomalies better and aid in their management. "A relook at the gross anatomy of the mesentery is of great significance, since it can provide better understanding of congenital gastrointestinal anomalies, such as malrotation and malfixation of intestines in the process of development of embryo in the womb," said Dr Gladwin V Raj, Associate Professor at Department of Anatomy, JIPMER, Puducherry.

Being highly vascular, it also has a role in drug metabolism, and some important immunological functions and disorders.

Mesentery had recently caught worldwide attention when a group of Irish scientists proposed it to be a new human organ, a top medical science journal 'Lancet' published that proposition. Globally, it is still a matter of debate.