After haemostasis has been achieved, the inner layer of anastomosis can be constructed using a continuous suture. This suture is inserted so that it lies on the antimesenteric surface when tied.
End-to-end anastomosis
Surgeons create anastomoses in many surgical procedures. They usually connect body channels that aren’t connected now to make them work better or make treatments possible. Most of these connections are in blood vessels and your digestive tract. But surgeons also connect your genitourinary tract, your pee pathway.
An end-to-end anastomosis joins two ends of a tube of tissue together. This type of anastomosis can be used to repair a ruptured blood vessel, or to reconnect your digestive tract after a procedure like a colon resection.
End-to-end ileocolic anastomosis is used after a right hemicolectomy or a transverse colon resection to connect your ileum with your large bowel. It can be performed using a hand-sewn or stapled technique. It can be difficult to pass a scope across the anastomosis, because of the narrow opening in the side wall of the colon, and it is prone to developing strictures. Balloon dilatation may be successful for this anastomosis, if it is done before the stricture forms.
End-to-side anastomosis
An end-to-side anastomosis is a surgical procedure used to connect two body channels that are previously unconnected. During this procedure, surgeons must ensure that all body channels have an adequate blood supply. This is important because a lack of blood flow may result in anastomotic leakage, which is a common cause of death after colon surgery.
This technique is typically used after ileocecal resection or right hemicolectomy. It joins a portion of the small bowel with a larger bowel and can be performed using a hand-sewn or stapled technique. It is also useful for joining portions of bowel with different luminal diameters.
During this procedure, the surgeon places a small amount of anaesthetic on the edges of the anastomosis. Then, he or she places the main EEA stapler instrument through the bowel and secures it with a purse-string suture. After the anastomosis has been completed, he or she places a hemostatic peritoneal suture around the mesenteric corner of the small intestine and a continuous all-coat suture on the anterior surface of the large bowel.
Side-to-side anastomosis
The side-to-side anastomosis technique connects the sides of two bowel segments instead of the ends. This is a more resilient and durable anastomosis. It is also less likely to develop stricture problems in the future. In addition, the anastomosis does not expose a large area of the intestine to injury.
This method is more difficult to perform than end-to-end anastomosis. However, the benefits outweigh the risks. In a recent study, patients who underwent side-to-side anastomosis had lower rates of stricture.
In the Prox. CIA-Cont. CIA and Dist. CIA-Ipsi. CIV end-to-side anastomosis models, the proximal cutting end of the donor CIA easily reached the contralateral or ipsilateral CIA under tension-free situations. However, the posterior wall of the CIA was at risk for injury due to excessive tension. The proximal portion of the CIA should be sutured intraluminally to prevent damage and stenosis. In addition, good distribution of stitches and wide orifice were recorded. These measurements are important for determining anastomotic leakage and patency.부산정형외과
Interposition grafts
Reoperations for common femoral artery (CFA) disease are increasingly common. When the proximal CFA is affected by severe stenosis, a bypass can be performed using the geniculate popliteal arteries or a Dacron interposition graft. However, distal bypass occlusion often requires above-the-knee resections.부산족저근막염
We studied three trainees with basic microsurgical experience who were trained to perform a standardized series of 20 femoral vein interposition grafts. Each graft was connected to a femoral vessel through inside-to-outside suturing, and the patency and leakage rate served as qualitative variables for efficiency control.
The grafts were constructed with a six millimeter thin-walled PTFE tube and were tapered for size matching with the internal carotid artery. The tunnel was created in the plane between the femoral and tibial condyles to prevent graft kinking. The ipsilateral lesser saphenous vein was harvested and marked with two end clamps to ensure a native lie prior to ligation. An expendable segment of the sural nerve harvested from the calf (nerve graft) or neck (great auricular nerve) was used to bridge the gap.