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Laparoscopic sutured anastomosis of the bowel

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Abstract

Background: Even though the safety and efficacy of sutured anastomosis have been proved in open surgery, laparoscopic sutured anastomosis is rarely performed because it is difficult and time-consuming. We aim at description of a standardized technique for laparoscopic sutured anastomosis of the bowel and definition of its learning curve. Methods: Fifty-six laparoscopic sutured anastomoses of cow small intestine were performed in a laparoscopic simulator. In a survival animal trial, 10 end-to-end, 2 gastrojejunostomy, 2 cholecystojejunostomy, 2 colocolic, and one side-to-side anastomoses were performed, using the same technique. Results: In the survival cases, we had no leaks or obstruction, minimal adhesions, and only one stenotic gastrojejunostomy. The mean end-to-end anastomotic time was 50 min. The technique was suitable for most sites in the GIT. The learning phase required 40 anastomoses in the simulator. Conclusions: The described technique seems relatively fast, safe, and universal, and it needs about 40 anastomoses to be mastered.

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Acknowledgements

The authors thank all the members of the Section for Minimally Invasive Surgery in the Department of Surgery, Tübingen University, Germany, for their enormous help, with special regard to Miss Christine Fleisch for her excellent assistance. The first author (MAH) expresses his gratitude to the “Deutscher Akademischer Austauschdienst” (DAAD) for giving him a research scholarship.

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Authors and Affiliations

  1. Department of General Surgery, Assiut University Hospital, Assiut, Egypt

    M. A. Hamad

  2. Section for Minimally Invasive Surgery, Department of General Surgery, Eberhard-Karls University, Tübingen, Germany

    B. Mentges & G. Buess

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  1. M. A. Hamad
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  2. B. Mentges
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  3. G. Buess
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Correspondence to M. A. Hamad.

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Hamad, M., Mentges, B. & Buess, G. Laparoscopic sutured anastomosis of the bowel . Surg Endosc 17, 1840–1844 (2003). https://doi.org/10.1007/s00464-002-8618-z

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  • DOI: https://doi.org/10.1007/s00464-002-8618-z

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