Anastomotic technique, gastrointestinal, side-to-side, open, continuous hand suture, double layer - general and visceral surgery

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  • Selecting the intestinal loops


    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.

  • 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.

  • Intestinal suture step 1B - double-layered suture - posterior wall

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    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

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  • Intestinal suture step 2B - double-layered suture - anterior wall

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  • Inspecting the anastomosis

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date of update: 06.07.2018
date of publication: 20.05.2012

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