Anastomotic technique, gastrointestinal, end-to-end, open, continuous, hand suture, rotation technique - general and visceral surgery

You have not purchased a license - paywall is active: to the product selection
  • Selecting the intestinal loop

    Video
     
    Selecting the intestinal loop
     

    As an example, the suture is demonstrated in a right-sided hemicolectomy. An ileotransversostomy is planned. Owing to the long mesenteries, the intestine can be rotated here; therefore, the anterior wall will be sutured first, and after rotating the intestine this will be followed by the posterior wall.

  • Dissecting the intestinal wall

    Video
     
    Dissecting the intestinal wall
     

    First, dissect free both intestinal walls at the planned anastomosis. Limit skeletonization of the intestinal wall to less than 1.5 cm for the small intestine and no more than 0.5-1 cm for the large bowel. Always check for a healthy, grayish-red color of the intestinal tissue, bleeding wound edges, and palpable or visible arterial pulses in the intestinal section to be sutured.

  • Resecting the intestine

    Video
     
    Resecting the intestine
     

    Block the intestine with intestinal clamps. By transecting the intestine with the scalpel perfusion of the intestinal wall will not be jeopardized.

    Note: The ileum is resected at an oblique angle to account for the bigger lumen of the transverse colon; if necessary, extend the ileum length of the anastomosis by slitting the ileum along its antimesenteric aspect.

  • Intestinal suture 1 (placing the stay sutures)

    Paid content (video)
    Paid content (image)
    Paid content (text)
  • Intestinal suture 2 (suturing the anterior wall)

    Paid content (video)
    Paid content (image)
    Paid content (text)
  • Intestinal suture 3 (suturing the posterior wall)

    Paid content (video)
    Paid content (image)
    Paid content (text)
  • Intestinal suture 4 (checking the anastomosis)

    Paid content (video)
    Paid content (image)
    Paid content (text)
  • Closing the mesenteric window

    Paid content (video)
    Paid content (image)
    Paid content (text)
date of update: 05.02.2023
date of publication: 13.03.2012

Single Access

Access to this lecture
for 3 days

€4.99 inclusive VAT

SEPA Maestro Mastercard VISA

webop-Account Single

full access to all lectures
price per month

for the modul: vascular surgery

from 8,17 €

hospitals & libraries

for the modul: vascular surgery

from 390,00 euros