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
Intestinal suture step 2A - double-layered suture - anterior wall
Intestinal suture step 2B - double-layered suture - anterior wall
Inspecting the anastomosis
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