Small
Bowel
Resection
Principles
See anastomosis notes
Ensure pink freely bleeding ends.
- sacrifice further cms to be safe if necessary.
- avoid tension, need adequate mobilisation
- avoid leaving mesentery twisted, close defect without affecting
blood supply.
- decompress grossly distended bowel via retrograde milking /
oblique needle decompression of large bowel.
Ends are different lengths?
End-to-end hand-sewn facilitated by Cheatle split.
Consider end-to-side, or side-side stapled.
Suture?
Interrupted 3-0 pds; ~3mm bites, ~3mm apart
In cases of infarction?
If patchy ischaemia, uncertainty of viability of remaining gut,
consider take-back at 24h.
Leaving ends stapled / blind in interim.