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Small Intestinal Resection – Open


Goals/Objectives

  • Indications for small bowel resection

  • Technique

  • Complications

Small Bowel Resection and Anastomosis

Bradley Champagne

From Ponsky J, Rosen MJ: Atlas of Surgical Techniques for the Upper GI Tract and Small Bowel: A Volume in the Surgical Techniques Atlas Series, 1st edition (Saunders 2009)

Step 1: Surgical Anatomy

  • The submucosal layer of the bowel is the strongest layer of the intestines, and regardless of the anastomotic technique must be incorporated in all anastomosis.

Step 2: Preoperative Considerations

  • The technique for small bowel resection varies depending on the clinical presentation, intraoperative findings, and location along the alimentary tract. It is preferable to utilize both stapled and hand-sewn techniques. Stapled anastomosis can be performed rapidly, accurately, and with a lower leak rate than hand-sewn anastomosis in some series. However, when there is a discrepancy in diameter secondary to obstruction or the resection is far proximal, a sutured anastomosis is preferable. Both techniques are described here.

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