The technique is demonstrated here by a Braun anastomosis as part of a classic Whipple procedure. The anastomosis is fashioned in two layers. Follow this link Segmental jejunal resection with side-to-side anastomosis to see a single-layer variant of this anastomosis.
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Selecting the intestinal loops
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Intestinal suture step 1A - double-layered suture - posterior wall
A so-called non-rotating technique is used here.
It consists of a double-layer full-thickness suture, with the posterior wall being sutured first. The suture material is PDS 5/0.Start with a seromuscular running suture apposing both posterior walls.
Keep the suture ends as stay sutures for orientation in the next step.
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Intestinal suture step 1B - double-layered suture - posterior wall
Now open the jejunum with the electrocautery on both sides of the suture placed previously.
As the next step, place a full-thickness running suture on the inside of the posterior wall.
Intestinal suture step 2A - double-layered suture - anterior wall
Follow this with the inner full-thickness running suture of the anterior wall. Stitch direction is
Follow this with the inner full-thickness running suture of the anterior wall. Stitch direction is
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