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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