8. Small Bowel Resection and Entero-Enterostomy
Objective
In case of small bowel obstruction due
to:
• Inflammation
• Tumor.
Bypass
the obstruction or remove the deceased segment and restore continuity of the
bowel.
Position
Supine.
Anesthesia
General.
Procedure
1. Open
the abdomen gain entry to the peritoneal cavity.
2. Identify
area to be resected.
3. Divide
mesentery to this area in the line of a shallow V, serially between ligatures.
4. The
apex of the V is toward the root of the mesentery.
5. Divide
bowel to be removed obliquely, removing more of antimesenteric border between
noncrushing clamps.
6. Approximate
noncrushing clamps to appose the two cut ends of bowel.
7. 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
• General set, 1
• Gastrointestinal set, 1.
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