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The anastomosis technique is demonstrated using a duodenojejunostomy in the context of a pylorus-preserving Whipple's operation. The distal duodenum has been transected in the meantime with a linear stapler.
Initially, the duodenal wall is skeletonized step by step.
Due to the short mesentery of the stomach, the anastomosis cannot be rotated. Therefore, a so-called non-rotatable technique is used here.
This consists of a two-row suture technique (suture material is PDS 4-0), with the posterior wall being worked on first.
Initially, a seromuscular continuous suture is started. In this process, the posterior wall of the duodenum is approximated to the posterior wall of the jejunum.
For better orientation for the next step, the suture ends remain as stay sutures.
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