Double-layered hand-sewn anastomosis: a valuable resource for the colorectal surgeon

Abstract

Hand-sewn anastomosis is an essential and fundamental skill for surgeons dealing with any gastrointestinal anastomosis. Despite the advances in minimally invasive surgery and stapling devices, there are still complex surgical circumstances when the surgeon’s surgical know-how are necessary. Therefore, a safe hand-sewn technique for bowel anastomosis is required to establish a tension-free, well-perfused, and sealed anastomosis that allows gastrointestinal continuity with no unexpected complications. We describe a step-by-step procedure for hand-sewn double-layered anastomosis that reflects these principles and is practical for small and large bowel anastomosis.

Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery

“…This is due to the ongoing debate regarding which method is safer. The essential points for ensuring safe bowel anastomosis, whether hand-sewn or stapled, include meticulous technique, adequate blood supply, and the absence of tension [13]. The choice of anastomosis method and configuration is influenced by various factors, such as the surgical approach, intestinal tension, and the surgeon's level of experience.…”