Resection and Anastomosis

Question 1

What is resection and Anastomosis

Answer 1

This is the excision of a segment of bowel followed by re-joining the two remaining segments.

Question 2

why is this procedure performed?

Answer 2

tumours, foreign bodies, necrosis and intussusception

Question 3

Instruments and materials

Answer 3

Two sterile instrument kits are required. One kit is used to perform the gastrotomy and remove the foreign body, and the second set of sterile instruments are used to close the abdominal cavity to avoid contaminating the abdominal cavity. These instruments should be kept separate, so they do not cause contamination. A Balfour or Gosset retractor, laparotomy sponge’s lavage solution, and a suction apparatus are needed.

Question 4

Surgical procedure

Answer 4

In this procedure, the intestines are inspected for blood supply, peristalsis and viability. If the surgeon is unsure of any of the above components, then that region of the intestines should be resected. Sutures are placed on either side of the necrotic section of bowel, occluding the blood supply. Doyens bowel clamps are placed alongside the sutures and a Rochester Pean or Carmalt clamp can be used to occlude the diseased region of bowel. The surgeon will then use a scalpel blade to remove the diseased segment. The remaining two viable segments of bowel are apposed together using a simple interrupted suture pattern. Sterile saline is injected into the lumen (the clamps should still be applied at this point; the saline is to ensure there are no intestinal leaks into the abdominal cavity. The abdominal cavity should be flushed with saline and new instruments selected for abdominal closure.