Friday, March 16, 2012

BOWEL RESECTION Procedure 6


SMALL BOWEL RESECTION
Position of the patient
Suspine
Anaesthesia
General
Surgical steps
· Open the abdomen (paramedian) and gain entry to the peritoneal cavity.
· Identify the area to be resected.
· Divide mesentery to this area in the line of a shallow V, serially between ligatures.
· The apex of the V is towards the root of the mesentery.
· Divide bowel to be removed obliquely, removing more of antimesenteric border between non-crushing clamps.
· Approximate non-crushing clamps to appose the two cut ends of bowel.
· Carry out end-to-end anastomosis – an inner continuous layer of catgut and an outer continuous layer of silk.
· Approximate cut end of mesentery with interrupted sutures.
Instruments required
· Laparotomy set,1
· Allen intestinal clamps, 1 pair
When is an intestinal resection indicated?
The operation may be required in the following cases:
· In cases of strangulation and gangrene of bowel
· Volvulus
· Intussusception (irreducible)
· Tuberculosis of intestine with stricture
· Intestinal fistula
· Regional enteritis


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