Milestones in the history of intestinal anastomosis
Lembert : Seromuscular suture technique for bowel anastomosis in 1826
Halsted : Favoured a one layer extramucosal closure, it was felt to cause the least tissue necrosis or
Currently accepted technique for intestinal anastomosis
The only appreciable shortcoming of the two-layer technique is that it is somewhat tedious and time-consuming to perform. Recently, several reports have appeared advocating a single-layer continuous anastomosis using monofilament plastic suture.
Single layer continuous extramucosal closure has now become widely accepted.
Single Layer , Extramucosal, Interrupted- End to End bowel anastomosis (simulation)
Side to side bowel anastomosis (simulated)
Difference between Extramucosal Technique and Seromuscular Suture Technique
Suture Materials used in Intestinal Anastomosis
The suture materials should be of 2/0–3/0 size and made of an absorbable polymer, which can be braided (e.g. polyglactin), or monofilament (e.g. polydioxanone), mounted on an atraumatic round-bodied needle.
the bowel wall.
Important Considerations while doing Bowel Anastomosis
In cases of major size discrepancy of size of bowel end to be anastamosed, a side-to-side or end-to-side anastomosis is done.
In cases of minor size discrepancy, Cheatle split (making a cut into the antimesenteric border) may
help to enlarge the lumen of distal, collapsed bowel and allow an end-to-end anastomosis to be fashioned.
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